Abdominal aortic aneurysm

avatar
Created by
Jess Lycett

Cards (12)

  • What is an AAA?
    Abdominal aortic aneurysm. It is dilation of the aorta with a diameter of more than 3cm.
  • Give 6 risk factors for AAA?
    Male
    Increased age
    Smoking
    Hypertension
    Family history
    Existing cardiovascular disease
  • What screening is offered for AAA?
    All men are offered an ultrasound scan at 65 years old. Those with an enlarged aorta of greater than 3cm are referred to the vascular team. They are referred urgently if it is greater than 5.5.cm.
  • What is the presentation of AAA?
    Most are asymptomatic
    Non-specific abdominal pain
    Pulsatile and expansile mass in the abdomen on palpation
    May be an incidental finding
  • Give two imaging modalities that can be used to diagnose AAA?
    Ultrasound scan
    CT angiogram
  • Give the 4 classifications of AAA and their sizes
    Normal - <3cm
    Small - 3-4.4cm
    Medium - 4.4-5.5cm
    Large - >5.5cm
  • What is the management of AAA?
    Treat reversible factors - stop smoking, healthy diet and exercise
    Have follow up scans - for small AAA have yearly scan, for medium AAA have 3 monthly scan.
    Elective surgical repair for large AAA, symptomatic or growing by 1cm yearly.
  • What 2 types of surgery can be done for elective repair of AAA?
    Laparotomy + artificial graft
    Endovascular aneurysm repair (EVAR) - stent via femorals
  • What does the DVLA have to do with AAA?
    DVLA need to be informed if aneurysm above 6cm
    Stop driving if above 6.5cm
    Stricter rules apply to drivers of heavy vehicles
  • What is the presentation of ruptured AAA?
    Severe abdominal pain radiating to the back or groin
    Haemodynamic instability
    Pulsatile expansile mass
    Collapse
    Loss of consciousness
  • What is permissive hypotension?
    When they aim for lower than normal blood pressure when performing fluid resuscitation.
  • What should happen if the patient is haemodynamically unstable with suspected but not confirmed AAA rupture?
    Take straight to surgery, surgical repair should not be delayed by getting imaging to confirm the diagnosis.