Cardiovascular Medicine Book

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Thoracic Aortic Aneurysm

Aka: Thoracic Aortic Aneurysm
  1. Definitions
    1. Thoracic Aortic Aneurysm
      1. Widened diameter of the thoracic aorta at least 1.5 times greater than normal thoracic aorta
  2. Epidemiology
    1. Incidence: 6-10 per 100,000 persons (approximately 15,000 persons in U.S. per year)
  3. Risk Factors
    1. Marfan Syndrome
    2. Loeys-Dietz Syndrome
    3. Family History of Aortic Dissection
  4. Types
    1. Location
      1. Aortic Root or ascending aorta (60%)
      2. Aortic Arch (10%)
      3. Descending Aorta (40%)
      4. Thoracoabdominal Aorta (10%)
    2. Shape
      1. Fusiform (uniform shape)
      2. Saccular (bulbous on one side)
  5. Complications
    1. Thoracic Dissection
      1. See Thoracic Dissection for risk factors
  6. Management: Control risk factors to prevent Aortic Dissection
    1. Tobacco Cessation
    2. Hyperlipidemia Management
    3. Hypertension Management (goal <130/80)
      1. Beta Blocker AND
      2. ACE Inhibitor or Angiotensin Receptor Blocker
  7. Management: Surgery Indications
    1. Asymptomatic patients without underlying conditions
      1. Diameter >5.5 cm in asymptomatic patient AND one of the following
        1. Degenerative aortic aneurysm
        2. Chronic Aortic Dissection
        3. Intramural hematoma
        4. Penetrating atherosclerotic ulcer
        5. Mycotic aneurysm
        6. Pseudoaneurysm
      2. Diameter <5.5 cm in asymptomatic patient AND
        1. Increase in ascending aortic diameter >0.5 cm/year
    2. Ascending Thoracic aorta or aortic sinus diameter in collagen vascular disorder
      1. Diameter >4.2 cm by echo (>4.4 to 4.6 cm by CT or MRI) in asymptomatic Loeys-Dietz Syndrome
      2. Diameter >4 cm in asymptomatic Marfan Syndrome patient desiring pregnancy
      3. Diameter >4 to 5 cm in asymptomatic Marfan Syndrome patient
        1. Especially if Family History of Aortic Dissection, increase in ascending aortic diameter >0.5 cm/year
    3. Asymptomatic patients with bicuspid aortic valve
      1. Diameter >5.5 cm in asymptomatic patient with bicuspid aortic valve
      2. Diameter >5.0 cm in asymptomatic patient with bicuspid aortic valve AND
        1. Family History of Aortic Dissection
        2. Increase in ascending aortic diameter >0.5 cm/year
      3. Diameter >4.5 cm in bicuspid aortic valve undergoing aortic Valve Replacement
  8. References
    1. Aronow (2018) Ann Transl Med 6(3): 66-8 [PubMed]
    2. Isselbacher (2005) Circulation 111:816-28 [PubMed]

Aortic Aneurysm, Thoracic (C0162872)

Definition (MSH) An abnormal balloon- or sac-like dilatation in the wall of the THORACIC AORTA. This proximal descending portion of aorta gives rise to the visceral and the parietal branches above the aortic hiatus at the diaphragm.
Concepts Disease or Syndrome (T047)
MSH D017545
SnomedCT 433068007, 155421001
English Aortic Aneurysms, Thoracic, Thoracic Aortic Aneurysms, Thoracic aortic aneurysm, Aortic Aneurysm, Thoracic, Aneurysm of thoracic aorta (disorder), Aneurysm of thoracic aorta, aneurysm of thoracic aorta (diagnosis), aneurysm of thoracic aorta, thoracic aortic aneurysm, Aortic Aneurysm, Thoracic [Disease/Finding], Aneurysm;intrathoracic, aortic thoracic aneurysm, thoracic aneurysm, aneurysm thoracic, aneurysms thoracic, thoracic aortic aneurysms, thoracic aorta aneurysm, aneurysm aortic thoracic, Aneurysm, Thoracic Aortic, TAA, Thoracic aortic aneurysm (disorder), intrathoracic; aneurysm, aneurysm; intrathoracic, aneurysm; thoracic aorta, Thoracic Aortic Aneurysm, aorta thoracic; aneurysm, intrathoracic aneurysm
Dutch aneurysma van aorta thoracalis, aneurysma; aorta thoracalis, aneurysma; intrathoracaal, intrathoracaal; aneurysma, aorta thoracalis; aneurysma, Aneurysma aortae thoracalis
German thorakales Aortenaneurysma, Thorakales Aortenaneurysma, Aortenaneurysma, thorakales
Italian Aneurisma dell'aorta toracica, Aneurisma aortico toracico
Portuguese Aneurisma da aorta torácica, Aneurisma da Aorta Torácica
Spanish Aneurisma de la aorta torácica, aneurisma de aorta torácica, aneurisma de aorta torácica (trastorno), Aneurisma Aórtico Torácico, Aneurisma de la Aorta Torácicoabdominal, Aneurisma de la Aorta Torácica
Swedish Aortabråck, bröst
Japanese ｷｮｳﾌﾞﾀﾞｲﾄﾞｳﾐｬｸﾘｭｳ, 大動脈瘤-胸部, 胸部大動脈瘤
Finnish Rinta-aortan aneurysma
Russian ANEVRIZMA AORTY GRUDNOI, AORTY GRUDNOI ANEVRIZMA, АНЕВРИЗМА АОРТЫ ГРУДНОЙ, АОРТЫ ГРУДНОЙ АНЕВРИЗМА
Czech Aneurysma hrudní aorty, aorta thoracica - aneurysma, aneurysma hrudní aorty
French Anévrysme aortique thoracique, Anévrisme aortique thoracique, Anévrisme de l'aorte thoracique, Anévrysme de l'aorte thoracique, Anévrisme thoracique aortique, Anévrysme thoracique aortique
Polish Tętniak aorty piersiowej
Hungarian Mellkasi aorta aneurysma
Norwegian Torakalt aortaaneurisme
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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