Presentation
Our review found that the clinical course of patients presenting with ischemia differed from that of patients presenting with pure bleeding. Most of the patients with ischemia underwent progressive deterioration. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
(Image: JFalcetti/iStock/Getty Images) An iliac aneurysm may cause symptoms such as lower abdominal pain, according to the University of Chicago. You may also feel pain in the lower back or in the groin. This pain may be felt as dull and throbbing. [livestrong.com]
Gradual with additional symptoms Dissecting aortic aneurysm - Onset of pain Abrupt without additional symptoms Dissecting aortic aneurysm - Quality of pain Dissecting aortic aneurysm - Severity of pain Dissecting aortic aneurysm - Timing of pain Doesn't [quizlet.com]
A 52-year-old man presented with abdominal pain followed by back pain and radiculopathy from subarachnoid hemorrhage in the spinal canal. The spinal angiogram demonstrated the presence of a dissecting aneurysm of the posterior spinal artery. [ncbi.nlm.nih.gov]
- Severe Pain
Typical symptoms include severe pain prior to or during a complete rupture of the blood vessel. If a leak or a rupture occurs, large volumes of blood can be lost over a short period of time and the condition may be fatal. [netdoctor.co.uk]
The symptoms of aortic dissection include: a sudden, severe pain across the chest, often felt in the back or between the shoulder blades pain in the jaw, face, abdomen, back or lower extremities feeling cold, clammy and sweaty fainting and shortness of [bhf.org.uk]
The patient with a ruptured aortic aneurysm exhibits severe pain and blood loss, leading to shock. A ruptured cerebral aneurysm produces neurologic symptoms and can resemble the clinical picture of stroke syndrome. [medical-dictionary.thefreedictionary.com]
[…] ischaemia and acute kidney injury. [ 1 ] Aortic dissection often presents in two phases: After a first event with severe pain and pulse loss, the bleeding stops. [patient.info]
- Swelling
A fusiform aneurysm is shaped like a sausage and represents a localized swelling or dilatation of the blood vessel. fusiform aneurysm Most aneurysms occur in arteries, chiefly the aorta and muscular arteries. [med.uottawa.ca]
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]
Age/degenerative disease of the aortic wall Uncontrolled high blood pressure Long-term use of tobacco Inflammation or swelling of the aorta Infection History of connective tissue disorders, such as Marfan syndrome, Ehlers-Danlos syndrome, or Loeys-Dietz [bcm.edu]
The chief signs of an arterial aneurysm are the formation of a pulsating tumor, and often a bruit (aneurysmal bruit) heard over the swelling. Sometimes there are symptoms from pressure on contiguous parts. [medical-dictionary.thefreedictionary.com]
[…] 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 [nlm.nih.gov]
- Surgical Procedure
The patient died 23 h after admission, before any surgical procedure was initiated. Figure 1. [anesthesiology.pubs.asahq.org]
The poverty of information about surgical procedures can be justified by the difficult or sometimes impossible access to the BA. Endovascular approach of BA dissection relayed in the past on occlusion of the parent vessel 6-8. [scielo.br]
[…] the parent artery, which should be accompanied by bypass surgery if necessary, may also be the surgical procedure of choice whenever possible for dissecting aneurysm of the carotid circulation. [ahajournals.org]
3, 7, 8, 10 – 13 ; however, these surgical procedures carry a high risk of neurologic complications due to the proximity of the aneurysm to vital structures such as the brain stem and cranial nerves. 14 Recently, endovascular treatment has been proposed [ajnr.org]
procedure he pioneered. [10] Later advances in the field of stent placement and percutaneous aortic fenestrations have further lowered mortality. [emedicine.medscape.com]
- Hypothermia
Deep hypothermia was used in 13 patients for spinal cord protection. RESULTS: No in-hospital mortality was observed. One patient had temporary spinal cord ischemia but was fully recovered by discharge. [ncbi.nlm.nih.gov]
Engl J Med 314: 1070–1074 CAS Google Scholar Graham JM, Stinnett DM (1987) Operative management of acute aortic arch dissection using profound hypothermia and circulatory arrest. [link.springer.com]
A series of patients with type B dissections demonstrated that aggressive use of distal perfusion, CSF drainage, and hypothermia with circulatory arrest improves early mortality and long-term survival rates. [emedicine.medscape.com]
Temperature regulation A fluid warmer, warming blanket, and warming water mattress are helpful to rewarm and prevent hypothermia after weaning from CPB. [ceaccp.oxfordjournals.org]
Respiratoric
- Hemoptysis
[…] patients Syncope Cerebrovascular accident (CVA) symptoms (eg, hemianesthesia, and hemiparesis, hemiplegia) [1] Altered mental status Numbness and tingling, pain, or weakness in the extremities Horner syndrome (ie, ptosis, miosis, anhidrosis) Dyspnea Hemoptysis [emedicine.medscape.com]
Gastrointestinal
- Vomiting
Physical and neurological examinations found headache, vomiting, right perceptive deafness, and right cerebellar ataxia. [ncbi.nlm.nih.gov]
Patients that experience sudden symptoms such as chest pain, characterized as a tearing sensation, or back pain, nausea, vomiting, a fast heart beat and possibly the feeling of impending doom, may be experiencing a tear or dissection of the aorta. [bcm.edu]
- Nausea
A 61-year-old woman suddenly experienced nausea. Computed tomography (CT) on admission showed a high-density mass with a double lumen in the right cerebellopontine angle without subarachnoid hemorrhage. [ncbi.nlm.nih.gov]
Patients that experience sudden symptoms such as chest pain, characterized as a tearing sensation, or back pain, nausea, vomiting, a fast heart beat and possibly the feeling of impending doom, may be experiencing a tear or dissection of the aorta. [bcm.edu]
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 [nlm.nih.gov]
- Dysphagia
Symptoms result from the acute painful tear felt as central chest pain, which radiates to the back, and from the compression of surrounding structures: Figure 1 A typical aneurysm of the thoracic aorta at surgery. dysphagia (esophagus) dyspnea (bronchi [ncbi.nlm.nih.gov]
Syncope Cerebrovascular accident (CVA) symptoms (eg, hemianesthesia, and hemiparesis, hemiplegia) [1] Altered mental status Numbness and tingling, pain, or weakness in the extremities Horner syndrome (ie, ptosis, miosis, anhidrosis) Dyspnea Hemoptysis Dysphagia [emedicine.medscape.com]
One case displayed deficits, dysarthria and dysphagia of the oculomotor nerve and facial nerve after internal trapping of the aneurysm was applied. [medsci.org]
- Epigastric Pain
A 45-year-old man presented to our emergency department with sudden onset of sharp epigastric pain. He gave history of hospital admission elsewhere, 6 months back for similar complaint. [ijri.org]
Cardiovascular
- Chest Pain
He presented with dyspnea, chest pain and amazing symptom of superior vena cava syndrome. The patient underwent open heart surgery with resection of ascending aorta aneurysm with classic Bentall operation. [ncbi.nlm.nih.gov]
Chest Pain Accreditation On June 16, 2005, Good Samaritan was given official Chest Pain Center designation by the Society of Chest Pain Centers and recognized for offering state-of-the-art heart care to its patients. [chihealthgoodsamaritan.org]
At 3 weeks after admission, her blood pressure and pulse rate had normalized and her chest pain had fully subsided. [kjim.org]
Patients that experience sudden symptoms such as chest pain, characterized as a tearing sensation, or back pain, nausea, vomiting, a fast heart beat and possibly the feeling of impending doom, may be experiencing a tear or dissection of the aorta. [bcm.edu]
- Pulse Deficit
[…] diastolic murmur over the aortic area Compression of the true aortic lumen: systolic murmur over any part of the aorta Pulse deficits: a difference of 20mmHg or more in blood pressure between arms, a weaker central or peripheral pulse compared to the [rcemlearning.co.uk]
Sudden chest or back pain accompanied by pulse deficits, aortic regurgitation, or neurological manifestations should alert the clinician to the diagnosis of acute aortic dissection. [circ.ahajournals.org]
Neurological deficit due to carotid artery involvement. Pulse deficit may be present initially, may develop, or may occur transiently. There is a difference in blood pressure in limbs on the right and left side of the body. [patient.info]
Musculoskeletal
- Back Pain
She was admitted to hospital with a new onset of back pain. Computed tomography revealed a new dissection tear originating from the distal side of the subclavian artery orifice. [ncbi.nlm.nih.gov]
Still, you might have: Back pain A deep pain on the side of your abdomen A throbbing sensation near your navel If the aneurysm ruptures, you might feel sick to your stomach, or suddenly develop an intense pain in your back or abdomen. [webmd.com]
Symptoms of a thoracic aneurysm may include: Pain in the jaw, neck, or upper back Pain in the chest or back Wheezing, coughing, or shortness of breath as a result of pressure on the trachea (windpipe) Hoarseness as a result of pressure on the vocal cords [urmc.rochester.edu]
Some people with abdominal aneurysms report abdominal pain, lower back pain, or a pulsating sensation in the abdomen. [medicalnewstoday.com]
Workup
Patients with valvular heart disease undergo workups with echocardiography or coronary angiography. [emedicine.medscape.com]
This time a real workup was done. CT Angiogram shows “filling defect” inside the left middle cerebral artery — filling defect is something inside the artery that shouldn’t be there. [neuroangio.org]
Treatment
DISCUSSION: Selecting a treatment method in SCD patients with a ruptured intracranial aneurysm is challenging and there are no clinical trials comparing treatment methods in this population. [ncbi.nlm.nih.gov]
Prognosis
prognosis. 10 Fig. 7 A Hamasaki/2014[62] 56/M 5 Proximal endovascular occlusion,. [medsci.org]
BACKGROUND: Management of intracranial basilar dissecting aneurysms has been controversial and challenging, and surgical and conservative treatments usually have a bad prognosis. [ncbi.nlm.nih.gov]
CT scanning may be used to confirm the diagnosis but is less helpful in complications and prognosis. [patient.info]
Prognosis evaluated at 3 months after the ictus with the GOS revealed that 21 of 32 patients (66%) in the bleeding group showed poor prognosis, whereas only 2 of 17 patients (12%) of the ischemic group showed poor prognosis. [ahajournals.org]
Etiology
The etiology and location of the lesion and distal flow to the lesion should be taken into consideration when planning the treatment. [ncbi.nlm.nih.gov]
Etiology Although the specific cause of the disease is not known, the lesion that generally is accepted as being precedent to dissecting aneurysm of the aorta is medial degeneration. [mdedge.com]
Etiology Causes of dissection can be separated into spontaneous, traumatic and iatrogenic 3: spontaneous especially in patients with fibromuscular dysplasia or connective tissue disorders, e.g. [radiopaedia.org]
Epidemiology
Abstract: Aortic Aneurysm and Aortic Dissection: Pathphysiology, Epidemiology and Imaging. [zora.uzh.ch]
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. [nlm.nih.gov]
He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]
Pathophysiology
The knowledge of epidemiology, pathophysiology and clinical presentation allows the most appropriate diagnostic evaluation in both acute and chronic situations. [zora.uzh.ch]
Marfan syndrome traumatic motor vehicle accidents, sport-related, strong coughing or nose blowing, chiropractic manipulation, lengthy telephone conversations 4,6 iatrogenic, e.g. cerebral angiography Pathophysiology Arterial dissection results from a [radiopaedia.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. [nlm.nih.gov]
Prevention
Because an angulated SMA trunk and compressed true lumen by the dilated false lumen prevented the insertion of a guidewire into the SMA via the transfemoral artery, transmesenteric approach under laparotomy was selected. [ncbi.nlm.nih.gov]