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Aortic Aneurysm and Dissection


Presentation

  • In conclusion, the present study did not find an increased prevalence of GCA/PMR among a cohort of Israeli patients with AA/D.[ncbi.nlm.nih.gov]
Renal Artery Stenosis
  • In the abdomen, an important consideration is not only detecting major branch vessels but also defining other vascular abnormalities that may affect aortic surgery, such as accessory renal arteries or renal artery stenosis.[journals.lww.com]
Multiple Congenital Anomalies
  • congenital anomalies, so described Congenital: anomaly, multiple NOS deformity, multiple NOS 512.8 Other spontaneous pneumothorax Pneumothorax 754.81 Pectus excavatum Congenital funnel chest 737.43 Scoliosis 701.3 Striae atrophicae, Atrophic spots of[genedx.com]
Non-Cardiac Chest Pain
  • Spiral CT in acute non-cardiac chest pain. Clin Radiol 1999; 5438–45. 12. Yamaguchi T, Kuroki K, Ohyama Y, Ishikawa T. Pitfalls of CT diagnosis of aortic dissection: nonvisualized intimal flap in the ascending aorta or aortic arch.[journals.lww.com]
Left Ventricular Dysfunction
  • One advantage of MRA over CTA is the ability to evaluate complications such as hemopericardium, left ventricular dysfunction, and valve regurgitation.[journals.lww.com]
Dry Skin
  • skin/mouth, thirst Excessive yawning High blood pressure Intense anxiety, anguish Pallor (paleness) Rapid pulse or weak/absent pulse Shortness of breath Diagnostic Tools Angiography Cardiovascular MRI CT Scan X-ray Echocardiogram Treatment Options We[medstarunionmemorial.org]
  • […] such as Marfan syndrome Chest trauma Aortic aneurysm Symptoms Back or chest pain Changes in thinking ability, confusion, disorientation Clammy skin, sweating Cough Decreased movement or sensation, any location Dizziness, fainting, nausea, and vomiting Dry[medstargeorgetown.org]
Short Arm
  • When blood is pumped out by the heart, it first travels through the ascending thoracic aorta (up the short arm of the candy cane), then down the descending thoracic aorta (first part of the long arm) into the abdominal aorta (the bottom of the candy cane[tadcoalition.org]
Mydriasis
  • This case emphasizes the importance of identifying physical stigmata of smooth muscle dysfunction, such as mydriasis, as potential markers for associated aortopathy and vascular diseases. aortic aneurysm ACTA2 mydriasis aortopathy genetics natural history[pediatrics.aappublications.org]
Slurred Speech
  • Aortic aneurysm rupture can lead to stroke, which causes sudden weakness or numbness in a limb, slurred speech, or lack of vision and balance. If you think you or someone you know is experiencing any of these conditions, call 9-1-1 immediately.[heart.stonybrookmedicine.edu]

Workup

  • A good patient history and physical examination are essential, along with imaging studies, electrocardiography, and laboratory studies (see Workup ). Acute aortic dissection can be treated surgically or medically.[emedicine.medscape.com]

Treatment

  • PARTICIPANTS: 360 088 treatment episodes of fluoroquinolone use (78%ciprofloxacin) and propensity score matched comparator episodes of amoxicillin use (n 360 088).[ncbi.nlm.nih.gov]
  • Treatment for an Aortic Aneurysm Surgical or interventional treatment of an aortic aneurysm or dissection will depend on the location and size of the aneurysm.[helios-gesundheit.de]
  • “Reducing unnecessary fluoroquinolone treatments or prolonged treatment courses, might have possibly prevented more than 200 aortic aneurysms in this population”.[loncarassociates.com]

Prognosis

  • CT scanning may be used to confirm the diagnosis but is less helpful in complications and prognosis.[patient.info]
  • If the operation was successful, it neutralized the effect of diagnosis on prognosis ( Figure 2 ). In the seminal Olmsted County study by Bickerstaff et al, 1 a TAD incidence of 5.3 of 100 000/year is reported.[circ.ahajournals.org]
  • Obstruction of branch vessels · DX o MRI if available is usually best for imaging ascending aorta o Contrast-enhanced CT can image arch and descending aorta o Transesophageal ultrasound, if available, especially for root and ascending aorta o Angiography · Prognosis[learningradiology.com]
  • Improved prognosis of thoracic aortic aneurysms: a population-based study. JAMA. 1998;280:1926–9. Guirguis-Blake J, Wolff TA. Screening for abdominal aortic aneurism. Am Fam Physician. 2005;71:2154–5. Creager MA, Loscalzo J. Diseases of the aorta.[cdc.gov]
  • Prognosis is usually good if the AAA is found before it ruptures. Focusing on heart health can prevent an AAA. This means watching what you eat, exercising, and avoiding other cardiovascular risk factors such as smoking.[healthline.com]

Etiology

  • BACKGROUND: Hereditary factors play an important etiologic role in thoracic aortic aneurysm and dissection (TAAD), with a number of genes proven to predispose to this condition.[ncbi.nlm.nih.gov]
  • Atherosclerosis is important for the etiology of descending aortic aneurysm and its histological features are similar to that of abdominal aortic aneurysm. Cystic medial necrosis is also important for the etiology of aortic dissection.[ci.nii.ac.jp]
  • Both twins had deep vein thrombosis of unclear etiology, possibly attributed entirely to immobility after surgery.[pediatrics.aappublications.org]
  • The etiology may differ depending on the location of the aneurysm.[omicsonline.org]
  • Consider thoracic aortic dissection in your differential diagnosis for any patient who complains of chest pain and aortic aneurysm in patients who have any sort of abdominal discomfort or syncope with an unknown etiology.[emsworld.com]

Epidemiology

  • The results presented confer light to the importance of mortality statistics and the need for epidemiologic studies to understand unique trends in our own population.[ncbi.nlm.nih.gov]
  • In Brazil, epidemiologic studies on aneurysms are scarce and the available literature is outdated.[bmcpublichealth.biomedcentral.com]
  • Aortic dissection: epidemiology, pathophysiology, clinical presentation, and medical and surgical management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 81.[medlineplus.gov]
  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.com]
Sex distribution
Age distribution

Pathophysiology

  • Genetic studies of human patients and murine models have yielded invaluable insights into the pathophysiology of aneurysm formation and progression in MFS.[ncbi.nlm.nih.gov]
  • Department of Pathophysiological and Experimental Pathology, Graduate School of Medical Sciences Kyushu University Higashi-ku, Fukuoka Japan[link.springer.com]
  • Aortic dissection: epidemiology, pathophysiology, clinical presentation, and medical and surgical management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 81.[medlineplus.gov]
  • Svensson (defines type of acute aortic syndrome) 1 – classic dissection with true and false lumen 2 – intramural haematoma or haemorrhage 3 – subtle dissection without haematoma 4 – atherosclerotic penetrating ulcer 5 – iatrogenic or traumatic dissection PATHOPHYSIOLOGY[lifeinthefastlane.com]
  • Pathophysiology The aortic wall is exposed to high pulsatile pressure and shear stress (the steep slope of the pressure curve; ie, the water hammer effect), making the aorta particularly prone to injury and disease from mechanical trauma.[emedicine.medscape.com]

Prevention

  • These poor outcomes are preventable by surgical repair; however, identifying at-risk individuals is difficult.[ncbi.nlm.nih.gov]

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