Aortic aneurysm overview

Aortic aneurysm Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating aortic aneurysm from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Thoracic Aortic Aneurysm

Abdominal Aortic Aneurysm

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Treatment

Medical Therapy

Surgery

Endovascular treatment of AAA

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Aortic aneurysm overview On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Aortic aneurysm overview

CDC on Aortic aneurysm overview

Aortic aneurysm overview in the news

Blogs on Aortic aneurysm overview

Directions to Hospitals Treating Aortic aneurysm overview

Risk calculators and risk factors for Aortic aneurysm overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Synonyms and keywords:

## Contents

* 1 Overview
* 2 Historical Perspective
* 3 Classification
* 4 Pathophysiology
* 5 Causes
* 6 Differentiating aortic aneurysm from other Diseases
* 7 Epidemiology and Demographics
* 8 Risk Factors
* 9 Screening
* 10 Natural History, Complications, and Prognosis
* 11 Diagnosis
* 11.1 Diagnostic Study of Choice
* 11.2 History and Symptoms
* 11.3 Physical Examination
* 11.4 Laboratory Findings
* 11.5 Electrocardiogram
* 11.6 X-ray
* 11.7 Echocardiography or Ultrasound
* 11.8 CT scan
* 11.9 MRI
* 11.10 Other Imaging Findings
* 11.11 Other Diagnostic Studies
* 12 Treatment
* 12.1 Medical Therapy
* 12.2 Surgery
* 12.3 Primary Prevention
* 12.4 Secondary Prevention
* 13 References

## Overview

[edit | edit source]

An aortic aneurysm is a dilation of the aorta representing an underlying weakness in the wall of the aorta at that location. While the stretched vessel may occasionally cause discomfort, a greater concern is the risk of rupture which causes severe pain, massive internal hemorrhage which are often fatal.

## Historical Perspective

[edit | edit source]

Aortic aneurysm was first discovered by Antyllus, a a Greek surgeon, in the second century AD.

In 1817, a ligation of the abdominal aorta was used by Astley Cooper to treat a ruptured iliac aneurysm.

## Classification

[edit | edit source]

Aortic aneurysm may be classified according to Crawford classification into 5 types: type 1, type 2, type 3, type 4 and type 5.

## Pathophysiology

[edit | edit source]

It is thought that aortic aneurysm is the result of either genetic disturbances and environmental risks such as smoking.

## Causes

[edit | edit source]

Aortic aneurysm may be caused by Marfan's syndrome, Loeys-Dietz syndrome, Ehler-Danlos syndrome, Turner Syndrome, Autosomal Dominant Polycystic Kidney Disease and other genetic disturbances. Its risk is greatly improved with smoking.

## Differentiating aortic aneurysm from other Diseases

[edit | edit source]

Aortic aneurysms must be differentiated from other diseases that cause either abdominal or thoracic pain, such as acute pancreatitis, ruptured viscus, and acute pericarditis.

## Epidemiology and Demographics

[edit | edit source]

The incidence of aortic aneurysm increases with age; the median age at diagnosis is 69 years.

## Risk Factors

[edit | edit source]

Common risk factors in the development of aortic aneurysms include smoking, male gender, hypertension, race (whites) and family history.

## Screening

[edit | edit source]

According to the USPSTF, screening for abdominal aortic aneurysm by ultrasonography is recommended once among patients aged 65 to 75 years who have ever smoked.

## Natural History, Complications, and Prognosis

[edit | edit source]

If left untreated, 80% of patients with aortic aneurysms may progress to rupture or dissection.

## Diagnosis

[edit | edit source]

### Diagnostic Study of Choice

[edit | edit source]

The diagnosis of aortic aneurysm is based on the observed diameter of the vessel, which include diameter larger than 5 cm for the ascending aorta, 4 cm for the descending aorta, and 3cm for the abdominal aorta.

### History and Symptoms

[edit | edit source]

The majority of patients with aortic aneurysm are asymptomatic.

### Physical Examination

[edit | edit source]

Patients with aortic aneurysm usually appear asymptomatic. Physical examination of patients with abdominal aortic aneurysm is usually remarkable for pulsating abdominal mass. If thoracic they may present with hoarseness, dysphagia and aortic regurgitation.

### Laboratory Findings

[edit | edit source]

There are no diagnostic laboratory findings associated with aortic aneurysm.

### Electrocardiogram

[edit | edit source]

There are no ECG findings associated with aortic aneurysm.

### X-ray

[edit | edit source]

An x-ray may be helpful in the diagnosis of thoracic aortic aneurysm. Findings on an x-ray suggestive of thoracic aortic aneurysm include widening of the mediastinum.

### Echocardiography or Ultrasound

[edit | edit source]

Abdominal ultrasound may be helpful in the diagnosis of abdominal aortic aneurysm. Findings on an ultrasound diagnostic of abdominal aortic aneurysm include aorta with a diameter larger than 3 cm.

### CT scan

[edit | edit source]

Thoracic or abdominal CT scan may be helpful in the diagnosis of aortic aneurysms. Findings on CT scan diagnostic of aortic aneurysms include widening of the aorta diameter.

### MRI

[edit | edit source]

Thoracic or abdominal MRI may be helpful in the diagnosis of aortic aneurysms. Findings on MRI diagnostic of aortic aneurysms include widening of the aorta diameter.

### Other Imaging Findings

[edit | edit source]

Angiographies may be helpful in the diagnosis of aortic aneurysms. Findings on an angiography diagnostic of aortic aneurysms include widening of the aorta diameter.

### Other Diagnostic Studies

[edit | edit source]

There are no other diagnostic studies associated with aortic aneurysm.

## Treatment

[edit | edit source]

### Medical Therapy

[edit | edit source]

Pharmacologic medical therapies for aortic aneurysms include blood pressure control and statin therapy if associated with atherosclerosis.

### Surgery

[edit | edit source]

The mainstay of treatment for aortic aneurysms is medical therapy. Surgery is usually reserved for patients with an abdominal aortic aneurysm larger than 5.5 cm. For thoracic aortic aneurysms, it is reserved for patients with symptoms, aneurysm that is growing more than 1 centimeter per year and/or signs of aortic dissection.

### Primary Prevention

[edit | edit source]

Effective measures for the primary prevention of aortic aneurysms include avoid smoking and controlling blood pressure.

### Secondary Prevention

[edit | edit source]

Effective measures for the secondary prevention of aortic aneurysms include ultrasound screening as described above.

## References

[edit | edit source]

Template:WikiDoc Sources