Aortic Aneurysm

Aortic AneurysmAortic Aneurysm

ByBy

Marcus A. ToddMarcus A. Todd

Who Is At RiskWho Is At Risk

Basketball PlayerBasketball Player

CongressmenCongressmen

Baseball PlayersBaseball Players

Racecar DriversRacecar Drivers

TeachersTeachers

StudentsStudents

ParentsParents

PresidentsPresidents

MillionairesMillionaires

ProfessionalsProfessionals

AortaAorta

Largest artery in the Largest artery in the bodybodyResponsible for Responsible for pumping blood out of pumping blood out of the heartthe heartProjects upward from Projects upward from the heartthe heartThen arches down Then arches down towards the abdomentowards the abdomen

Aneurysm of the AortaAneurysm of the Aorta

A Widening, Bulge or A Widening, Bulge or Ballooning.Ballooning.

Usually a weak spotUsually a weak spot

Expands to at least Expands to at least 1.5 times of normal 1.5 times of normal sizesize

Normal size aprox 1 Normal size aprox 1 inchinch

Types of AneurysmTypes of Aneurysm

But I Felt FineBut I Felt Fine

Characterized by Characterized by degeneration of cellsdegeneration of cells

Tissue is weakTissue is weak

Lacks ElasticityLacks Elasticity

No pain yetNo pain yet

Why? What’s WrongWhy? What’s Wrong

First Indication is First Indication is localized localized enlargementenlargement

When reaches size When reaches size of half inch bigger of half inch bigger then complete then complete aorta, referred to aorta, referred to as an aneurysmas an aneurysm

Aortic tissue might Aortic tissue might tear, even if not tear, even if not enlargedenlargedAorta has two Aorta has two layerslayersInner layer can tear Inner layer can tear and leak between and leak between outer layerouter layerSeparation of Separation of layers called layers called DissectionDissection

DissectionDissection

SurgerySurgery

DissectionDissection

Surgical repairSurgical repair

Uses leg graftUses leg graft

Or graft from other Or graft from other Sources Sources

How Do You KnowHow Do You Know

Discovered in Discovered in different waysdifferent ways

Sometimes pressure Sometimes pressure or painor pain

Routine physicalRoutine physical

Chest X-rayChest X-ray

Often no warning Often no warning symptomssymptoms

Bicuspid Aortic Valve???Bicuspid Aortic Valve???

No Can’t beNo Can’t be

They existThey exist

1 out of every 200 1 out of every 200 aneurysm has itaneurysm has it

Puts you at risk for Puts you at risk for aneurysm or aneurysm or dissectiondissection

OK!! I Have IT, What do I Do.OK!! I Have IT, What do I Do.

Post surgery MRI or CT scan benchmark Post surgery MRI or CT scan benchmark

Annual MRI or CT scan check-up Annual MRI or CT scan check-up

Ongoing blood pressure optimization Ongoing blood pressure optimization

PT/INR monitoring if on the anticoagulant PT/INR monitoring if on the anticoagulant Coumadin Coumadin

Lifestyle recommendationsLifestyle recommendations

MedicationsMedications

ThrombolyticsThrombolytics ContraindicatedContraindicated

HeparinHeparin IndicatedIndicated

Calcium Channel Calcium Channel IndicatedIndicated

Bata BlockersBata Blockers IndicatedIndicated

What If That Does Not WorkWhat If That Does Not Work

Surgery my FriendSurgery my Friend

High risk of deathHigh risk of death

Some Times electiveSome Times elective

Most times emergencyMost times emergency

Risky ProceduresRisky Procedures

Lots of PainLots of Pain

Thoracic Aortic Injury Thoracic Aortic Injury (Trauma)(Trauma)

Rollover of the vehicle Rollover of the vehicle occurs occurs A fatality is involved A fatality is involved A person is ejected A person is ejected from the vehicle from the vehicle The vehicle sustains a The vehicle sustains a dent of more than 12 dent of more than 12 inches inches A prolonged period of A prolonged period of time was required to time was required to extricate the victim extricate the victim from the vehicle from the vehicle

So What Can We As Nurses So What Can We As Nurses Do?Do?

Pt teachingPt teaching Life style changes, Diet, activities, ect.Life style changes, Diet, activities, ect.

Pain managementPain management Meds, breathing techniques, positions, ectMeds, breathing techniques, positions, ect

ObservationObservation Does your Pt look like they hurt?, Rubbing Does your Pt look like they hurt?, Rubbing

their chest? Saying it is only indigestion?their chest? Saying it is only indigestion?

More To DoMore To Do

AssessmentsAssessments All V/S, Demeanor, posture, Pain levelAll V/S, Demeanor, posture, Pain level

Direction to other helpDirection to other help If Pt is not satisfied with info supplied give If Pt is not satisfied with info supplied give

other avenues for helpother avenues for help

Therapeutic communicationTherapeutic communication Look, listen, touch, empathetic Look, listen, touch, empathetic

Need More Info??Need More Info??

Thoracic Aortic Surgery ProgramThoracic Aortic Surgery Program

Cedars-Sinai Medical CenterCedars-Sinai Medical Center

8700 Beverly Blvd., Suite 62158700 Beverly Blvd., Suite 6215

Los Angeles, CA 90048Los Angeles, CA 90048

Phone: 1-800-CEDARS-1 (233-2771)Phone: 1-800-CEDARS-1 (233-2771)

Fax: (310) 423-0127Fax: (310) 423-0127

http://www.csmc.edu/2405.html#aortichttp://www.csmc.edu/2405.html#aortic