Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
23 Cards in this Set
- Front
- Back
|
arterial aneurysm is secondary to ___ most often?
|
atheroschlerosis
|
|
|
most common site of dissection?
|
ascending aorta (within 10cm) second most common site is distal to the left subclavian art
|
|
|
2 diferent classifiacation methods of aortic dissections?
|
standford and debakey
|
|
|
3 subsets of the Debakey classification?
|
Type 1: involves ascending, arch, descending aorta
type 2: ascending aorta type 3: descending aorta, distal to left subclavian art a: originates distally and extends prox and distal b:originates distally and extends distal to diaphragm |
|
|
stanford classification?
|
A; ascending aorta and arch with or without the descending
B: inolves thoracic aorta distal to subclavian artery |
|
|
Etiology of dissections?
|
dz that affect the media, weaken the aortic wall, high BP, high shearing forces, hydraulic stress that ruptures intima
|
|
|
number 1 risk factor for aortic dissection? others?
|
HTN, trauma, CT disorders, bicuspid aortic valve, syphilis, aortitis
|
|
|
Cystic medial necrosis?
|
degenerative changes that occur with aging. degrade collagen, elastin, smooth muscle, resulting dposition of basophilic ground substance forming cyst like pools.
|
|
|
how many aortic dissections are missed on initial eval?
|
38%
|
|
|
number one symptom of aortic dissection?
|
chest pain
|
|
|
who do aortic dissections occur in?
|
black 40-70 y.o.
|
|
|
pain of aortic dissection?
|
caused by stretching of wall and eventual tearing. sudden onset differentiates in from acute MI, anterior chest with posteriormigration to back, lumbar region
|
|
|
BP differential in aortic dissection?
|
>20 mmHg, blood pressure differential found in 20% of people without aortic dissection
|
|
|
Neurological symptoms of dissection?
|
syncope, paralysis/hemiplegia, altered mental status, peripheral nerve ischemia, horner syndrome
|
|
|
muffled heart sounds, JVD, and narrow pulse pressure may indicate?
|
cardiac tamponade
|
|
|
Are labs needed for the diagnosis of aortic dissection?
|
no, should be done way before labs
|
|
|
CXR finding in aortic dissection?
|
widening mediastinum, blunting of the aortic knob, left apical cap, tracheal esophageal deviation
|
|
|
gold stadard for diagnosing aortic dissection?
|
angiography
|
|
|
what is quickly replacing angiography in dissection dx? Other dx imaging options?
|
helical CT scan
TEE, MRI (good for chronic and post-op) |
|
|
ECG changes in aortic dissection can mimic?
|
the ones seen in acute cardiac ischemia. Crushing chest pain with no ECG changes is likely a dissection
|
|
|
TX for aortic dissection?
|
pain (morphine), decrease HR (beta blocker), decrease BP (anti-hypertensive), maintain tissue perfusion
|
|
|
Target HR and BP for dissection?
|
60
100-120 |
|
|
Type a vs type b management?
|
type a = surgery
type b = BP control with beta blocker and surgery if further complications arise. endovascular stent |
