Definition
An AAA (abdominal aortic aneurysm) is defined as enlargement of at least 3 cm of the abdominal aorta. The majority of abdominal aortic aneurysms begins below the renal arteries and ends above the iliac arteries. The exact cause of (AAAs) is unknown. However, it is thought to be due to a degenerative process of the abdominal aorta caused by atherosclerosis. Artherosclerosis represents a response to vessel wall injury caused by inflammation, genetically regulated defects in collagen and fibrillin, increased protease activity within the arterial wall, and mechanical factors (Stoelting p. 143).
Pathophysiology
The abdominal aorta consists of three distinct tissue layers including: the intima, media, and adventicia. There is
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There is an increase in the concentration of proteolytic enzymes compared to their inhibitors in the abdominal aorta as age progresses. It is also thought that metalloproteinases (MMPs) may be a factor in the development of AAAs (Stoelting p. 143). There is an increase in expression and activity of MMPs in people with AAAs. MMPs are present in normal aortic tissue and are responsible for vessel remodeling. These proteinases are secreted into the extracellular matrix of AAAs by aortic smooth muscle cells and macrophages. Increased MMP activity favors the degradation of collagen and elastin in aneurysmal tissue (Laake).
Signs and Symptoms
Patients with ruptured AAAs present in many different ways. The most common manifestation of rupture is back pain with a pulsatile abdominal mass and hypotension. Additional symptoms may include syncope, flank mass, groin pain, or paralysis (Dalman and White). Unstable patients with a suspected ruptured abdominal aortic aneurysm need immediate operation and control of the proximal aorta without preoperative confirmatory testing or optional volume resuscitation (Stoelting, p. 144).
Anesthesia Management
Surgical intervention is presently the only effective method of treating AAAs. The risk of surgical repair is outweighed by the risk of aneurysm rupture or aneurysm related death. Patients
Treatment is wonderful when treating intracranial aneurysm. The most common approach is surgery, because blood
Ann Hayes, age 68, initially was admitted to the hospital for elective surgical repair of an abdominal aortic aneurysm. Her surgery was documented as uneventful. However, complications developed during her 5th postoperative day as a result of a small bowel perforation.
It was established that the patient’s symptoms were due to an aortic regurgitation this was confirmed by echocardiogram. The use of the SOAPIER model is an effective means of providing rationale for a holistic clinical decision making. The findings and treatment options were discussed in a multidisciplinary meeting including Mr Jones and family. The family were informed that surgery was the safest treatment option. Complications that could happen with or without surgery were also explained ensuring that the patient had adequate understanding to make a valid choice about his treatment. Mr Jones agreed that a replacement of the aortic valve with a mechanical valve was necessary, thus it last for more than twenty years or more . Mr Jones
2. What two arteries represent the terminal branches of the abdominal aorta? Right and left common iliac artery.
Mesentaric artery, vena cava, abdominal aorta iliolumbar artery and vein common iliac vein, iliac artery, iliac vein.
An overriding aorta is where the major blood vessel is not in place or moved. In tetralogy
The beneficiary was an 82 year old man who had a history of multiple health problems, including chest pain, coronary artery disease, elevated cholesterol, high blood pressure, diabetes, chronic kidney disease, and obesity. In 2014 he underwent a cardiac catheterization and the repair of an abdominal aortic aneurism.
Atherosclerosis is associated with the major killer ailments in America, which include strokes, heart attacks, as well as peripheral vascular disease. The condition arises when there are a narrowing and hardening of the arteries. This is usually a gradual process, and it slowly blocks the arteries. When this happens, it will impede smooth blood flow. It is estimated that at least one million Americans lost their lives to a condition associated with atherosclerosis for the past few years.
ACS also referred to as Acute Coronary syndrome is the blockage of blood flow to the heart. Some symptoms that occur when ACS takes place is chest pains (angina pectoris), having pains in the upper and lower extremities, shortness of breath, nausea and sweating. There are risk factors that can increase your risk for ACS such as smoking, high blood pressure, high cholesterol and diabetes. Some ways in order to test for ACS is a blood test and electrocardiogram. It can show whether or not heart cells are dying. After being diagnosed with ACS, treatment is available. Some treatment options include medications, angioplasty and stents.
1882).According to Lewis et al., researchers have not identify a single cause of OA, however, there are few factors that contribute to the development (p. 1881). Some factors are estrogen reduction to menopause women, genetic factors, obesity, overuse of knees by persistent exercise, and aging. In my patient’s case, aging and obesity led her to have OA. Her BMI is 34.1 which fall into category of obesity (see
The main issue is the aorta which is the main artery can increasingly enlarge and lead to a dissection which is when the aorta erupts and that can lead to death. About forty percent of people with marfan syndrome that have an aorta that erupts will die immediately. Even if you have surgery after the aorta dissects there is a ten to twenty percent chance you could die. Most people with this disorder should check that their aorta is not rapidly or increasingly growing. The normal size for an aorta is about an inch, if it gets bigger than 4.7 centimeters, then it would be a good idea to get surgery. Luckily, most people that have to have a non- emergency surgery have a 98% or greater chance of success. There are usually two types of surgery they can do to replace the aorta. The first one is the traditional method which is where they replace the aorta and put in graft and replace the aorta valve with a mechanical valve or the valve sparing method where the replace the aorta with a tube graft and re- implant the original valve. Surgery is very necessary for people with enlarged
In order to measure the shoulder function, I asked the patient to put both hands together behind her head. The patient performed the shoulder’s test without difficulty or limitations in mobility due to pain. I did not ask the patient to perform the test as indicated to avoid over stretching the abdominal area that was inflamed and red due to the pseudo-aneurism.
Atherosclerosis means "hardening of the arteries"; this is caused by a build up of cholesterol and other fatty substance within the walls of the arteries. In atherosclerosis, fatty deposits called plaque, build up on the inner wall of the coronary arteries. These fatty deposits usually develop over
Presently, the treatment strategies used are risk factor modification, conventional pharmacology and surgical revascularization. These strategies have hitherto not been of enormous solution as the disease progression still result in recurrent symptoms. This has now led to the exploitation of advances in comprehending the vascular biology of atherogenesis to introduce novel cell and molecular-based therapies. The application of immunomodulation, lipid-lowering agents like statins, gene transfer, antisense technology and so on has resulted in new therapeutic strategies to interrupt cell proliferation and disorder of the vessel wall. In this essay, immunomudulation and lipid-lowering agent shall be discussed.
The wall of an artery consists of three layers. The innermost layer, the tunica intima (or just intima), contains simple squamous epithelium, basement membrane and connective tissues. The epithelium is in direct contact with the blood flow. The middle layer, the tunica media, is primarily smooth muscle and is usually the thickest layer. It not only provides support for the vessel but also changes vessel diameter to regulate blood flow and blood pressure. The outermost layer, which attaches the vessel to the surrounding tissue, is the tunica externa or tunica adventitia. This layer is connective tissue with varying amounts of elastic and collagenous fibers. The connective tissue in this layer is quite dense where it is adjacent to the tunic media, but it changes to loose connective tissue near the periphery of the vesse