Abdominal Aortic Aneurysm
Original Editors - Justin Rosinski and Clint Morris from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Top Contributors - Clinton Morris, Justin Rosinski, Elaine Lonnemann, Evan Thomas, Kim Jackson, Lucinda hampton, WikiSysop, David Olukayode and Admin
Definition/Description[edit | edit source]
An aneurysm is defined as an increase in the diameter of a vessel compared to normal segments by 50% or more (Merck). This occurs as a result of localized weakening of the arterial wall, and must include all 3 layers (intima, media, and adventitia) of the arterial wall to be considered a true aneurysm (Merck). Aneurysms are most common in the aorta, particularly the abdominal and thoracic regions, but may also affect any part of the vascular system, including lesser arteries and veins (Goodman & Fuller).
Aneurysms are typically defined as fusiform or saccular (Merck), with fusiform aneurysm defined as a widening in the circumference of the artery in a localized area and saccular aneurysm as a localized herniation of the arterial wall (Merck). A dissecting aneurysm may also develop, and is similar to a fusiform aneurysm in that it is a bilateral enlargement of arterial wall, except that there is separation of the layers of the artery (Goodman & Fuller). A pseudoaneurysm is defined as a leaking of blood from the arterial lumen into connective tissue, contained outside of the arterial wall (Merck).
Although an aneurysm may occur in any artery, they are most common in the abdominal and thoracic regions (Merck). The abdominal aorta begins at the aortic hiatus in the diaphragm (approximately T12 vertebral level), and ends at approximately the L4 vertebral level, where it splits into the right and left common iliac arteries (Moore). The abdominal aorta is approximately 13 cm in length (Moore). In the abdominal aorta, the most common location of an AAA is just below the renal arteries (Merck). The most common complications arising from an abdominal aortic aneurysm (AAA) include pain from ischemia, thromboembolism, spontaneous dissection, and rupture of the aneurysm leading to hemorrhage and possible death (Merck).
Prevalence[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
Porter RS, Kaplan JL. The Merck manual of diagnosis and therapy. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2011.
Aggarwal S, Qamar A, Sharma V, Sharma A. Abdominal aortic aneurysm: A comprehensive review. Experimental And Clinical Cardiology [serial on the Internet]. (2011, 2011 Spring), [cited March 24, 2016]; 16(1): 11-15. Available from: MEDLINE.
Moore KL, Agur AMR, Dalley AF, Moore KL. Essential clinical anatomy. Baltimore, MD: Lippincott Williams & Wilkins; 2015.
Miyake T, Morishita R. Pharmacological treatment of abdominal aortic aneurysm. Cardiovascular Research [Internet]. (2009, May 19) [cited March 24, 2016];83(3):436–43. Retrieved from: http://cardiovascres.oxfordjournals.org/content/83/3/436
Goodman CC, Snyder TEK. Differential diagnosis for physical therapists: screening for referral. St. Louis, MO: Saunders/Elsevier; 2013.
Goodman CC, Fuller KS. Pathology: implications for the physical therapist. St. Louis, MO: Saunders/Elsevier; 2009.
Majeed K, Hamer A, White S, Pegg T, Wilkins G, Williams M, et al. Prevalence of abdominal aortic aneurysm in patients referred for transthoracic echocardiography. Internal Medicine Journal [serial on the Internet]. (2015, Jan), [cited March 24, 2016]; 45(1): 32-39 8p. Available from: CINAHL.
Golledge J, Hankey G, Yeap B, Almeida O, Flicker L, Norman P. Reported High Salt Intake Is Associated with Increased Prevalence of Abdominal Aortic Aneurysm and Larger Aortic Diameter in Older Men. Plos ONE [serial on the Internet]. (2014, July), [cited March 24, 2016]; 9(7): 1-6. Available from: Academic Search Complete.
Li X, Zhao G, Zhang J, Duan Z, Xin S. Prevalence and Trends of the Abdominal Aortic Aneurysms Epidemic in General Population - A Meta-Analysis. Plos ONE [serial on the Internet]. (2013, Dec), [cited March 24, 2016]; 8(12): 1-11. Available from: Academic Search Complete.