Presentation
In the emergent setting, patients presenting with acute interscapular pain along with haemodynamic instability require immediate evaluation. [ncbi.nlm.nih.gov]
Presentation A dissecting or ruptured aneurysm usually presents with pain and collapse. Thoracic aortic aneurysm (TAA) It will cause chest pain that may be indistinguishable from acute myocardial infarction in terms of nature and distribution. [patient.co.uk]
The classical triad of pain, hypotension, and a pulsatile mass is present in only 2550% of patients. Different sites of aneurysm rupture determine the various clinical presentations seen in patients. [zarinslab.stanford.edu]
Entire Body System
- Collapse
Considering patient's clinical conditions, the graft collapse wasn't treated at that time. [ncbi.nlm.nih.gov]
Someone told me to go outside and get some fresh air, but as I stood up I blacked out and collapsed to the floor.” Max came round slowly and was taken to hospital. [bhf.org.uk]
Presentation A dissecting or ruptured aneurysm usually presents with pain and collapse. Thoracic aortic aneurysm (TAA) It will cause chest pain that may be indistinguishable from acute myocardial infarction in terms of nature and distribution. [patient.co.uk]
- Weakness
In this condition, the main artery leaving the heart develops a weak spot in its wall and balloons out. Sometimes it tears or ruptures. [peoplespharmacy.com]
The pulse will be rapid, weak and thready. Hypotension is common. With a ruptured AAA there may well be a pulsatile mass in the vicinity of the bifurcation of the aorta. This is a few centimetres above the umbilicus and a little to the left. [patient.co.uk]
An aortic aneurysm develops from a weakness in the wall of the aorta. This weakness can be present at birth or can develop as the result of disease or injury. [emedicinehealth.com]
Those with Marfan syndrome may have a weakness in the aortic wall that makes them more susceptible to aneurysm. [mayoclinic.org]
- Asymptomatic
Aneurysms are asymptomatic so 95 per cent of the time people don’t even know if they’ve had one. Ritter’s family, for example, learned that he had a type of thoracic aneurysm that ran in his family. [globalnews.ca]
Annular rupture can range from asymptomatic to an immediate catastrophic event (2–7,13,15). [interventions.onlinejacc.org]
Asymptomatic chronic traumatic aneurysms are not always a risk for sudden death unless too large. [en.wikipedia.org]
However, even asymptomatic patients with inflammatory abdominal aortic aneurysm or abdominal aortic aneurysm that have had symptoms of emboli, pain, or bowel obstruction require emergent repair regardless of aneurysm size. [emedicinehealth.com]
An asymptomatic 78-year-old man with a history of percutaneous coronary intervention to the middle left circumflex coronary artery, hypertension, and hyperlipidemia. ( A, B ) Location of plaques on non-obstructive angioscopy projected onto aortography [jstage.jst.go.jp]
- Swelling
This can help spot a swelling in the aorta early on, when it can be treated. The test involves a quick and painless ultrasound scan to see how big your aorta is. [nhs.uk]
The situation is quite different in patients who are stocky or obese, when it may be difficult or impossible to feel pulsation or a definite swelling. [familydoctor.co.uk]
Symptoms of aortic aneurysm may be related to the location, size and growth rate of the aneurysm and can include: Pain in the chest, neck, and/or back Swelling of the head, neck, and arms Coughing, wheezing, or shortness of breath Coughing up blood Symptoms [marfan.org]
[…] conditions linked to aortic dissection include: Bicuspid aortic valve Coarctation (narrowing) of the aorta Connective tissue disorders (such as Marfan syndrome and Ehlers-Danlos syndrome) and rare genetic disorders Heart surgery or procedures Pregnancy Swelling [medlineplus.gov]
CT showed multiple defects and swelling in the brain stem and the left cerebellum. These defects were assumed to be partially due to some grade of ischemia or to the trauma. [ejcts.oxfordjournals.org]
- Pallor
Symptoms are caused by a decrease of blood flowing to the rest of the body, and can include: Anxiety and a feeling of doom Fainting or dizziness Heavy sweating (clammy skin) Nausea and vomiting Pale skin ( pallor ) Rapid, weak pulse Shortness of breath [medlineplus.gov]
In less serious cases, it might cause numbness, weakness, tingling, pallor, or coldness in an arm or leg, loss of sensation, light-headedness, or localized pain. Any of these symptoms can also occur with dissection of the aorta. [emedicinehealth.com]
Respiratoric
- Respiratory Distress
Other lesions seen with MRI were focal lung contusions in 5 patients (Fig 4 ), diffuse bilateral lung opacity in a respiratory distress syndrome in 1 patient, rib fractures associated with pleural effusions in 5 patients, and liver focal contusions in [circ.ahajournals.org]
This study also demonstrated a clear trend toward an increased rate of complications, such as sepsis, myocardial infarction, acute respiratory distress syndrome, and prolonged ventilation with conventional surgical repair (66%) compared with endovascular [ejcts.oxfordjournals.org]
Gastrointestinal
- Abdominal Pain
The patient was readmitted two years later with severe abdominal pain, a large retroperitoneal hematoma and contrast extravasation below the location where the aortic plaque had presented. [ncbi.nlm.nih.gov]
When present, symptoms of an aortic rupture may include: Severe chest pain Severe back pain Severe abdominal pain Signs of external chest injury Causes and Risk Factors The condition is caused by trauma to the aorta. [cedars-sinai.edu]
Abdominal aortic aneurysm (AAA) Ruptured AAA presents with a classical triad of pain in the flank or back, hypotension and a pulsatile abdominal mass; however, only about half have the full triad. [patient.co.uk]
- Vomiting
Finally, any procedure that can make a patient gag and vomit, such as the use of a nasogastric tube to remove blood from the stomach, should be avoided as the straining from gagging and vomiting could further injure the torn aorta. [thedoctorwillseeyounow.com]
Other common symptoms include syncope and vomiting. Examination A patient with a ruptured aneurysm at any level is likely to look pale and unwell and to be cold and sweaty. The pulse will be rapid, weak and thready. Hypotension is common. [patient.co.uk]
Damage Pain Burning Tingling Numbness Weakness Changes in sensation to light touch, pain or temperature, or the sense of body position Other Fluoroquinolone Complications: Digestive distress, nausea, diarrhea, constipation, stomach pain, heartburn, vomiting [peoplespharmacy.com]
You might vomit, become sweaty, or feel dizzy. [webmd.com]
- Nausea
Symptoms of FQ Nerve Damage Pain Burning Tingling Numbness Weakness Changes in sensation to light touch, pain or temperature, or the sense of body position Other Fluoroquinolone Complications: Digestive distress, nausea, diarrhea, constipation, stomach [peoplespharmacy.com]
Symptoms are caused by a decrease of blood flowing to the rest of the body, and can include: Anxiety and a feeling of doom Fainting or dizziness Heavy sweating (clammy skin) Nausea and vomiting Pale skin ( pallor ) Rapid, weak pulse Shortness of breath [medlineplus.gov]
Other symptoms may include nausea, shortness of breath or heavy sweating. Victims may suffer a precipitous drop in blood pressure from inadequate circulation, causing light-headedness or fainting. [bottomlineinc.com]
Some people describe the following symptoms of an aortic aneurysm: A pulsating bulge or a strong pulse in the abdomen Feeling of fullness after minimal food intake Nausea Vomiting Where the aorta widens into a bulge, blood clots (thrombi) are more likely [emedicinehealth.com]
Cardiovascular
- Hypotension
Abdominal aortic aneurysm (AAA) Ruptured AAA presents with a classical triad of pain in the flank or back, hypotension and a pulsatile abdominal mass; however, only about half have the full triad. [patient.co.uk]
First stage-TEVAR Clinical presentation Hypotension: hemorrhagic shock (mean arterial pressure Sizing and preparation The patient is placed in a supine position. [annalscts.com]
He remained severely hypotensive despite vasopressors and died after 5 hours CPR. [ncbi.nlm.nih.gov]
Injury Prediction Rule Age > 50 Unrestrained Hypotension Thoracic injury Abdominopelvic injury Extremity fracture Head injury The Probability of Aortic Rupture: Prevalence of Aortic transection in blunt chest trauma 4 studies (n=8772 pts), prevalence [chestx-ray.com]
- Hypertension
The phenomenon has been uniformly found in individuals with hypertension. The author reports a sudden unexpected death caused by spontaneous rupture of the ascending aorta in a 57-year-old man with a history of hypertension. [ncbi.nlm.nih.gov]
Reduced resistance aortic wall Increasing age pregnancy (debatable) EXAMINATION Features include: aortic regurgitation is common hypertension (if hypotensive ensure it is not due to limb discrepancy caused by an occluded vessel – check BP in the arm [lifeinthefastlane.com]
Abstract Spontaneous rupture of the aorta is usually associated with aneurysm formation (luetic or arteriosclerotic in origin), or with dissection of the wall secondary to medial necrosis, with or without hypertension. [annals.org]
Causes of aortic dissection Hypertension is present in roughly two-thirds of aortic dissections. [americannursetoday.com]
Your doctor can prescribe proper medication therapy for hypertension or high cholesterol, if need be. Additionally, not smoking tobacco products also benefits your health. [healthline.com]
- Chest Pain
Presentation A dissecting or ruptured aneurysm usually presents with pain and collapse. Thoracic aortic aneurysm (TAA) It will cause chest pain that may be indistinguishable from acute myocardial infarction in terms of nature and distribution. [patient.co.uk]
Postoperatively, the patient complained of dyspnea and chest pain. In 25 minutes after arrival in the postanesthesia care unit (PACU), the patient was in asystole. [ncbi.nlm.nih.gov]
In most cases, the symptoms begin suddenly, and include severe chest pain. The pain may feel like a heart attack. Pain can be described as sharp, stabbing, tearing, or ripping. [medlineplus.gov]
When present, symptoms of an aortic rupture may include: Severe chest pain Severe back pain Severe abdominal pain Signs of external chest injury Causes and Risk Factors The condition is caused by trauma to the aorta. [cedars-sinai.edu]
Musculoskeletal
- Muscle Strain
Some people have milder pain, which is sometimes mistaken for muscle strain, but this is less common. [healthline.com]
Urogenital
- Flank Pain
Louis, Missouri Primary signs of Aortic Aneurysm rupture Aortic aneurysm rupture is the most important diagnosis you want to be able to exclude in patients with acute abdominal pain especially when they present with back or flank pain. [radiologyassistant.nl]
as in an AMI) Other features end-organ symptoms: neurological, syncope, seizure, limb paraesthesias, pain or weakness, flank pain, SOB + haemoptysis aortic regurgitation hypertension most have ischaemic heart disease Atypical presentations are common [lifeinthefastlane.com]
Workup
The diagnostic workup starts with a chest radiograph. 20 34 Mirvis et al, 20 studying 205 patients with TAR, found that chest radiographs had a low specificity but high positive predictive value of 96% in patients in the supine position and 98% in patients [circ.ahajournals.org]
Treatment
Resolution of the acute event was obtained without further surgical treatment. 18 months after endovascular treatment, the patient remains in good health. [ncbi.nlm.nih.gov]
Discussion The treatment of aortic rupture traditionally has been conventional surgery, but since the a dvent of endovascular treatment by placement of a stent graft, this therapeutic modality has gradually become the treatment of choice for ruptured [vasculardiseasemanagement.com]
Prognosis
[…] aneurysm > 7 cm reduced thrombus size thrombus fissuration discontinuity in calcification hyperattenuating crescent sign well defined peripheral crescent of increased attenuation within the thrombus of a large abdominal aortic aneurysm Treatment and prognosis [radiopaedia.org]
Prognosis No more than one in three patients with a ruptured aortic aneurysm will reach hospital alive; 20% of those who do, fail to reach theatre. Delay in diagnosis is likely to result in death. [patient.co.uk]
The initial management of these injuries varies based on the location and severity of the aortic injury and the patient's overall physiologic condition and prognosis. [scielo.br]
Etiology
Chronic hypertension and a penetrating atherosclerotic ulcer of the ascending aorta were the apparent underlying etiologies of the aortic rupture in the present case. [ncbi.nlm.nih.gov]
Etiology Thoracic aortic injury can result from either blunt or penetrating trauma: blunt trauma (more common) rapid deceleration (eg. motor vehicle accident, fall from great height) crush injury penetrating trauma stab wound gunshot wound Location aortic [radiopaedia.org]
This summary describes theoretical and practical considerations of the etiology, pathophysiology, classification, natural history, diagnostic strategies, and treatment approaches of annular rupture. [interventions.onlinejacc.org]
Complete full-thickness transection of the thoracic aorta is rapidly fatal in the field and is rarely the presenting etiology for exsanguinating hemorrhage during hospital trauma resuscitations. [scielo.br]
Epidemiology
@gmail.com. 2 Department of Vascular Surgery, University of Athens Medical School, "Attikon" University Hospital, Athens, Greece. 3 Department of Hygiene, Epidemiology and Medical Statistics, Athens University, Medical School, Athens, Greece. [ncbi.nlm.nih.gov]
It is updated with the most recent basic clinical research, epidemiological findings, medical, surgical and endovascular therapies of the aorta. [books.google.com]
Epidemiology Ruptured abdominal aortic aneurysms (AAAs) cause 12,000 deaths per year; 8,000 of these are infra-renal. [ 2 ] Women are much less frequently affected. [patient.co.uk]
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]
Pathophysiology
This summary describes theoretical and practical considerations of the etiology, pathophysiology, classification, natural history, diagnostic strategies, and treatment approaches of annular rupture. [interventions.onlinejacc.org]
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]
[…] subclavian artery Svensson (defines type of acute aortic syndrome) classic dissection with true and false lumen intramural haematoma or haemorrhage subtle dissection without haematoma atherosclerotic penetrating ulcer iatrogenic or traumatic dissection PATHOPHYSIOLOGY [lifeinthefastlane.com]
Pathophysiology of abdominal aortic aneurysms: insights from the elastase-induced model in mice with different genetic backgrounds. Ann N Y Acad Sci 2006; 1085 :5973. [CrossRef] [Medline] Lederle FA, Johnson GR, Wilson SE, et al .. [zarinslab.stanford.edu]
Prevention
[…] facilitating the development of new prevention strategies and devices. [ncbi.nlm.nih.gov]
An aortic occlusion balloon can be placed to stabilize the patient and prevent further blood loss prior to the induction of anesthesia. [en.wikipedia.org]