aortic aneurysms, dissections, and ruptures

22 Pages·2014·1.61 MB·English

by  Motsi Valentine

AORTIC ANEURYSMS,
DISSECTIONS, AND RUPTURES
An Emergency Perspective
GOALS
•  Review Anatomy of the Aorta
•  Review Aneurysms, Dissections and Ruptures
•  Discuss Differing Presentations in the Emergency Patient
•  Emphasize the importance of our Assessment and History
ANATOMY REVIEW OF THE AORTA
4 parts of the Aorta More Details…
Artery Anatomy Thoracic vs Abdominal
CLASSIFICATIONS OF DISSECTIONS
Stanford
Debakey

RISK FACTORS

•  **Hypertension •  Pregnancy
•  **Smoking •  Trauma - deceleration injuries
•  Atherosclerosis •  Cardiac- surgeries/catheterizations
•  Hyperlipidemia •  Genetic disorders i.e. Marfan’s
syndrome, Ehlers Danlos Syndrome
•  Family History AAA
and other connective tissue
•  Stimulant use (cocaine)
disorders
•  Arteritis
•  Male
•  Syphilis, TB •  African descent
DIAGNOSIS
•  Presentation/symptoms depend on location of the rupture or dissection
•  Mimics other conditions
•  Delays of diagnosis is the MOST common problem with these patient in the
Emergency Department
CLASSIC TRIAD OF SYMPTOMS
•  Tearing/Ripping Abdominal or Chest Pain through to back
•  Hypotension
•  Pulsatile Abdominal Mass
*****These are present in only 25-50% of patients*****
COMMON PRESENTATIONS
•  Renal Colic
•  MI or Acute Coronary Syndrome
•  Congestive Heart Failure
•  Pulmonary Embolus/Pneumonia
•  Stroke / Neurological Symptoms
•  Right Pleural Effusion
•  Cholecystitis, Diverticulitis/GI pain
•  Musculoskeletal pain