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  1. Localized abnormal dilation of BV or heart
  2. True - bounded by gen. Complete/ attn art wall, blood within confines of circulatory system, e.g. Post MI, post atherosclerosis, syphilis, congenital
  3. False – pseudoaneurysm
  4. Extra vascular hematoma communicating with intravascular space (pulsating hematoma)
  5. Wall of BV- breached. Eg leaking anastomosis.
  6. Arterial dissection - blood enters the wall of artery, as a hematoma dissecting between its layers. 

1.  Causes of true aortic aneurysm:

  1. Atherosclerosis - M. comm. Cause
  2. Cystic medial degeneration Q
  3. Others Congo syphilis Circulating organisms directly infecting arterial wall
  4. Inf. (Mycotic aneurysm Septic embolus lodging in vessel
  5. Trauma     Adj. Supp. Process.
  6. Systemic disease - vasculitis 

2.  Atherosclerotic aortic Aneurysm:

Abdominal aorta{below renal artery & above bifurcation); comm. iliac arteries, arch & descending Thoracic aorta

  • Inflammatory abdominal aneurysm &mycotic abdominal aneurysm 

3.  Syphilitic aneurysm:

   Syphilitic (Leutic) Aneurysms: characteristic of tertiary syphilis

  1. Almost always confined to thoracic aorta.
  2. Ascending and transverse portion of the arch are favoured sites
  3. Due to dilation of ring, the aortic valve may become incompetent, leading to luetic heart disease (AR).
  4. Contraction of fibrous scars may lead to wrinkling of intervening segments of aortic intima, producing what has been called "tree barking' (seen in radiograph).
  5. Aneurysms leads to dilation of aortic valve or narrowing of coronary ostia
  6. Luetic aortitis may cause aortic valve dilation resulting in valvular insufficiency.  

Aortic Dissection: 2 groups

  1. 40-60 yrs. with antecedent HT (in> 90% cases)
  2. Younger - connective tissue disease (Marfan syndrome)

a. Usually intimal tear (with sharp, jagged edges) in ascending aorta (within 10 mm of aortic valve)

b. Dissection may extend proximally / distally; usually between middle and outer thirds.

c. CMD (cystic medial degeneration.) is seen in Marfan syndrome. Q


  1. Type A:
  2. More comm. (& dang.) proximal lesion: inv. either ascending portion only or both ascending & descending

5.  Type B: not inv. ascending Aorta, beginning distal to subclavian art. Q

C/F are due to

  1. Rupture - 5-10% of aneurysm> 5 cm
  2. Embolism from mural thrombus
  3. Compression on surrounding structures
  4. Occlusion of branch vessel
  5. Presentation as abdominal mass 

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