10.

0 Vascular Aneurysms

DEFINITION:
A localised abnormal dilatation of a blood vessel.
Dilation of a blood vessel by >100% = aneurysm. Dilation of a blood vessel by >50% = arteriomegaly

A chronic valvular heart diseasDEFINITION:

EPIDEMIOLOGY:
A chronic valvular heart diseasDEFINITION:
5% of over 50’s
A chronic valvular heart diseasDEFINITION:
15% of over 80’s
A chronic valvular heart diseas Risk factors:
M:F 6:1
R/F’s as for atherosclerosis
AETIOLOGY:
FHx (7x risk)
Congenital (berry aneurysm in Circle of Willis)
Smoking and emphysema (alpha 1 antitrypsin
Atherosclerotic (most common) deficiency stops collagen breakdown)
Traumatic (after interventional radiology)
Inflammatory (mycotic or syphilitic)
Connective Tissue disorders (Marfans, Ehlers Danlos)

PATHOPHYSIOLOGY:
True = Dilation involving all 3 layers of BV wall

False = Formed by a breach in a vessel wall with a sac composed of compressed surrounding tissues /
fibrin. Only involves the intima layer (usually after trauma or iatrogenic causes such as needles and
cannulation in BV walls.

Lumen > Tunica intima (SM) > Tunica media (SM + collagen) > Tunica adventitia (collagen)

2 forms:
Fusiform = spindle shaped and involving the whole circumference
Sacular = small segment of wall ballooning to form the aneurysm

Most commonly located: Infra renal aorta (AAA) > iliac > popliteal > femoral > suprarenal aorta

SYMPTOMS: SIGNS:
Mostly asymptomatic Expansile pulsatile mass
Rupture causes sever back pain radiating to the Hypotension, shock
abdomen
CCF, bruit, lower limb ischaemia and oedema due to
Palpable pulsatile mass erosion into IVC.