General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Moderate physical activity has a preventive effect on the progression (progression) of atherosclerotic (arteriosclerosis-related) aneurysms. Competitive sports should be refrained from (from an aortic diameter > 4 cm!). Review of … Aneurysm: Therapy
To prevent aneurysm, attention must be paid to reducing individual risk factors. Aneurysm of the vessels supplying the brain Behavioral risk factors Alcohol abuse Nicotine abuse (applies to both sexes) Proportion of female smokers with intracranial (“localized within the skull”) aneurysms is about four times higher than among women without aneurysms Prevention factors Genetic factors: … Aneurysm: Prevention
An aneurysm often does not cause any symptoms. The following symptoms and complaints may indicate an aneurysm of the vessels supplying the brain: Headache Cranial nerve failures (visual disturbances, hearing disturbances, dizziness, etc.) Symptoms of acute rupture Acute diffuse headache of unprecedented intensity. Disturbance of consciousness Meningismus (painful stiffness of the neck) Nausea / vomiting … Aneurysm: Symptoms, Complaints, Signs
Pathogenesis (disease development) Atherosclerosis (= intimal lesion/injury to the inner layer of a vessel) is the most common cause of aortic aneurysm (medial lesion/injury to the middle layer of a vessel). The pathogenesis is still very unclear. Of importance seems to be an increased activity of matrix metalloproteinases (MMPs) in affected patients. These regulate connective … Aneurysm: Causes
Medical history (history of illness) represents an important component in the diagnosis of aneurysm. Family history What is the general health of your family members? Are there any diseases in your family that are common? Are there any hereditary diseases (connective tissue diseases) in your family? Social history What is your profession? Current medical history/systemic … Aneurysm: Medical History
Respiratory System (J00-J99) Spontaneous tension pneumothorax – life-threatening form of pneumothorax in which increased pressure in the pleural space causes problems with blood flow to the heart as well as impaired unfolding of the reciprocal lung. Cardiovascular system (I00-I99). Diseases of the cardiovascular system, unspecified. Pulmonary embolism – partial (partial) or complete obstruction of a … Aneurysm: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by an aneurysm: Cardiovascular system (I00-I99) Aortic dissection (synonym: aneurysm dissecans aortae) – acute splitting (dissection) of the wall layers of the aorta (main artery), with a tear of the inner layer of the vessel wall (intima) and hemorrhage between the … Aneurysm: Complications
According to DeBakey, thoracic aortic aneurysm can be classified as follows. DeBakey Description DeBakey I Intimal (inner vessel wall) tear in the ascending aorta; ; spread distally to include the aortic arch or even the descending aorta DeBakey II Intimal tear in the region of the ascending aorta; end of tear also in the region … Aneurysm: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? Hernias (fractures)? Auscultation (listening) of … Aneurysm: Examination
Aneurysm cannot be diagnosed by laboratory parameters. The following 1st-order laboratory parameters-obligatory laboratory tests-should nevertheless be determined. Small blood count Fasting glucose (fasting blood glucose) Inflammatory parameters – CRP (C-reactive protein). Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin. Renal parameters … Aneurysm: Test and Diagnosis
Therapeutic target Prevention of rupture (“rupture”). Therapy recommendations Acute uncomplicated type B aortic dissection: Acute therapy ward (monitoring hemodynamics and urinary output). Analgesia (administration of analgesics). Lowering systolic blood pressure to less than 120 mmHg by intravenous administration of beta-blockers (esmolol, metoprolol) and vasodilators (labetolol, nitroprusside)Note: To prevent reflex tachycardia by administration of peripheral vasodilators, … Aneurysm: Drug Therapy
Obligatory medical device diagnostics. Transthoracic echocardiography (ultrasound of the heart through the chest) – if thoracic aortic aneurysm is suspected. Abdominal ultrasonography (ultrasound examination of the abdominal organs; with ultrasound contrast agent, if necessary) – if abdominal aortic aneurysm is suspected. Computed tomography of the skull (cranial CT, cranial CT or cCT) – if aneurysm … Aneurysm: Diagnostic Tests
