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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Aneurysm III: Interprofessional Care01:26

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

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A New Clinically Driven Classification for Acute Aortic Dissection.

Salah D Qanadli1,2, Sonaz Malekzadeh1, Nicolas Villard1

  • 1Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.

Frontiers in Surgery
|July 14, 2020
PubMed
Summary
This summary is machine-generated.

A new classification for acute aortic dissection (AAD) includes the aortic arch and malperfusion syndrome (MPS). This system aids in treatment decisions for AAD, improving patient outcomes.

Keywords:
acute diseaseaortic dissectioncomputed tomography angiographyendovascular proceduresselection for treatment

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Area of Science:

  • Cardiovascular Surgery
  • Radiology
  • Vascular Medicine

Background:

  • Acute aortic dissection (AAD) is a life-threatening condition.
  • Current classifications may not fully capture the complexity of AAD, particularly involving the aortic arch and malperfusion.
  • Improved classification is needed for better treatment strategies.

Purpose of the Study:

  • To introduce and evaluate a novel classification scheme for AAD.
  • The new system incorporates the aortic arch as a distinct entity and integrates malperfusion syndrome (MPS) patterns.
  • To assess the feasibility and clinical utility of this classification in a large patient cohort.

Main Methods:

  • Retrospective review of pre-therapy CT angiograms from 226 AAD patients.
  • Reclassification of AAD based on a new scheme: Type A (ascending aorta), Type B (descending aorta), Type C (aortic arch).
  • Grading of malperfusion syndrome (MPS) from 0 (none) to 3 (static and dynamic).

Main Results:

  • The new classification identified 152 Type A, 50 Type B, and 24 Type C dissections.
  • Type C dissections, involving the aortic arch, constituted 11% of cases.
  • Malperfusion syndrome varied across types, and Type C showed significantly higher rates of endovascular/hybrid interventions (37%).

Conclusions:

  • The proposed AAD classification is feasible and effectively identifies Type C dissections.
  • This classification system aids in decision-making and guides subsequent treatment selection.
  • The new scheme offers a more comprehensive approach to AAD management.