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Aortic Dissection and Aneurysm (Aortic dissection (Intimal tear with…
Aortic Dissection and Aneurysm
Aortic dissection
Intimal tear with blood ripping through media
High Stress plus weak wall
Proximal 10 cm of aorta (high stress)
preexisting weakening of wall
Hypertension
hypertension causes hyaline arteriolosclerosis of vasovasorum in adventitia, smooth muscle atrophy in media because there is no oxygen
weakening of wall
Marfans syndrome and Ehlers Danlos can cause weakness of connective tissue in media
Sharp tearing chest pain that radiates to the back
Complications
Compression of renal artery with end organ ischemia
pericardial tamponade
fatal hemorrhage if leaks into mediastinum
Thoracic aneurysm
tertiary syphillis
endarteritis of vasovasorum
treebark appearance of vessel wall
Complications
dilatation of aortic valve root, resulting in aortic valve insufficiency
thrombosis and embolism (loss of laminar flow)
AAA
usually arises below the renal arteries, but above the aortic bifurcation
cause: atherosclerosis
seen in those w increased risk of atherosclerosis: male, smokers, over 60, HTN
Pulsatile abdominal mass that grows with time
Complication
Rupture when > 5cm in diameter
hypotension, pulsatile abdominal mass, flank pain
