Presentation
Hypertension was the most predisposing factor and was present in 29 (58.0%) of 50 patients. On admission, hypertension was present in 26 (56.5%) of 46 patients, and hypotension was present in 14 (30.4%) of 46 patients. [ncbi.nlm.nih.gov]
Entire Body System
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Pallor
Patients typically present with sudden unilateral extremity pain and often pallor and loss of pulses (see also Acute Peripheral Arterial Occlusion ). [merckmanuals.com]
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]
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Hypoxemia
[4] cardiac arrest during spinal anesthesia usually resulted from hypoxemia and hypercarbia associated with unappreciated respiratory insufficiency. [anesthesiology.pubs.asahq.org]
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Cape Verde
Mauritius, Seychelles, and Cape Verde all had much lower probabilities of death during childhood than did other countries in this region. [ncbi.nlm.nih.gov]
Gastrointestinal
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Abdominal Pain
Most cases show evidence of a large arteriovenous fistula which can, on occasions, dominate the clinical picture, e.g. cyanosed lower extremities or cardiac failure, but abdominal pain is the major feature. [ncbi.nlm.nih.gov]
In retrospect, persistent fever and abdominal pain of our patient was suggestive of infected AAA. [shmabstracts.com]
Additional Comments The most common symptom of an abdominal aortic aneurysm is abdominal pain or discomfort. The patient has a history of aortic aneurysms. [millerandzois.com]
Clinical findings Onset may be abrupt or gradual; pulsatile abdominal mass, early satiety, nausea, vomiting, constipation, pain or claudication, waxing and waning abdominal paining that may remit spontaneously, rebound tenderness. [medical-dictionary.thefreedictionary.com]
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Severe Abdominal Pain
Many patients with this man's history are told by their doctors f you've got any severe abdominal pain (or back or flank pain) to the emergency room and tell them you have an aneurysm. [millerandzois.com]
abdominal pain and a known abdominal aortic aneurysm. [theanesthesiaconsultant.com]
abdominal pain radiating into back faintness, syncope, hypotension Prognosis:64-94% die before reaching hospital Increased risk: size 6 cm, growth 5 mm / 6 months, pain tenderness Peripheral embolization Infection Spontaneous occlusion of aorta Prognosis [learningradiology.com]
Case presentation A 79-year-old woman was admitted to the emergency department of Peking Union Medical College Hospital complaining of severe abdominal pain with unknown causes for 4 hours. [bmcsurg.biomedcentral.com]
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Acute Abdomen
The differential diagnosis for ruptured AAA involves other causes of abdominal pain, including acute abdomen. Investigations If an aneurysm is ruptured, investigations need to be swift and pertinent. [patient.info]
This also serves to exclude other causes of acute abdomen and predict endograft size. Some are concerned that the extra time required for imaging may adversely affect outcome but recent research suggests this is not the case. [ceaccp.oxfordjournals.org]
World J Emerg Surg 2014, 9: 6. 10.1186/1749-7922-9-6 PubMed Central View Article PubMed Google Scholar Kauvar DR: The geriatric acute abdomen. Clin Geriatr Med 1993, 9: 547–58. [doi.org]
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Abdominal Bruit
Careful examination of all patients with a ruptured aneurysm, particularly listening for an abdominal bruit, will usually allow the diagnosis of aortocaval rupture to be made. [ncbi.nlm.nih.gov]
Free rupture of the AAA will present in same way as any ruptured AAA Formation of a large arteriovenous (AV) fistula may occur if there is no external AAA leak Signs and Symptoms ( Cinara 2005 ) Palpable mass (80-90%) Abdominal bruit (75%) Palpable thrill [coreem.net]
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Abdominal Tenderness
Thirty percent do not have abdominal tenderness on exam [ 25 ]. In fact, nearly half of all cases of diverticulitis are misdiagnosed initially [ 26 ]. [doi.org]
Cardiovascular
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Vascular Disease
Tim Resch, MD, PhD, is with the Vascular Center, Department of Hematology and Vascular Diseases at Skane University Hospital in Malmö, Sweden. He has disclosed that he is a consultant to Cook Medical. Dr. [evtoday.com]
Diseases Cardiovascular Diseases Aortic Diseases Aneurysm, Ruptured Rupture Wounds and Injuries Tranexamic Acid Antifibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Hemostatics Coagulants [clinicaltrials.gov]
Homepage Rare diseases Search Search for a rare disease Familial thoracic aortic aneurysm and aortic dissection Disease definition Familial thoracic aortic aneurysm and aortic dissection is a rare genetic vascular disease characterized by the familial [orpha.net]
What Is Vascular Disease? Most Americans are familiar with heart disease and with the consequences of blockages in the vessels that carry blood to and from the heart. [vascularweb.org]
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Irregular Heart Rhythm
Complications of the procedure Open repair • Myocardial infarction (heart attack) • Irregular heart rhythms (arrhythmias) • Bleeding during or after surgery • Injury to the bowel (intestines) • Limb ischemia (loss of blood flow to legs/ feet) • Embolus [slideshare.net]
Skin
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Grey Turner's Sign
Rupture can also create a connection between the aorta and intestine or inferior vena cava. [18] Flank ecchymosis (appearance of a bruise) is a sign of retroperitoneal bleeding, and is also called Grey Turner's sign. [16] [19] Aortic aneurysm rupture [en.wikipedia.org]
Neurologic
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Amnesia
You also give .4 mg scopolamine IV for amnesia. The surgeon makes the incision and clamps the aorta in minutes. The bleeding is retroperitoneal. There is no blood in the abdomen. After aortic clamping, the BP rises to 100 systolic. [theanesthesiaconsultant.com]
Urogenital
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Cesarean Section
The surgeon scrubs and gowns, and the nurses prep as they would for a stat cesarean section. You leave both arms out for line access. You do a rapid sequence induction with etomidate and succinylcholine, and intubate the trachea. [theanesthesiaconsultant.com]
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Incontinence
Nevertheless, prompt diagnosis may be difficult due to many different symptoms, such as severe chest pain, back pain, abdominal pain, cold sweat, dyspnea, disturbance of consciousness, vomiting, incontinence, melena, etc. [healio.com]
Workup
And he survived waiting several hours at his hospital for workup and eventual transfer which is a stress test. [vascsurg.me]
Aneurysm was noted during workup for back pain, and CT was ordered after AAA was identified on radiography. No evidence of rupture is seen. Signs and symptoms AAAs are usually asymptomatic until they expand or rupture. [emedicine.medscape.com]
Serum
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Base Deficit
The arterial blood gas results were: pH 7.30, PaCO 2 31 mmHg, PaO 2 573 mmHg, base deficit 9.3 meq/l, and hematocrit 22%. Because the patient's hematocrit was significantly lower than his preoperative value, it was remeasured. [anesthesiology.pubs.asahq.org]
Factors which contribute to the development of ACS include anaemia, prolonged hypotension, cardiopulmonary resuscitation, hypothermia, severe acidosis (base deficit 14 mEq) and aggressive fluid resuscitation ( 4l h 1 ). [ceaccp.oxfordjournals.org]
Microbiology
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Staphylococcus Aureus
Many pathogens can cause infected aortitis, with Salmonella species and Staphylococcus aureus being the predominant organisms. Early diagnosis and surgical intervention is essential for survival. [shmabstracts.com]
Hypertrophy
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Ventricular Hypertrophy
The preoperative electrocardiogram displayed left ventricular hypertrophy and was suggestive for anterior ischemia. However, the patient gave no history of angina, dyspnea, hypertension, or diabetes. [anesthesiology.pubs.asahq.org]
Treatment
The patient underwent open treatment for a ruptured abdominal aortic aneurysm in another hospital. The procedure was complicated by extreme blood loss which prevented concommitant treatment of two large iliac aneurysms. [ncbi.nlm.nih.gov]
Prognosis
Prognosis May be fatal if untreated. ruptured aortic aneurysm Surgery The transmural disruption of the integrity of the aorta, which usually occurs in a background of aortic dissection Clinical Onset may be abrupt or gradual; pulsatile abdominal mass, [medical-dictionary.thefreedictionary.com]
However, there is no scientific evidence that aneurysm size has any correlation with a better or worse prognosis after rupture. [scielo.br]
Criteria are needed to identify patients with a poor prognosis so that treatment and resources may be directed to those with a better outlook. [ncbi.nlm.nih.gov]
Acute renal failure after ruptured abdominal aortic aneurysm: an improved clinical prognosis. Crii Care Med 1979; 7 :59–62. CrossRef Google Scholar 12. ADAR R, RABBI I, BASS A, et al. [link.springer.com]
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.info]
Etiology
This book considers mainly etiology, pathogenesis, and pathophysiology of aortic aneurysms (AA) and aneurysm rupture and addresses anyone engaged in treatment and prevention of AA. [intechopen.com]
The maximum decrease in blood pressure usually occurs 15–30 min after the subarachnoid injection. [1] Therefore, the abrupt onset of cardiac arrest in our patient suggests presence of other etiologic factors, such as RAAA, responsible for the circulatory [anesthesiology.pubs.asahq.org]
(See Etiology .) AAAs generally affect elderly white men. Smoking appears to be the risk factor most strongly associated with AAA. [emedicine.medscape.com]
Epidemiology
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.info]
View Article PubMed Google Scholar Gillum RF: Epidemiology of aortic aneurysm in the United States. J Clin Epidemiol. 1995, 48 (11): 1289-1298. [bmcnephrol.biomedcentral.com]
Epidemiology Frequency United States The incidence of aortic aneurysm is 5.9 cases per 100,000 person-years. [1] Mortality/Morbidity The cumulative risk of rupturing a thoracic aortic aneurysm (TAA) is related to aneurysm diameter. [emedicine.com]
Pathophysiology
Pathophysiology Degenerative changes in the wall of the aorta lead to cystic medial necrosis. [emedicine.com]
This book considers mainly etiology, pathogenesis, and pathophysiology of aortic aneurysms (AA) and aneurysm rupture and addresses anyone engaged in treatment and prevention of AA. [intechopen.com]
We report a case of cardiac arrest and RAAA during spinal anesthesia and discuss the pathophysiologic changes associated with cardiac arrest after spinal anesthesia in context with RAAA. [anesthesiology.pubs.asahq.org]
PATHOPHYSIOLOGY Aorta consists of 3 layers- Intima, Media & Adventitia. Certain diseases causes weakening of the aortic walls, reduces its elasticity. [slideshare.net]
Prevention
The procedure was complicated by extreme blood loss which prevented concommitant treatment of two large iliac aneurysms. [ncbi.nlm.nih.gov]
If caught early, treatments can be used to prevent rupture of the aneurysm. [clinicaltrials.gov]
Preventive Services Task Force. Ann Intern Med. 2005;142:203–11. [cdc.gov]
The researchers say that, in principle, if raising HDLs can be induced using a drug, it could offer a preventative measure to reduce the chance of an aneurysm developing for individuals considered at high risk of aneurysms. [sciencedaily.com]
Prevention is by decreasing risk factors, such as smoking, and treatment is either by open or endovascular surgery. Aortic aneurysms resulted in about 152,000 deaths worldwide in 2013, up from 100,000 in 1990. [en.wikipedia.org]