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
- 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]
Pain concentrated in the back can be confused with acute lumbar back pain from arthritis of the spine or a disc problem – especially if leakage of blood around the nerves in the lumbar area lead to ‘sciatica’ – pain radiating down the leg. [familydoctor.co.uk]
It is important to recognize the atypical symptoms of aortic dissection and maintain a broad differential diagnosis if patients complained of abdominal pain. [ncbi.nlm.nih.gov]
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]
- 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]
- Severe Pain
This usually begins with very sudden and extremely severe pain in the area where the aneurysm is located. [sharecare.com]
Some people with an AAA have: a pulsing sensation in the tummy (like a heartbeat) tummy pain that doesn't go away lower back pain that doesn't go away If an AAA bursts, it can cause: sudden, severe pain in the tummy or lower back dizziness sweaty, pale [nhs.uk]
Chest pain and pain in the upper back are the most common symptoms of this condition. There’s typically severe pain, coupled with a feeling that something is sharp or tearing in your chest. [healthline.com]
For example the bed-bound patient in a nursing home with severe mental and/or physical problems may be most considerately managed with really good pain relief and without transfer to hospital. [familydoctor.co.uk]
[…] retrosternal chest pain – anterior dissection interscapular pain – descending aorta severe pain (‘worst ever-pain’) (90%) sudden onset (90%) sharp (64%) or tearing (50%) migrating pain (16%) down the back (46%) maximal at onset ( not crescendo build up [lifeinthefastlane.com]
- Ecchymosis
Unusual presentations of ruptured abdominal aortic aneurysm are transient lower limb paralysis right upper quadrant pain groin pain testicular pain testicular ecchymosis (blue scrotum sign of Bryant) iliofemoral venous thrombosis The aneurysmal rupture [radiopaedia.org]
Ruptured abdominal aortic aneurysm presenting as painless testicular ecchymosis: the scrotal sign of Bryant revisited. J Emerg Med 2008 July 8. [Epub ahead of print] Eimany A, Roberts AK. [zarinslab.stanford.edu]
Clinical exam is notoriously non-specific and described findings such as an intracapsular murmur or pseudocoarctation are unlikely to be appreciated during a trauma resuscitation. 13 Sternal and rib fractures, chest wall ecchymosis, flail segments, hemo [scielo.br]
- Surgical Procedure
In our experience, there was no paraplegia in the surgical or endovascular group related to the aortic procedure. Thirty-day mortality in the endovascular group was 7.7% compared to 21.2% in the conventional surgical group. [ejcts.oxfordjournals.org]
Respiratoric
- Hoarseness
Other symptoms can include: Difficulty breathing Hoarseness Pain at the site of injury Shock back to top Expert Diagnosis of Traumatic Aortic Injury at UCLA Diagnostic imaging is used to determine the extent of traumatic aortic injuries. [heart.ucla.edu]
But as it grows, you may notice some signs, including: Chest or back pain Difficulty breathing or swallowing Shortness of breath Coughing Hoarseness Your doctor often can diagnose a thoracic aortic aneurysm with tests such as an X-ray, an echocardiogram [webmd.com]
Even fewer complain of difficulty swallowing, difficulty speaking, hoarseness, or shortness of breath — all possible signs of a torn aorta. Frighteningly, most have no symptoms at all. [thedoctorwillseeyounow.com]
As a thoracic aortic aneurysm grows, some people may notice: Tenderness or pain in the chest Back pain Hoarseness Cough Shortness of breath Aortic aneurysms can develop anywhere along the aorta, which runs from your heart through your chest and abdomen [mayoclinic.org]
Symptoms [ edit ] Symptoms are often unreliable, but include: Severe tearing chest pain (sometimes) cough dyspnea dysphagia back pain hoarseness High upper body blood pressure Low lower body blood pressure Blood pressure is usually high in the upper body [en.wikipedia.org]
- Cough
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]
But as it grows, you may notice some signs, including: Chest or back pain Difficulty breathing or swallowing Shortness of breath Coughing Hoarseness Your doctor often can diagnose a thoracic aortic aneurysm with tests such as an X-ray, an echocardiogram [webmd.com]
Encourage the patient to use an incentive spirometer and to splint when coughing. Finally, discuss the plan of care with the patient and family. [americannursetoday.com]
As a thoracic aortic aneurysm grows, some people may notice: Tenderness or pain in the chest Back pain Hoarseness Cough Shortness of breath Aortic aneurysms can develop anywhere along the aorta, which runs from your heart through your chest and abdomen [mayoclinic.org]
Symptoms [ edit ] Symptoms are often unreliable, but include: Severe tearing chest pain (sometimes) cough dyspnea dysphagia back pain hoarseness High upper body blood pressure Low lower body blood pressure Blood pressure is usually high in the upper body [en.wikipedia.org]
- 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]
You might vomit, become sweaty, or feel dizzy. [webmd.com]
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]
- Gagging
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]
[…] completely from the heart, which would almost inevitably kill the patient, hospital staff take measures to keep the blood pressure low. [1] Such measures include giving pain medication, keeping the patient calm, and avoiding procedures that could cause gagging [en.wikipedia.org]
- Diarrhea
Indigestion or diarrhea are perceived to be the most common complications of such medications. [peoplespharmacy.com]
Cardiovascular
- 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]
- Heart Disease
Coarctation of the aorta is one of the more common congenital cardiac defects accounting for between 5 and 10% of cases of congenital heart disease. It has traditionally been divided into infantile (pre-ductal) and adult (ductal) types. [ncbi.nlm.nih.gov]
Read more about risk factors for heart disease and how to control them. Psychological challenges After a year, Max had recovered physically but started experiencing anxiety. “I’d never dealt with anything like this before,” he says. [bhf.org.uk]
Diseases of the aorta. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 57. Conrad MF, Cambria RP. [medlineplus.gov]
[…] the following Web sites: Medline Plus External National Heart, Lung, and Blood Institute External American Heart Association External References Centers for Disease Control and Prevention. [cdc.gov]
Screening is also important for women if they have smoked or have a history of heart disease, or a family history of aneurysm or aortic dissection. Patients with no sign of disease usually don’t require additional tests/screening. [bottomlineinc.com]
- Systolic Murmur
There can be bruising of the anterior chest wall, and a systolic murmur can be heard on the bottom of the heart. [5] Causes [ edit ] The injury is usually caused by high speed impacts such as those that occur in vehicle collisions and serious falls. [ [en.wikipedia.org]
Signs include anterior chest wall contusion, unexplained hypotension, upper limb hypertension, or acute coarctation syndrome (decreased lower limb pulses with normal upper limb pulses), differences in pulse amplitude, and a systolic murmur audible over [emj.bmj.com]
- Weak Pulse
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]
Skin
- Ulcer
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]
Musculoskeletal
- Fracture
Sternal fracture and rib fractures were detected by PMCT and aortic rupture by PMCTA. The cause of death was hemorrhagic shock due to traumatic aortic rupture. [ncbi.nlm.nih.gov]
[…] of first or second rib Scapula Fracture [fpnotebook.com]
- Contusion
We report a patient who was transferred from a municipal hospital with the emergency complex of blunt head trauma and chest and abdominal contusion. Chest computed tomography scan revealed aortic rupture. [ncbi.nlm.nih.gov]
Right rib fractures, right pleural effusion, and right lung focal contusions are visible. Table 1. [circ.ahajournals.org]
ABC's Blunt Chest Trauma A: Aortic Transection B: Bronchial Fracture C: Cord Contusion D: Diaphragmatic Rupture E: Esophageal Fracture F: Flail Chest G: Gas (subtle pneumothorax, pneumomediastinum) H: Heart (cardiac injury) I: Iatrogenic injury (misplaced [chestx-ray.com]
In 9 patients treatment was delayed for more than 7 days after trauma due to severe pulmonary contusion in four, severe head injury in three, and infection in two. [ejcts.oxfordjournals.org]
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]