Presentation
Patients have increased risk of presenting life threatening aortic rupture. The documents contained in this web site are presented for information purposes only. [orpha.net]
CD-68, a macrophage marker that is normally absent in aorta tissue, is weakly present in the adventitia of thoracic aorta (arrow, K) and strongly present in the media and adventitia of abdominal aorta (arrows, L). [pediatrics.aappublications.org]
Acute aortic dissection [ 11 ] This may present with: Severe, sharp pain in the chest, neck or back. The pain may migrate as the dissection progresses. [patient.info]
In both syndromic and non-syndromic TAAD, the age of onset and presentation of aortic disease is variable. [uwcpdx.org]
Entire Body System
- Weakness
[…] stroke 0002140 Patent ductus arteriosus 0001643 Peripheral arterial stenosis 0004950 Pes planus Flat feet Flat foot [ more ] 0001763 Pneumothorax Collapsed lung 0002107 Prenatal maternal abnormality 0002686 Retrognathia Receding chin Receding lower jaw Weak [rarediseases.info.nih.gov]
Abdominal aortic aneurysm are caused by a weakness in the blood vessel wall that develops over time. The specific cause of this weakness is still unknown but we know some of the factors that contribute to AAA formation. [canadianvascular.ca]
Several hundred thousand Americans have these weak patches, called aneurysms (ANN-you-rizms). National statistics say that aortic aneurysms account for approximately 45,000 deaths a year. [health.harvard.edu]
[…] aortic aneurysm (TAA) may be diagnosed using the following exams: Chest x-ray Chest CT scan Intravascular ultrasound Diagnostic angiogram Transesophageal echocardiogram Surgery & Treatments of Aortic Aneurysm Some aneurysms need surgery to strengthen weak [heart.memorialhermann.org]
- Swelling
However, depending on the size, growth rate, and location of these abnormalities, they can cause: pain in the jaw, neck, chest, or back swelling in the arms, neck, or head difficult or painful swallowing hoarseness shortness of breath wheezing chronic [heart.ucla.edu]
One that is close to the skin’s surface may hurt and swell, with a visible throbbing mass. When an aneurysm ruptures, you experience pain, dizziness, nausea, vomiting, clammy skin, rapid heart rate, shock or plunging blood pressure. [heart.memorialhermann.org]
However, depending on the size, growth rate, and location of these abnormalities, they can cause pain in the jaw, neck, chest, or back; swelling in the arms, neck, or head; difficult or painful swallowing; hoarseness; shortness of breath; wheezing; a [ghr.nlm.nih.gov]
- Severe Pain
Symptoms of aortic dissection Most common symptom: Severe pain in the chest (front, back or both). Less common symptoms: Pain in abdomen, numbness or weakness in one or both legs, loss of consciousness, symptoms of a stroke. [my.clevelandclinic.org]
The classic symptom is sudden onset of severe pain in the chest, back, or abdomen that has a ripping, stabbing, or tearing feel. [health.harvard.edu]
Back pain between the scapula is usually a sign of descending aorta aneurysm. Thoracic aorta aneurysm rupture is a medical emergency. Aneurysm rupture presents with severe pain, hypotension, and shock. B. [clinicaladvisor.com]
- Congestive Heart Failure
End-organ cardiovascular complications from acute dissection of the ascending aorta include aortic regurgitation, syncope, pericardial tamponade, myocardial ischemia or infarction, and congestive heart failure [ 3 ]. [omicsonline.org]
heart failure Acute Neurologic Complaints. [thesullivangroup.com]
- Pallor
[…] they can cause: pain in the jaw, neck, chest, or back swelling in the arms, neck, or head difficult or painful swallowing hoarseness shortness of breath wheezing chronic cough coughing up blood severe, sudden chest or back pain unusually pale skin (pallor [heart.ucla.edu]
Aortic dissections usually cause severe, sudden chest or back pain, and may also result in unusually pale skin (pallor), a very faint pulse, numbness or tingling (paresthesias) in one or more limbs, or paralysis. [ghr.nlm.nih.gov]
Respiratoric
- Chronic Cough
cough coughing up blood severe, sudden chest or back pain unusually pale skin (pallor) faint pulse numbness or tingling (paresthesias) in one or more limbs paralysis Some individuals in affected families show mild features of related conditions called [heart.ucla.edu]
cough; or coughing up blood. [ghr.nlm.nih.gov]
- Painful Cough
While only half of those with thoracic aortic aneurysms complain of symptoms, possible warning signs include: Pain in the jaw, neck, and upper back Chest or back pain Coughing, hoarseness, or difficulty breathing [my.clevelandclinic.org]
- Pleural Effusion
Neurologic complications include ischemic stroke or transient ischemic attack, peripheral neuropathy, paraplegia/ paraparesis, and pleural effusion [ 3 ]. [omicsonline.org]
- Pneumonia
The procedure can cause a number of problems: Bleeding Respiratory issues, including pneumonia. Kidney problems, including losing kidney function - this is usually for a short time, but can be long-term. [myresults.org]
Cardiovascular
- Heart Failure
Systolic and Diastolic Heart Failure. Echocardiography is recommended for patients which history of dyspnea or heart failure. Fluid balance should be maintained postoperatively. Avoid beta blockers in fulminant heart failure. D. [clinicaladvisor.com]
failure, and cardiovascular death. [thesullivangroup.com]
End-organ cardiovascular complications from acute dissection of the ascending aorta include aortic regurgitation, syncope, pericardial tamponade, myocardial ischemia or infarction, and congestive heart failure [ 3 ]. [omicsonline.org]
Skin
- Skin Discoloration
Affected individuals may also have a soft out-pouching in the lower abdomen (inguinal hernia ), an abnormal curvature of the spine ( scoliosis ), or a purplish skin discoloration (livedo reticularis) caused by abnormalities in the tiny blood vessels of [heart.ucla.edu]
In addition to cardiac defects, TAAD can manifest with other features including: congenital heart abnormalities, inguinal hernia, scoliosis, a purplish skin discoloration (livedo reticularis) caused by abnormalities in the tiny blood vessels of the skin [genedx.com]
[…] the skin (dermal capillaries ). [ghr.nlm.nih.gov]
- Blister
Saccular aneurysm: Small, lop-sided blister on one side of the aorta that forms in a weakened area of the aorta wall. [my.clevelandclinic.org]
Neurologic
- Tingling
[…] and progression rate of dilatation/dissection, patients may be asymptomatic or may present dyspnea, cough, jaw, neck, chest or back pain, head, neck or upper limb edema, difficulty swallowing, voice hoarseness, pale skin, faint pulse and/or numbness/tingling [orpha.net]
neck, chest, or back swelling in the arms, neck, or head difficult or painful swallowing hoarseness shortness of breath wheezing chronic cough coughing up blood severe, sudden chest or back pain unusually pale skin (pallor) faint pulse numbness or tingling [heart.ucla.edu]
Aortic dissections usually cause severe, sudden chest or back pain, and may also result in unusually pale skin (pallor), a very faint pulse, numbness or tingling (paresthesias) in one or more limbs, or paralysis. [ghr.nlm.nih.gov]
- Paresthesia
[…] chest, or back swelling in the arms, neck, or head difficult or painful swallowing hoarseness shortness of breath wheezing chronic cough coughing up blood severe, sudden chest or back pain unusually pale skin (pallor) faint pulse numbness or tingling (paresthesias [heart.ucla.edu]
Aortic dissections usually cause severe, sudden chest or back pain, and may also result in unusually pale skin (pallor), a very faint pulse, numbness or tingling (paresthesias) in one or more limbs, or paralysis. [ghr.nlm.nih.gov]
Physical Exam Diplopia Dysphagia Dyspnea Flank pain if the renal arteries are involved Abdominal findings related to mesenteric ischemia Horner’s syndrome Hypertension Hypotension if associated with cardiac tamponade, hypovolemia, excessive vagal tone Limb paresthesias [thesullivangroup.com]
Workup
The Level C recommendation is: “ The decision to pursue further workup for acute non-traumatic aortic dissection should be at the discretion of the treating physician. ” In other words, there are no clinical decision rules. [thesullivangroup.com]
Pleura
- Pleural Effusion
Neurologic complications include ischemic stroke or transient ischemic attack, peripheral neuropathy, paraplegia/ paraparesis, and pleural effusion [ 3 ]. [omicsonline.org]
Treatment
Our thoracic aortic disease treatment experience Cardiothoracic and vascular surgeons at the UPMC Heart and Vascular Institute offer treatment for descending TAAs and TAAAs. [upmc.com]
Treatment What are the treatments for FTAAD? There are a number of treatments for FTAAD. Blood pressure medications can reduce stress on the aorta, and beta-blockers are often prescribed by doctors treating the condition. [myresults.org]
The possible role of medical treatment in other TAAD diseases is not well studied but pragmatically, treatment as for MFS is adopted. [annalscts.com]
Type III dissection originates in the descending thoracic aorta and propagates most often distally with nonsurgical treatment usually recommended [ 3 ]. [omicsonline.org]
Surgery [ edit ] Decisions about repairing an aortic aneurysm are based on the balance between the risk of aneurysm rupture without treatment versus the risks of the treatment itself. [en.wikipedia.org]
Prognosis
There are significant perioperative mortality and complication rates (see 'Prognosis', below). [patient.info]
Prognosis and Patient Counseling. At discharge, patients are restricted in terms of their physical activity. They should be instructed to avoid heavy lifting. Blood pressure should be monitored. [clinicaladvisor.com]
Although non-dissecting TAA patients who have undergone appropriate elective surgical treatment have a near-normal prognosis [4] – [6], and despite progress in predicting the risk of TAD in patients with established TAA based on aortic size criteria, [journals.plos.org]
Patients have increased LDL values from birth, and an increased cardiovascular risk, making early diagnosis and treatment imperative for improved prognosis. Three main causative genes have been associated with FH: LDLR, APOB and PCSK9. [clinicalgenome.org]
Etiology
Aneurysms in aortic arch are contiguous with those of ascending or descending aorta and have the same etiology (cystic medial necrosis or atherosclerosis). [wikiecho.org]
Both twins had deep vein thrombosis of unclear etiology, possibly attributed entirely to immobility after surgery. [pediatrics.aappublications.org]
Etiology and classification The etiology of TAAD is complex and heterogeneous. [annalscts.com]
Goldstein LJ, Davies RR, Rizzo JA, Davila JJ, Cooperberg MR, et al. (2001) Stroke in surgery of the thoracic aorta: incidence, impact, etiology, and prevention. The Journal of thoracic and cardiovascular surgery 122: 935–945. [journals.plos.org]
The etiology of thoracic aortic aneurysm is dependent on the location of the aneurysm. Ascending thoracic aorta aneurysm can be caused by cystic medial degeneration, genetics, familial, atherosclerosis, and infection such as syphilis. [clinicaladvisor.com]
Epidemiology
Epidemiology [ 2 ] The true incidence and mortality rate of TAAs is not known. [patient.info]
LeMaire SA, Russell L (2011) Epidemiology of thoracic aortic dissection. Nature reviews. Cardiology 8: 103–113. View Article Google Scholar 3. Elefteriades JA (2010) Indications for aortic replacement. [journals.plos.org]
Moreover, recent USA data from 2006–2007 of isolated descending thoracic aorta aneurysms found 23% of ideal candidate (uncomplicated, elective descending aortic aneurysms) underwent to TEVAR, the remaining 77% underwent open surgical repair. [18] Epidemiology [en.wikipedia.org]
Pathophysiology
Definitions Pathophysiology Key History Key Physical Exam Risk Factors for TAD / AoD Classification Systems Differential Diagnosis Clinical Risk and Safety Pearls Thoracic Aortic Dissection Evaluation & Management Guidelines Definitions Acute Aortic Syndromes [thesullivangroup.com]
[…] disease Hypertension Loeys-Dietz Syndrome Hypercholesterolemia Hyperhomocysteinemia Elevated C-reactive protein Tobacco use Peripheral vascular disease Marfan syndrome Ehlers-Danlos type IV Bicuspid Aortic Valve Syphilis IgG4-related disease Pregnancy Pathophysiology [en.wikipedia.org]
Familial thoracic aortic aneurysm/dissection with patent ductus arteriosus: genetic arguments for a particular pathophysiological entity. Eur J Hum Genet 2004;12:173-80. Loeys BL, Dietz HC, Braverman AC, et al. [annalscts.com]
Prevention
If the aortic diameter increases rapidly or reaches a critical size (between 4.5 – 5.0 cm), elective surgery is recommended to prevent rupture. [tadcoalition.org]
Generally you should try to live as healthy a lifestyle as possible to prevent such things as aneurysms, heart attacks and strokes. [canadianvascular.ca]
Screening with ultrasound is indicated in those at high risk, prevention is by decreasing risk factors such as smoking, and treatment is either by open or endovascular surgery. [en.wikipedia.org]
In some cases, the aneurysm may need to be surgically repaired to prevent life-threatening events such as an acute aortic dissection or rupture of the aorta. [johnritterresearchprogram.org]
Once a thoracic aortic aneurysm is detected, death can effectively be prevented by skilful clinical decision-making and timely surgical intervention. [openheart.bmj.com]