Aortic aneurysm - symptoms by type, treatment and operation. Thoracic aortic aneurysm

- pathological local expansion of the main artery, due to the weakness of the walls. Along with the localization of aortic aneurysm, it can manifest itself with pain in the chest or abdomen, in the presence of pulsating swelling, symptoms of compression of susceptible organs: indigestion, cough, dysphonia, dysphagia The basis for the diagnosis of aortic aneurysms is based on radiological (chest x-ray and black empty, Aortography) and ultrasound methods (USG, USS of the thoracic / cranial aorta). Surgical treatment of aneurysms in the transfer of resection to aortic prostheses or closed endoluminal aneurysm prostheses with a special endoprosthesis.

Country houses

Aortic aneurysm is characterized by non-reversible enlargement of the arterial stovbur on the bordering distance. The reduction of aortic aneurysms of the developmental localization is approximately onset: aneurysms of the cranial part of the aorta become 37% of the tumors, the viscid aortic appearance - 23%, the aortic arch - 19%, the decayed appearance of the thoracic aorta - 19.5%. Thus, on the part of aneurysms of the thoracic aorta in cardiology, 2/3 of all pathologies are brought to the top. aneurysms breastfeeding the aorta is often confused with іnshim aortic vads - aortic insufficiency and coarctation of the aorta.

cause

For etiology, all aortic aneurysms can be broken down on an aneurysm and on a nabut. Formation of vomiting aneurysms tied with recessionary ills aortic stinks:

Erdheim syndrome
recessive deficiency in elastin i in.

Addition of aortic aneurysms can cause inflammation and non-fatigue etiology:

post-burn aneurysms there are cases of specific and nonspecific aortitis in case of fungal lesions of the aorta, syphilis, pislyoperative infections.
Non-burning degenerative aneurysms accumulation of atherosclerosis, defects in suture material and aortic prostheses.
Hemodynamic-post-stenotic and traumatic aneurysms tied with mechanical aortic clothes
idiopathic aneurysms develops with aortic necrosis.

Factors for the formation of aortic aneurysms are abductions, patients become, arterial hypertension, tyutyunopalinnya and alcohol malignancy, and spasmodic tightness.

pathogenesis

Besides the defectiveness of the aorta in the form of aneurysms, they take on the role of mechanical and hemodynamic factors. Aneurysms often occur in functionally stressed zones, so they know about the increase in blood flow, the steepness of the pulse rate and form. Chronic traumatization of the aorta, as well as the activity of proteolytic enzymes, is reduced to the destruction of the elastic skeleton and nonspecific degenerative changes in the judgment.

Formed aneurysm of the aorta progressively grow in size, splinters on the її ї step of growth in proportion to the increase in diameter. The blood flow in the aneurismatic mouse is developed and turbulent in nature. At the distal arterial bed, it is less than 45% of the blood to come up close, because it is in the aneurysm. The price is tied up with that, you can drink in aneurismatic emptying, the shelter is straightened out by the bridles of the walls, and the central tendency is streamed by the mechanism of turbulence and the presence in aneurysms of thrombotic masses. The presence of thrombi in empty aneurysms is a factor in the risk of thromboembolism in the distal aortic thrombosis.

Classification

aortic aneurysm
aneurysm of the combined localization - thoracoabdominal part of the aorta.

Assessment of the morphological budov and aortic aneurysms allows for information and injuries (pseudoaneurysm):

aneurysm reference are characterized by vitality and vitality of all types of aorta. For the ethology of reference aortic aneurysms, cause atherosclerotic or syphilic.
pseudoaneurysm... The side of the grave aneurysm is represented by a complete tissue, which was established as a result of the organization of pulsating hematoma; The vascular aortic walls in the form of grave aneurysms are not closed. For walking, they are often traumatic and operative.

Behind the shape, there are mischievous and spindle-like aneurysms of the aorta: persistent are characterized by local vypinnymi of the stinka, others - by diffuse enlargements of the entire diameter of the aorta. In normal adults, the diameter of the viscid aorta should be close to 3 cm, the lower thoracic aorta - 2.5 cm, the cranial aorta - 2 cm.

About urahuvannyam key overrun razr_znyayut inadvertent, accelerated, rasharovyutsya aortic aneurysms. Up to the number of specific accelerated aortic aneurysms, aneurysmal microscopic aneurysm is observed, which is supervised by massive internal bleeding and hematomas; thrombosis of aneurysms and thromboembolism of arteries; phlegmon of nasal tissue in case of aneurysm infection.

A special type is the exfoliating aortic aneurysm, if through the opening of the inner membrane of the roof it penetrates through the balls of the artery and expands under the grip along the course of the judgment, gradually exfoliating it.

Symptoms of aortic aneurysms

Clinically, manifest aortic aneurysm variably and enrichment with localization, size of aneurysmal mouse, its length, ethiological incapacitation. Aneurysms can be asymptomatic or superficially symptomatic and appear on prophylactic examinations. It serves as a provincial manifestation, amazed by the change of the aorta, її stretching and compression syndrome.

Aneurysm of the cranial aorta

The clinker of aneurysms of the cranial aorta is manifested by passing or persistent diffuse pains, discomfort in the abdominal area, discomfort, vagina in the epigastric state, the appearance of a reapplication of the slurry, tediousness, bloating, dysfunction. Symptoms may be associated with the compression of the cardiac cavity of the slunk, 12-palate intestine, and the results of the visceral arteries. Often ailments spontaneously begin to manifest the strength of the pulsation in the stomach. On palpation, there is stress, cramped, sickly pulsating illumination.

Thoracic aortic aneurysm

For aneurysms of the visceral aortic arteries, such as pain in the area of the heart or behind the sternum, or for enlargement of the pressure or stenosis of the ventricular arteries. Patients with aortic lack of turbulence, tachycardia, spoiled. Aneurysms of great razmіrіv vklikayut development of the syndrome of the upper void vein with headaches upper half tuluba.

Aneurysm of the aortic arch should be made to compress the travoductus with the manifestations of dysphagia; at the same time rotary nerve vinikє hoarse voice (dysphonia), dry cough; The bladder nerve is superimposed on bradycardia and slug. With compression of the trachea and bronchial tubes, the backward and stridorous behavior develop; suppressed root of the lung- congestion and part of pneumonia.

In case of aneurysm of the lower aortic periaortal sympathetic gossip, there is pain in the left hand and shoulder. In case of occurrence of intercostal arteries, ischemia of the spinal cord, paraparesis and paraplegia can develop. Compression of ridges supervises over usuratsy, degeneration and substitutions for the form of kyphosis. Depression of the vessels and nerves is clinically manifested by radicular and intercostal neuralgia.

accelerating

Aortic aneurysms can be accelerated with the development of massive bleeding, collapse, shock and heart failure. Having buried aneurysms, you can enter the system of the upper empty vein, pericardial and pleural emptying, Stravohid, black empty. When a lot of important things develop, in an hour I will fatally - a syndrome of the upper empty vein, hemopericardium, tamponade of the heart, hemothorax, Legeneva, shlunkovo-intestinal or bleeding in a black vein.

With the release of thrombotic masses from aneurismatic emptying, a picture of the state of the occlusion of the symptoms develops: cyanosis and painfulness of the toes, livelihood on the skin of children, weight. In case of thrombosis of nirkovy arteries, vascular renovascular arterial hypertension and nirkoval deficiency; with severe cerebral arteries - stroke.

diagnostics

Diagnostic joke for aortic aneurysms includes an assessment of sub-active and active data, radiological, ultrasound and tomography tests. The auscultatory sign of aneurysms is the presence of systolic murmur in the projection of aortic enlargement. Aneurysms of the cranial aorta appear at palpation of the abdomen in a puffy pulsating light. Instrumental diagnostics:

X-ray. We plan rentgenologіchnogo obstezhennya patsієntіv of aneurysms of the aorta grudnoї abo cherevnoї vklyuchaєtsya rentgenoskopіya i rentgenografіya grudnoї klіtki, oglyadova rentgenografіya cherevnoї porozhnini, rentgenografіya stravohodu i zheludka.Na zaklyuchnomu etapі obstezhennya vikonuyut aortografіyu for danimi yakoї utochnyuyutsya lokalіzatsіya, rozmіri, protyazhnіst aortic aneurysm that її representations to susceptible to anatomical structures.
SPL. With the development of aneurysms of the viscid aortic appearance, echocardiography is observed; in other vipads, ultrasound (ultrasound) of the thoracic / cranial aorta is performed.
Computer tomography. CT (MSCT) of the thoracic / cranial aorta allows precisely and on purpose to reveal aneurysmal enlargement, to reveal the appearance of enlargement and thrombotic masses, para-aortic hematomy, and calcification.

Based on the results of the complex instrumental conditioning, the decision is taken to show up to the operative treatment. Aneurysm of the thoracic aorta followed by differentiation from pukhlin legends and middle; aneurysm of the cranial aorta - from the common diagnosis of black emptying, the reduction of lymph nodes in the breech, and in the womb.

Treatment of aortic aneurysms

In case of asymptomatic non-progressive interruption of aortic aneurysms, a dynamic visualization of the forensic surgery and radiological control should be used. For lowering riziku happy carried out hypotensive and anticoagulant therapy, lowering the level of cholesterol.

It is promptly indicated for aneurysms of the cranial aorta with a diameter of more than 4 cm; aneurysms of the thoracic aorta with a diameter of 5.5-6.0 cm, or if the aneurysms are smaller, the size is larger by 0.5 cm per period. When developing aortic aneurysms, it is indicated to an extreme surgical intervention in absolute terms.

In case of hemodynamically significant aortic insufficiency of resection of the viscid thoracic aorta, use the aortic valve prostheses. Endovascular prosthetics of aortic aneurysms with stent placement serve as an alternative to the incontinence of the aortic aneurysm.

Forecast and prevention

The prognosis of aortic aneurysms, head-on, is indicated by changes in atherosclerotic lesions of the cardiovascular system. In general, natural plin aneurysms are unpleasant and are associated with a high risk of death from the development of aorta and thromboembolic acceleration. The incidence of cutting aortic aneurysms with a diameter of 6 and over cm becomes 50% per pik, of a lesser diameter - 20% per pik. Early detection and planning surgical treatment aortic aneurysm was proved to have low intraoperative (5%) mortality and good results.

Preventive recommendations include the control of the arterial grip, organizing the correct way of life, regularly advising a cardiologist and angiohirurg, medication therapy for supportive pathology. Individuals from the group on the development of aortic aneurysms are screened by ultrasound.

The aortic aneurysm was taken to be nazivati, having established itself in n_y enlightenment, which changes the normal diameter of the sudin two times (and more). A defect appears as a result of the ruining of elastic fibers (filaments) of the central shell, as a result of which there is a lot of fibrous tissue to be pushed up, thus expanding the diameter of the blades and bringing them to the springs. In the world of development of aortic aneurysms, development of aortic aneurysms

Classification of aortic aneurysms

In the surgery, there are a few classifications of aortic aneurysms: in the presence of aortic aneurysm, the location of the segments, the nature of the clinical transition, the structure of the aneurysmal mouse and the form.

For the localization of the onset of the type of aortic aneurysm of the thoracic viddil:

aneurysm of the viscous aortic artery;
sinus Valsalvi;
arc areas;
the lowest part;
cranial and thoracic viddiliv.

It means that the diameter of the viscous aorta in the norm is guilty of folding close to 3 cm, and the lower aorta - 2, 5. The cherevna aorta, in its own devil, is guilty of not more than 2 cm. razi.

For localization of aneurysms of the cranial cavity of the aorta, it is possible to develop:

suprarental aneurysms (to lie up to the upper part of the cranial aorta with vyhidnye hilkami);
Infrarenal aortic aneurysm
total.

Here are some of the following:

aneurysms of the podbanі (non-inflammatory, fiery character, Idiopathic);
like.

Classification of aneurysms by form:

Mishechkuvati - presented in the viglyad of the interlaced type of wall (not borrowing and half of the aortic diameter);
pidrozdіlyayutsya on clubs, bichni, which expand and descend into the pelvic area of the artery;
spindle-like aneurysm of the aorta - vinikє as a result of stretching of the aortic scaffold over the whole cola or part of the segment;

For the structure of the mouse, aneurysms are developed:

pomilkov aortic aneurysm, or a pseudoaneurysm (the stink of the cicatricial tissue).
true (budova such aneurysms make up the structure of the self).

Regularly from the keynote perebigu look:

dissecting aortic aneurysm;
asymptomatic aneurysm;
accelerated;
typical.

Under the term “aneurysm has been slowed down”, we rely on respect for the development of the bear, which, as a rule, is supervised by clear internal bleeding and further confirmed hematomas. Not included in the given situation and thrombosis of aneurysms, which are characterized by increased reliance on blood flow.

One of the most unsafe manifestations is the artery aneurysm. In this vypadku through the lumen at the inner shell to pass through the roof, which penetrates between the balls of the aortic stems and grows along the vessels under the pouring vice. In addition, the development of aortic aneurysms is observed during the process.

Is it necessary to know about aortic aneurysms?

As it was said earlier, all aneurysms go on and on. The development of the first is characterized by aortic aortic ailments of a decaying nature (fibrous dysplasia, Marfan syndrome, Ehlers-Danlos syndrome, congenital wadi elastin and Erdheim's syndrome).

Aneurysms of an unsettled character are diagnosed for a long time ignition processes, Caused by specific (syphilis, tuberculosis) and nonspecific aortitis ( streptococcal infectionі rheumatic fever), And also as a result of fungal infections and infections, prompt engagement.

If there are non-inflammatory aneurysms, then the main reasons for the diagnosis are atherosclerosis, the transfer of prosthetics and defects, which are accepted by the application of seams.

The core of the aortic system. This type of aneurysm is traumatic in nature.

Do not go without respect і vіk people, the manifestation of arterial hypertension, sinister alcoholic beverages, Kurinnya. In this case, the development of Sudin aneurysms is also great.

Description of cranial aortic aneurysms

Aneurysm of the celiac aorta is most often diagnosed in people older than 60 years. Especially, the development of the development of the disease grows with regular promotion arterial viseі kurnnі.

Aneurysm of the cranial aorta is manifested in the eyes of dull, numb and stepwise growing pains in the abdomen. Inadvertently, as a rule, they are seen from the navel and from the back, from across. When such symptoms appear, it turns to a lykarya, in which aneurysms of the cranial aorta can open up.

Before indirect symptoms occur:

loss of waste at vase;
haircut;
constipate, scho trivayut up to 3 days;
ruinous sechovipuskannya;
attack nirkovo coli;
ruinous destruction in pictures.

Also, in case of a celiac aneurysm, there can be problems with running through impaired blood circulation.

Thoracic aortic aneurysm. describe the affliction

In case of aneurysm of the visceral aortic appearance, the patient is screeching for severe pain behind the breastbone and in the heart. If it is enlightened in the meaning of the world, then it is clear that it is empty upper veni For a reason, there can be a lot of problems on the faces, hands, shia, as well as mіgren.

Aneurysm of the aortic arch is often symptomatic. It is localized in the area of the shoulder blades and behind the sternum. The aneurysm of the aorta of the thoracic viddilu without the middle is tied to the pressurized organs of the organs.

With tsom:

there will be a strong grip on the stravohid, through which the covtal process and bleeding will break down;
ailments vidchuvaє zadishku;
to prevent sleepiness and bradycardia;
Vital nerve damage is characterized by a dry cough and the appearance of hoarseness in the voice.

When the cardial part of the slunk is squeezed, there are pains in the 12-palate intestine, nudota, ryasna bloating, inappropriate views into the shlunk, cutting.

Aneurysm of the lower aorta is accompanied by severe pain in the area of the chest wall, back pain, anemia and cough.

Kudi to hide and how to get sick?

Aortic aneurysm of the heart is diagnosed with additional decile methods. One of the most victorious is radiography. The procedure is carried out in 3 steps. The head with a good X-ray is more visual to the education of the stravohode. On the sign of aneurysms of the low form of the artery, they appear in the lung.

Slid it means that in most ailments there will appear a little less favor to the stravohod. The solution is to sposter calcification - the local purchase of calcium from the salts in the aneurismatic bag.

If one suffers from cranial aneurysms, then in this case, X-ray diffraction shows the manifestation of calcification and Shmorl's grizzly.

It is more important to diagnose aneurysms with ultrasound of the aortic heart. Before it is allowed to develop the size of the viscous prospect, the deciduous, as well as the aortic arch, the cranial capillaries. The ultrasound scan will show the body of blood-bearing vessels, which can enter the aorta, as well as changes in the area of the wall.

CT scan is also known to have been diagnosed as aneurysms and cause aneurysms of the cranial artery.

The incidence of dissection of aortic aneurysms with sizes less than 5 cm is minimal. Called in such a way to fall ill to seek additional medications, as they become stagnant for the therapy of a high arterial grip. Beta blockers are introduced before them. Such preparations will speed up the strength of the heart very quickly, change the strength and bring the grip back to normal.

Likewise, you can prescribe drugs to eliminate high levels of cholesterol. It has been reported that the stink of changing the risk of lethal result and attack and insult has been reported.

As soon as the aneurysm reached the size of 5 cm, then the doctor, better for everything, to recognize the operation, so as to determine the correct operation, as well as the diagnosis of thrombosis. Surgery for visible aneurysms and prosthetic repairs and localization.

As soon as the doctor has revealed an aortic aneurysm, then, better for everything, I will recommend to radically remember the zvichny way of life. For the cob slid shkіdlivyh ringtone, Zokrem: kurinnya and vzhivannya of alcoholic beverages.

Prevention of aortic aneurysms in polygons in implanted products, corny for the heart (kiv, sauerkraut, citrus) and in physicists, they have the right to increase the frequency of hearts.

symptoms

Symptoms of the cranial aortic aneurysm

Most often such pathology is found in the black empty. I was sick before getting sick in the main burning of people from 60 years of age. In foldable vipads, multiple aneurysms of the cranial viddyla of the aorta are established. Symptoms in the most vipad flare.

Well, you can see a patient when you vipinnya the walls of the dish, the abdomen, lock up and straighten out the persecution, lowering the vagina. With great sizes of aneurysms, it is possible to form an epigastric pulse with pulsating illumination.

If the expanded embossing on the navkolishny nerves and fabrics, there may be embellishments, ruining the functions of the secular paths and creating paresis nig. Alle most often, with aneurysm of the cranial aorta, the first signal is to attack the pain. They occur unsupported, often extend across the groin or legs. Bіl triva kіlka years and disgustingly let it flow in lіkіv. If aneurysms are inflamed, the temperature may rise. In some cases, the fingers are blue and cold.

Thoracic aortic aneurysm symptoms

Most of the diagnostics of the disease, as well as the enlargement of the judgment is localized in the area of the aortic arch. Symptoms when there are more turns.

It is most common for patients to skip for small throbbing pains in the chest and back. Falsely, the aortic enlargement can be seen in the shoulder, or in the upper abdomen. Moreover, extravagant antibiotic drugs do not help children.

It also helps to develop a dry cough and aneurysm embossed on the bronchi. Inodi expansion of the court is embossed on the nerves of the core. That is, it seems to be a bit chilly and hoarse.

Protodiastolic murmur is often observed through the enlargement of the aorta and the control of the bloodstream in case of aneurysm of the viscous aortic cavity.

With a large aneurysm, enlargement can be seen with visual inspection. There is a small pulsating fluff in the sternum area. You can also swell the veins in the shia.

Symptoms of aortic aneurysms

The pathology of the artery in the whole of the world may not manifest itself for a trivial hour. Ailments are infrequent in the heart, which are known by the pills. Some of the symptoms are: stuntedness, coughing, and poor motility, which may also be due to heart failure. Often the disease is diagnosed to be deprived of a strong attack of angina pectoris during the EKG.

Symptoms of aortic aneurysms in the brain

Expansion of small sizes does not show itself to itself. Mothers may have a headache, or with similar symptoms of a patient's symptoms, they can quickly turn into a drug. It is possible to get sick with a great aneurysm, if it is embossed on navkolishny nerves and fabrics. With a wide range of illnesses, these are the views:

the pain is localized not only in the head, but in the apples;

you can make a cloudy dawn;

Inodi evolve at the expense of the sensitiveness of the shkiri of denunciations.

Signs of a rosharuvannya or aneurysm development

In the case of a bagatech of illnesses, it is diagnosed as soon as it appears. In the case of great spindle-like enlargements, aneurysms grow wider. This is also part of the bush in the cranial viddili of the aorta. Small miserable aneurysms with increased blood pressure may develop. How many symptoms are spontaneous with such acceleration?

Persha sign - tse sharp bile... Vona is bottled step by step from one moment on all heads or on a black empty. In case of aneurysms of the thoracic appearance, it is often taken for the manifestation of an infarction.

The patient's squeeze will drop sharply. Spostering signs of a shock: I’m a little boy, engrossed in anxiety, not responding to food, starting to get lost.

Aneurysms can be discovered by a sick person at any moment. At the time of the daily medical assistance, the death of the patient often ends. To that, be it the loss of self-esteem and troublesome symptoms of innocence, be lost without respect.

diagnostics

How to develop an aortic aneurysm, how can it develop asymptomatically in a number of cases, and appear as if it is normal, or if it’s rosted, but not if it’s a cause of death? Deyaki vipadki mayut specific signs aneurysms of the aorta and produce to all sorts of slowdowns, so to clutter up the life of people. Danes become ill most often spasmed from people who have been kidnapped. Cyclic pathologies of the vertebral column, hypertension and impaired metabolism.

There are two types of aneurysms that develop in the body of people:

Aneurysm of the thoracic aorta - located in the thoracic cavity;
Aneurysm of the cranial aorta - to be found in the crank empty.

The development of aneurysms depends on their shape, parameters and obvious acceleration. Signs of aortic aneurysms surgical engagement... Decreased internal bleeding in 2 drops from 5 to a fatal result.

diagnostics

Diagnosis of aortic aneurysms is important for several reasons:

Signs of aortic aneurysm do not appear;
Symptoms for those with illnesses (for example, cough and discomfort in the chest cavity are more likely to occur in patients with illnesses); Pathology is rarely learned in lykarsk practice.

If the sign of illness is evident, it is necessary to consult a therapist or a cardiologist. stink first glance, The results of which are considered rigorous. The diagnosis of aortic aneurysm is often confirmed when the diagnosis is carried out.

How to diagnose aortic aneurysm?

Diagnostics of aortic aneurysms

A physical look to serve for the collection of the first tributes (skarg) without the collection of folding methods. Diagnostics of aortic aneurysms in polyagus in a callous survey, percussion (prostokuvannya), palpation (promising), auscultation (hearing with a stethoscope) and vimiri vise. pislya viyavlennya characteristic signs indicate a further diagnosis of aortic aneurysms;
X-ray showing the internal organisms of the breasts and abdomen. On the sign of the good one can see the vipinnya of the aortic arch or її zbіlshennya. To reveal the parameters of aneurysms, a contrasting tongue is inserted into the vessel. Through the care and trauma of such a diagnosis of aortic aneurysms, it is designated for special indicators;
Electrocardiography is used to determine the activity of the heart meat. EKG aneurysms aorta can also help to recognize ailments from ischemic ailments of the heart. With atherosclerosis, a servant causing aneurysm formation, suffers from coronary artery disease, which may cause an infarction. How to find aortic aneurysm? On the cardiogram, it is possible to show specific signs of aortic aneurysms, the type of pathology of the heart-vascular system;
Magnetic resonance and computer tomography give the possibility of all the necessary parameters of aneurysms - growth, size, shape and size of the dishes. Pathognomonic CT-signs of aortic aneurysms are shown to increase the size of the wall and expand the education of the judge. At the beginning of the meeting mozhlive lykuvannya;
Ultrasound dosage- Ultrasound examination of aneurysms of the cranial aorta є one of the advanced diagnostic methods. Vono additionally helps to increase the fluidity of the blood flow and the apparent vorticity, swirling of the judgment;
Laboratory analyzes include laboratory and biochemical analysis of blood, as well as slaughter. How can you diagnose aortic aneurysm by analysis? They have such signs of aortic aneurysms: chronic form Infectious ailments, as a result of aortic aneurysms. It also helps to increase the number of non-segmented neutrophils. The improvement of the laryngeal blood is manifested in the presence of an increase in the level of platelets, changes in the factors of the larynx and in the case of the formation of blood clots in empty aneurysms. A high level of cholesterol shows the appearance of atherosclerotic plaques in the vessel. In the analysis of this, there may be a small amount of blood.

Pererakhovani signs of aortic aneurysms are not characteristic symptoms of the disease and do not appear in all patients.

lykuvannya

When carrying out diagnostic tests and diagnostics of "aortic aneurysm", there are several options for the development of the pod. One of the options can be dynamically cautious in a forensic surgeon, and one of them is without a priori treatment of aortic aneurysms.

Dynamically cautious and roentgenologic dosage is shown to be less than that, if the disease is asymptomatic and non-progressive, aneurysm of small size (up to 1-2 cm). As a rule, such a diagnosis is made as a result of passing the medical committee or a medical look at the robot. Such a motive may be deprived of the reason for the persistent caution and prophylaxis of young accelerated patients (antihypertensive and anticoagulant therapy). Drug treatment aortic aneurysms do not get stagnant through the appearance of effective specific drugs.

Hoch i Je deyakі vislovlyuvannya about efektivnіst sibіrskih herbal infusions that rіznih kropovogo Lots Other in lіkuvannі aneurysms lіkuvannya folk zasobami, yak i ranіshe zalishaєtsya absolutely neefektivnim nedovedenim i, i Mauger zastosovuvatisya Abo protsesі pіslyaoperatsіynoї reabіlіtatsії, Abo yak netraditsіyny method nespetsifіchnoї profіlaktiki. Before such procedures

Only surgical involvement is shown in the last vipads.

If there is no surgical treatment?

Prototypes shown before operation є:

State of impairment of coronary blood circulation - a history of infarctions, which appear on the EHC for the last three months;
The state of impairment of cerebral blood circulation with the appearance of neurological symptoms - insult and post-insult;
Evidence of mental deficiency or active tuberculosis,
Reveal of nirkovo lack of, and moreover, it is accustomed, so it is obvious.
Svidoma vidmova people and hope vilikuvatisya without operation.

Surgical solutions to achieve profitably and without mediocrity due to the type of aneurysm, localization, the possibilities of a cardiological hospital and the center of quality of a forensic surgeon. At the same time, scho techniques to complete the bagato (it is written about them below), the skin patient with an aneurysm before the operation will take away the preoperative training. Vona polyagaє in the offensive: approximately 20-24 years before the operation, conduct specific antibiotic therapy, sensitive to staphylococci and intestinal sticks. Also, before the operation, the patient has gone out of the way of food and nothing is left for 10-12 years before the operation.

Regularly from localization to see:

aneurysm without anterior aortic arch (coming out of the empty heart), thoracoabdominal aortic aneurysms,
viscid aneurysm
aortic aneurysm Operation of aortic aneurysms, or, more precisely, the technique of carrying out, without predominantly lying in the form of an aneurysm of the aortic class.

Treatment of aneurysms of the thoracic and viscid aorta.

Surgical treatment of ailments with aneurysm of the thoracic aorta and viscid symptoms are susceptible to:

Radical involvement - at the end of them, edge resection and resection of aneurismatic emptying with replacement of a prosthesis from synthetic materials are stuck.
Paliativnі - grasping the thoracic aortic opening with a prosthesis. Such an operation is performed only in quiet areas, as it is not possible to perform a radical operation and when it comes to risky aneurysms.

It might mean that an extraordinary operation is to be seen in that case, that it is necessary to treat aortic aneurysms, and terminov - in case of slowed down aneurysms by melena, pain syndrome and the appearance of hemoptysis.

Craiova radical resection is performed in case of mishkuvati (mishkopodibny) aneurysms and if you borrow a third of the aortic radius. The essence of such an operation is in the resection and in the visualization of the aneurysm and suturing of the aortic wall with sutures in the two surfaces of the clock to fix the local blood flow.

Tangential resection does not transfer blood flow through the aorta - in the same surgical technique as well.

Radical resection of endoprosthetics appears to be in that case, as the aneurysm is spindle-like and loses more than a third or half of the circumference of the aorta.

The technique, in principle, does not take the form of a marginal resection for the blame of the moment when an endoprosthesis is installed on the site of a resected aneurysm - after the implantation of the prosthesis, the blood is included in the prosthesis and as a result of adequate progression.

The operation of aneurysms of the viscid aortic viddyla is carried out either simultaneously, or because of the lack of the aortic valve. During one-stage operation, up to one endoprosthesis is fitted with a biomechanical aortic valve. In cases where the aortic insufficiency is mute and only the viscous aorta is observed, special fragmentation of the prosthesis with rigid (static) frames is fixed, so it is called the combination of the prosthesis. The essence of such a method of polyagi is that the rosette in the aorta of such explants is carried out to the inevitable edges of the aorta and is fixed with specific measures. Then, over the implanted endoprosthesis, the aortic staple is sutured tightly. Perevaga її in that such a technique allows to speed up an hour of blood flow through the main vessels by 25-30 khvili.

Treatment of aneurysms of the cranial aorta.

Surgical treatment of aneurysms of the cranial aorta is stagnant with aneurysmatic enlargement of the aorta twice as low, or with a diameter of 4 cm.

Preoperative preparation, in addition to the main stages, including the general correction of abnormal pathologies, which can accelerate the surgical treatment (atherosclerosis, arterial hypertension, instability of the angina pectoris) Infrarenal aneurysms are operated from the middle laparotomic approach, with suprarenal and total stagnation left-sided thoracophrenolumbotomy laparotomy along the ninth intercostal space. The operation can be carried out behind the decilcom by methods:

The aneurysm is resected and a little shock is seen, and then aortic prosthesis is violated, or bypass.
The aneurysm is resected, a little mischief is not seen, and a prosthesis is placed on the first place or a shunt is placed.
Endoprosthetics for aneurysms of the cranial aorta: endoprosthesis is installed on the frameworks (it can be fitted with or without resection of aneurysms).
Stenting of aortic aneurysms is stagnant in case of advanced surgery and rapid development of surgery. The essence of such an operation is in the setting of an anesthesia in an open stand, which can open up to an aneurismatic mouse, and by itself is involved in the bloodstream.

For the operation of aneurysms of the cranial aorta, the patients are shown reabilitation in the fallowness as a result of the "malice" process, as well as in the course of diagnostics and elimination of the delayed procedure, and the need for an operative engagement in the out-of-the-box stand. In the main rehabilitation of the field in correct eating, Vidmovu from a shkidlivy call, a healthy way of life and an inner physical life.

Among the most frequent localizations of aneurysms, there is another form: aneurysm of the aortic heart. Treatment with such localization is shown as a rule of thumb in cases of aneurysmal enlargement of 6 cm, conservative therapy and active progressive process.

In vipads, if there is a lack of a mitral valve in the order of the aortic aneurysm, MK plastic is performed. In case of aortic aneurysms with such background diseases, the mitral valve pid gallant anesthesia replace with a piece implant. Such operations are carried out on the basis of a piece of blood circulation apparatus for the operation of a heart meat robot.

liks

Medicinal ailments do not get rid of, ale є prophylaxis and rehabilitation of the operation. Yakis vitamins, drugs are taken. Write about tse. The development of the process to the treatment through the operation.

People zasobi

Treatment of aortic aneurysms for the help of folk

In case of aortic enlargement and aneurysm development, no surgical intervention is necessary. on early stage sickness, as well as against, without the needless acceleration, effective prevention and treatment of aneurysms of the cranial aorta by folk methods.

Effective people

Normalize self-esteem for people and make blood-bearing judges more helpful folk aortic aneurysms. Herbal infusions are even more effective and tonic.

Glid is the most affordable and efficient. More than a long time ago, people have seen the power of the Roslin community. Fruits and leaves to take revenge on helpless important vitamins, important metal that іnshe). Most effective glid in case of heart failure. Now and again, help polish the blood circulation, normalize the grip. To prepare a simple liqueur infusion, it is necessary to add dry berries to the gall (4 tablespoons), pour sprinkles (3 bottles) and infuse it.
Anastasia Kalini is an anti-fiery power, struggling with bad luck, as well as cinnamon for spasms of sudin and hypertension. The fruit of the flower of the Roslin is to avenge the majesty of Vitamin S, which is necessary for the body, especially, before the hour is getting sick. To that, with such a ruptured, like an aneurysm of the cranial aorta, likuvannya folk zobov'yazkovo can include a whole miraculous nastіy. Zvychano well, viburnum is not a panacea, ale for complex treatment Bring me just some cinnamon. To prepare an infusion of dry berries, pour sprinkles and insist 3, 5 years.
Cleanliness - good additional help when struggling with the most common cause of the development of aneurysms - atherosclerosis. Leaves, stems and branches of the growing line hang, and then napolyagayut on sprinkles. Recommended vipivati 50 grams infusion.
Nastiy kropu є not less brown. Cryp with a low grip, assimilating the head beat and beneficially pouring into the heart of the robot. For infusion, you can vikoristovuvat і grass, and nasinnya. 1 tbsp pour sprinkle on the crop (about 200 ml) and infuse for a year. The treatment of aortic aneurysms by folk remedies requires a healthy way of life and a balanced attitude. Slid unique physical, as well as psychological navantages.

Before you start working with a doctor, you need to take a consultation with a doctor.

The information should be pre-eminent in nature and not critical to the point of departure. Do not indulge in self-abuse. At the first symptoms of a disease, it turns to a lykar.

Andriy Mironov, Zhenya Belousov, Albert Einstein, Charles de Gaulle ... Who got all of these people? Їх ob'єdnav tragic final: dissection of aortic aneurysms. Tse zhvoryuvannya can be called "a bomb from the old-fashioned mechanizm". And, unfortunately, its efficiency is unhealthy growth. Over the last quarter of a century, the frequency of growth has grown more than 6 times.

With "planned" roztinov, aortic aneurysms of the developmental localization appear in 7% of people who have died from their ailments. As soon as the diagnosis is made, more than 50 thousand people are shown in the whole world. At the same time, if you are responsible for the judgment of the surgeons, to carry out all the screening procedures, then the patients in the country are three more.

Aneurysm of the aorta nagato is not safe, less insult. To go to the USA, in the country with advanced medicine, as a result of the aortic diseases of more than 15 thousand people, half of them - before the arrival of the "great help". Aortic aneurysm is a tenth of all causes of death in a kidnapped person.

Aneurysm should not be buried in diameter. So, with a diameter of close to 4 cm, the mortality rate becomes 5% in ric, and if the diameter of the increase is up to 9 cm, the mortality rate increases to 80% in ric. Years of life will soon give up the funeral bell ...

A quick transition on the road

What kind of ailment?

I will write an "optimistic" entry, cognizable from the nearest aneurysm. So tse take?

Aneurysm (aneurysmal enlargement) is a price for the judgment of the judgment, in order to save all the verdicts. In the case of do-it-yourselfers, it will be necessary to locally change the diameter of the court until it is expanded.

Aneurysms can be found in the vessels, be it a caliber, ale only in arteries, splinters of a court of elastic type. In the veins (vines of the mnіsny type) the grip is lower, and the vipinnya does not form.

Oskіlki aorta є the head of a human body, then іsicum of aneurysms, the most stretching of the judgment.

Main reasons for development

Vіk є a factor in the development of aneurysms, as well as atherosclerosis, more precisely, atherosclerotic plaques. Krym them, all the sickness, as groaning of the shipwreck, to produce up to її vipinnyya.

Until such a disease, it is trivial to carry diabet And also syphilis, which is a specific type of infection - syphilic mesaortitis.

It was an hour that the tribute appeared, that in case of aneurysms I take care of the fate of herpes infection. Hypertensive ailmentє to finish with a strong factor of riziku.

But nevertheless, in the overwhelming number of vipads, atherosclerosis is atherosclerosis and high numbers "Filthy" cholesterol... Control of the level of cholesterol of the skin Lyudina is healthy is guilty of repairing 45 years.

An important factor on the offensive is the price. Tyutyun vzagali douzhe pouring into the judgment. Win can provoke the development of varicose veins, thrombophlebitis, regional endorsement. She has a trivial experience in the treatment of aortic aneurysms.

According to the data of authoritative medical journals, a nonsmoking cholovik will die of aneurysms by up to five times less, and not a chick with experience. If there are 100 patients with a size of aneurysms greater than 4 cm and more, then it will appear, but only 25 of them are not fired. Naturally, risik grows due to the experience of smoking, and due to the number of cigarette smokers.

Classification

The aorta is the one who found the vessel of our body. We will not describe the topography of the aorta and її gilok, it’s not necessary. Say, just, now, if you fix it from the lynch, you’ll start and turn around, making an arc.

At the top of their points of view, the head is up to the head, then turn around, setting the chest up. We'll enjoy the triplet crank aorta to join two great clubs of arteries.

On its own the face of aneurysms can be found in different parts of the country:

Aneurysm of the cranial aorta - more than 95% of all types.
Thoracic aortic aneurysm.
Aneurysm of the aortic arch.

Besides, there may be aneurysm of the heart (myocardial vascularity), and in the backward structures of mortality it is more significant to develop aneurysms in the brain, but the stench is not the subject of this statute.

Why is the black aorta "taking over all the time"? The one who finds it, as well as the one who is closer to nig. And the legs, as it were, didn’t just get venous thrombosis, but it’s more often that there are judgmental processes and illness, for example, regional endorsement.

Symptoms of aortic aneurysms are always visible. Itself in tsom and є the accessibility of the disease. Smell s'yavayutsya only todі, if the aneurysm has become majestic. The whole catastrophe is going to be ripped off.

How many symptoms are there in the presence of significant aneurysms? All the symptomatology is a central sign of the huddle of cymbals by "blowing up a little" of the suspension structures.

Aortic arch aneurysm

Symptoms of malaria, in connection with the manifestation of a great number of structures:

vinikє pulsating beat in the breasts, or behind the breastbone, as it can be seen in the back;
with a compression of the trachea and bronchial tubes, a dry, painful cough, with a change in education dikhalnyh nobles- zadishka;
when it is detected in the process of the rotary throat nerve, the hoarseness of the voice is pronounced;
If the aneurysm has squeezed the upper empty vein, then there will be swelling and blue discoloration, the veins will swell, the symptoms will swell and there will be symptoms of internal cranial hypertension: head bill, Lowered Zoru;
when compressing the stravohode, it can be difficult to cope with it;
If there is a nice nerve, then Horner's syndrome (ptosis, myosis, enophthalmos) will develop on the side of the depression, so that upper vernacular, Post-zvuzhennya zinitsi and change (zapadannya) full-time apple.

Signs of a thoracic aortic aneurysm

Inodi is a sign of aneurysms that do not burst right up to breakup. Ale, in the presence of localization in the chest, there are:

strong beat mіzh shoulder blades і in the breasts, pulsing;
parts of the burning of legends when compressing їх ідділів;
showing bradycardia;
when compressing sudin spinal cord Potent development of long-term symptoms - parallel and paresis in the legs, lack of sensitivity, non-triviality;

Symptoms of a cranial aortic aneurysm

A cranial aortic aneurysm often presents with abdominal pain. Before the speech, do people somehow seem to form food like "empty empty aneurysm?" It is recommended to see an anatomical handler, to see the aorta, to lie retroperitoneally, and to lie in the black empty space.

In addition to pain in the abdomen, symptoms of aneurysms can be:

pulsation in the stomach, for a bit "rocking";
with a compression of the 12th intestine, the symptoms may be clear: abortion, nudity and bloating;
at the compression of the sequel, there is a congestion of the slaughter in the misci, the development of pyelonephritis, the development of dysuria;
in case of compression of nerve roots of the disease, simulation of "chondrosis" with pain across;
nareshty, vinikє chronic lack of blood circulation in the legs, weight, loss of trophism (cold shkiri, hair loss, lameness of nigtiv).

It can be seen that the symptomatology of aortic aneurysms in different cases is even worse than the bagata, and it can be entered by an unsettled diagnostic route of the patient. Happily, the diagnosis of aneurysms, with the emergence of visualization methods before the diagnosis (ultrasound, CT, MRI), has already lagged.

diagnostics

As soon as the lamented lamented their heads, now three simple crocs are enough:

Carrying out ultrasound examination of the heart and empty empty;
Conducting MRI of empty breast organs with contrast;
To clarify the diagnosis - aortography (angiography).

All. The price can be changed for a day. Singingly, aneurysm of the aorta is a single disease, as it is so easy to diagnose with such a problem.

Varto only has an uncomfortable pulsation, pulsating pain - it is necessary to go to the ultrasound scan.

In terms of screening, it is necessary to generate ultrasound of sleep arteries: if there are significant atherosclerotic plaques, it means that it can be posed in the aorta.

Food was transferred, and all of the abnormalities of the aneurysm are so microscopic, as in the main stovbury of the aorta. Tse is far from the case. Є aortic aneurysm. With a great number of sources, the inner ball of the judge appears, and the roof under the great grip "inflates the swarm", which is getting bigger and bigger. With a tsiomu vinikє episodic pain.

Characteristically, it is not possible to lie down from the position of the body, but only from the arterial vise. Chim vishche, tim boluchishe.

As the process is triple, and dissection (development) of the aorta stinks grows, then the pain grows strong when attacked, and then weakens, as the grip in the "swarm" is smaller, as a result of the increase.

Nadal win attack guest ischemia in quiet organs, which suffer from unstable blood during dissection. Mossy infarction of nirok, intestines, insult and a lot of important acceleration.

In some cases, with a rosary aneurysm of the thoracic aorta, it may not be possible to cleanse the blood of the heart itself, and there is no important infarction.

The tragic final of the dissection is a recession, with the appearance of profuse bleeding, a blistering development of a hemorrhagic shock, a development of a severe heart - a verdict and multiple organ failure and death by holding out a drop of khilin.

Treatment of aortic aneurysms - drugs and surgery

Treatment of aortic aneurysms is only surgical. I want you to smell the "mud of the Dead Sea", rehabilitation, reflexology - the price of charlatans.

є single view conservative politics- not openly enter during dissection of the aorta, as long as it didn’t break out: the introduction of blockers, sodium nitroprusside, reducing the vice, changing the speed of the louse, and also changing the tone of the aortic wall, making the progress.

Methods of operative treatment

There are two types of operations for cranial aortic aneurysm:

1) An operation is seen, as a result of a laparotomy (growth) on the abdomen.

This operation has been promoted since 1951, and the result is a simple replacement of an uzhenoi dilyanka with a prosthesis. The operation gives good results, high prosthesis failure, low mortality. One short - an important access to the aorta, as not all patients can be transferred: the operation is nearly 4 years old.

Ale science does not stand on the ground: in Danish hour the standard is endoprosthetics.

2) Endoprosthetics without any development.

A special endoprosthesis, which is stored in metal and polytetrafluorethylene fabric, is delivered by ships to the site of expansion. It’s not a win-win aneurysm, but it’s better to be sewn up to it at the beast of a call. In such a rank, in the development of the aorta, it will be prodovzhuvati pratsyuvati.

The whole operation is carried out in the form of an X-ray cardiohirurgia, the proof is not even possible, and the patient is on his feet. Ale Rosiya, who is the head, cannot afford such prostheses, and the cost of food is about 500 thousand rubles. That is why our land is pratsyu "in the old way."

I, on the other hand, about prevention.

prophylaxis

In order to bring the development of aneurysms to the minimum, it is necessary to follow the offensive rules:

a unique number of injuries, and in adulthood, a unique type of injury, including sports;
do not tolerate vantage;
monitor the level of blood glucose and cholesterol;
do not smoke;
stitches behind a vise;
writing the achievement of the 50-richesky vik once in two rocks of the sonic arteries of ultrasonic scanning.

Hypotensive - what is it? Causes, symptoms by species, ...

The basis for the diagnosis of aortic aneurysms is made up of radiological (chest x-ray and black emptying, aortography) and ultrasound methods (ultrasound, ultrasound of the thoracic / cranial aorta). Surgical treatment of aneurysms in the transfer of resection to aortic prostheses or closed endoluminal aneurysm prostheses with a special endoprosthesis.

aortic aneurysm

Aortic aneurysm is characterized by non-reversible enlargement of the arterial stovbur on the bordering distance. The reduction of aortic aneurysms of the developmental localization is approximately onset: aneurysms of the cranial part of the aorta become 37% of the tumors, the viscid aortic appearance - 23%, the aortic arch - 19%, the decayed appearance of the thoracic aorta - 19.5%. Thus, on the part of aneurysms of the thoracic aorta in cardiology, 2/3 of all pathologies are brought to the top. Aneurysms of the thoracic aortic cavity are often associated with other aortic cavities - aortic insufficiency and coarctation of the aorta.

Classification of aortic aneurysms

In the forensic surgery, the classification of aortic aneurysms is proponated from the urahuvannya of their localization by segments, form, structure of the walls, etiology. According to the segmental classification: aneurysm of the Valsalvi sinus, aneurysm of the viscid aortic artery, aneurysm of the aortic arch, aneurysm of the congestive aortic artery, aneurysm of the aneurysmal aortic, aneurysm of the aneurysmal aortic

Assessment of the morphological budov and aortic aneurysms allows for the possibility of information and injuries (pseudoaneurysm). Aneurysm is characterized by vitality and vitality of all types of aorta. For the ethology of reference aortic aneurysms, cause atherosclerotic or syphilic. The side of the grave aneurysm is represented by a complete tissue, which was established as a result of the organization of pulsating hematoma; The vascular aortic walls in the form of grave aneurysms are not closed. Pseudoaneurysms for walking are often traumatic and operative.

With the help of a clinician, aortic aneurysms are unstable, accelerated, and develop. Up to the number of specific accelerated aortic aneurysms, aneurysmal microscopic aneurysm is observed, which is supervised by massive internal bleeding and hematomas; thrombosis of aneurysms and thromboembolism of arteries; phlegmon of nasal tissue in case of aneurysm infection. A special type is the exfoliating aortic aneurysm, if through the opening of the inner membrane of the roof it penetrates through the balls of the artery and expands under the grip along the course of the judgment, gradually exfoliating it.

Ethiological classification of aortic aneurysms is reported to the patient when looking at the causes of illness.

Causes of aortic aneurysms

For etiology, all aortic aneurysms can be broken down on an aneurysm and on a nabut. The formation of congenital aneurysms is associated with recessive aortic diseases - Marfan's syndrome, fibrous dysplasia, Ehlers-Danlos syndrome, Erdheim's syndrome, recessive deficiency in Elastin and IN.

Addition of aortic aneurysms of the ignition etiology is found in cases of specific and nonspecific aortitis in case of fungal lesions of the aorta, syphilis, pislyoperative infections. Up to the number of non-burned or degenerative aortic aneurysms, there are symptoms of congestion, atherosclerosis, defects in suture material and prostheses. Mechanical aortic ears should be produced until hemodynamic-post-stenotic and traumatic aneurysms are approved. Idiopathic aneurysms develop with aortic necrosis.

Factors for the formation of aortic aneurysms are abductions, patients become, arterial hypertension, tyutyunopalinnya and alcohol malignancy, and spasmodic tightness.

Pathogenesis of aortic aneurysms

Besides the defectiveness of the aorta in the form of aneurysms, they take on the role of mechanical and hemodynamic factors. Aortic aneurysms often occur in functionally stressed zones, so that they are aware of the increase in blood flow, the steepness of the pulse rate and form. Chronic traumatization of the aorta, as well as the activity of proteolytic enzymes, is reduced to the destruction of the elastic skeleton and nonspecific degenerative changes in the judgment.

Symptoms of aortic aneurysms

Clinically, manifest aortic aneurysm variably and enrichment with localization, size of aneurysmal mouse, its length, ethiological incapacitation. Aortic aneurysms can be asymptomatic or superficially symptomatic and appear on prophylactic glances. A provincial manifestation of aortic aneurysms is to serve as a large amount of aortic malignancy, as well as compression syndrome.

For aneurysms of the visceral aortic arteries, such as pain in the area of the heart or behind the sternum, or for enlargement of the pressure or stenosis of the ventricular arteries. Patients with aortic lack of turbulence, tachycardia, spoiled. Aneurysms of great razmіrіv viklikayut development of the syndrome of the upper empty vein with headaches, in a big way revealing that upper half of the tulub.

Aneurysm of the aortic arch should be made to compress the travoductus with the manifestations of dysphagia; if the rotary nerve is clenched, the voice is hoarse (dysphonia), dry cough; The bladder nerve is superimposed on bradycardia and slug. With compression of the trachea and bronchial tubes, the backward and stridorous behavior develop; suppressed root of the lung - congestion and part of pneumonia.

In case of aneurysm of the lower aortic periaortal sympathetic gossip, there is pain in the left hand and shoulder. In case of occurrence of intercostal arteries, ischemia of the spinal cord, paraparesis and paraplegia can develop. Compression of the ridges supervises oversuppression, degeneration and substitutions for the form of kyphosis; Depression of the vessels and nerves is clinically manifested as radicular and intercostal neuralgia.

Collapsed aortic aneurysms

Aortic aneurysms can be accelerated with the development of massive bleeding, collapse, shock and heart failure. Cutting through aneurysms can enter the system of the upper empty vein, pericardial and pleural emptying, stravohid, black emptying. When a lot of important things develop, in an hour I will fatally - a syndrome of the upper empty vein, hemopericardium, tamponade of the heart, hemothorax, Legeneva, shlunkovo-intestinal or bleeding in a black vein.

With the release of thrombotic masses from aneurismatic emptying, a picture of the state of the occlusion of the symptoms develops: cyanosis and painfulness of the toes, livelihood on the skin of children, weight. With thrombosis of nircoval arteries, vinicaє renovascular arterial hypertension and nirkova lack; with severe cerebral arteries - stroke.

Diagnosis of aortic aneurysms

In the plan of radiological conditions for patients with aneurysm of the thoracic or cranial aorta, X-ray and X-ray of the chest cell, oglyad X-ray of the chest emptying, X-ray of the stratohode and slunk are included. With the development of aneurysms of the viscid aortic appearance, echocardiography is observed; in other vipads, ultrasound (ultrasound) of the thoracic / cranial aorta is performed.

Computed tomography (MSCT) of the thoracic / cranial aorta allows exactly and on purpose to reveal aneurysmal enlargement, to reveal the appearance of enlargement and thrombotic masses, para-aortic hematomas, and calcification. At the final stage, the aortography should be examined, for details of which the localization, size, length of aortic aneurysms and the length of the aneurysm of the aorta and the extension to the anatomical structures should be specified. Based on the results of the complex instrumental treatment, the decision is taken to show before the operative treatment of aortic aneurysms.

Aneurysm of the thoracic aorta followed by differentiation from pukhlin legends and middle; aneurysm of the cranial aorta - from the common diagnosis of black emptying, the reduction of lymph nodes in the breech, and in the womb.

Treatment of aortic aneurysms

In case of asymptomatic non-progressive interruption of aortic aneurysms, a dynamic visualization of the forensic surgery and radiological control should be used. To reduce the risk of young people, hypotensive and anticoagulant therapy is carried out, reducing the level of cholesterol.

Surgical treatment of aortic aneurysms in the presence of an aneurysm of a malignant disease, suturing a defect or substituting a leg prosthesis. The anatomical localization is characterized by resection of aneurysms of the cranial aorta, thoracic aorta, aortic arch, thoracoabdominal part of the aorta, subrenal aorta.

Forecast and prevention of aortic aneurysms

The prognosis of aortic aneurysms, head-on, is indicated by changes in atherosclerotic lesions of the cardiovascular system. In general, natural plin aneurysms are unpleasant and are associated with a high risk of death from the development of aorta and thromboembolic acceleration. The incidence of cutting aortic aneurysms with a diameter of 6 and over cm becomes 50% per pik, of a lesser diameter - 20% per pik. Early detection and planned surgical treatment of aortic aneurysms is justified by low intraoperative (5%) mortality and good indicative results.

Aortic aneurysm - lykuvannya in Moscow

Dovidnik hvorob

Ailment heart i sudin

Ostannі novini

designated only for knowledge

I will not replace the qualified medical assistance.

Aortic aneurysm. Folding, diagnostics and treatment

Collapsed aortic aneurysms

Confirmation of blood clots. In empty aneurysms, be it fusiform or saccular, the normal blood flow will collapse. A new vorticity, which can lead to the approval of thrombi, is at work. A thrombus in this vipadku will be a glued platelet. Overburdened in empty aneurysms, the thrombus does not even get worse in blood circulation. However, after leaving the aneurysm, the thrombus can get stuck in the vessels of a smaller diameter. Transmission, de same thrombosis will occur, is practically uncomfortable. Blocked can appear mozkova artery(With the picture of the ischemic insult), arteries of nirka, pechinka, kintsivok. Thrombosis zupinyaє appropriate arterial blood to the visible organ, which leads to shvidkoy bend of the tissue. Thrombosis often ends with the death of the patient. The problem is that the aneurysm can hardly be shown to itself, and the patient does not see about the manifestation of a new disease. At the same hour, the impaired blood flow already began to fade, and the stroke, for example, became the first (and often remains) manifestation of the ailment.
Pneumonia. Pneumonia can be a common aneurysm of the thoracic aorta, as the rest of the bronchial tubes are visible or embossed on the trachea. At the norm of airway nozzles, there is a small amount of mucus, which cleans the bronchi and blooms. It is too late to produce before the mucus accumulates in the singing form of the lung. Here you can find a friendly mind for the development of infection. As soon as you have drunk it, pneumonia will develop.
Compression of the ducts. Aneurysms at the upper part of the cranial aorta є with susides from the boneless organs. A great aneurysm can, for example, overwhelm the gut ducts, which go down the gum mikhur to the twelve-fingered intestine. At the same time, in a persistent way, the process of etching will collapse. There is an aggravated risk of cholecystitis, pancreatitis, and ailments can suffer from diarea, constipation, flatulence.
Rizik sick heart. Aneurysm of the thoracic aorta of significant size can affect the nerves of gossip and regulate the robot's heart. Through the chain of ailments in some cases, a stike of bradycardia or tachycardia is promoted. In addition, in the thoracic aorta itself, the vice often grows, through which it can be added to the lid on the left side. As a result, there may be no rotation changes in the aortic valve of the heart or in the heart muscle. To create a vision of aneurysms and normalization of the grip of damage in the robot, the heart may be overstated.
ischemia lower kintzivok... Ishemiyu is called kisneve hunger fabric. At the lower end of the arterial shelter, you can eat in smaller numbers through the infrarenal aortic aneurysm (aortic infertility). There is a shortage of acidity before the destruction of the renewal of the client. Rizik frostbite, trophic worms (through the lack of food) and other soft tissues grow. Aneurysm, in this case, will play the role of a provoking factor.

Rise of aortic aneurysms

trauma and fall;

reception of actions of medicines (especially to move the vice);

psychomotional stress.

Most often and more often it is possible to develop aortic ballooning aneurysms, as this is the reason why it is less important. However, you can find yourself in such a state of calmness.

raptus weakness;
loss of evidence;
noise in the vuha;
raptor beel;
shvidke zblіdnennya shkіri;
singing with dark beaches on the abdomen (when a large amount of blood is bought up in the black or in the belly empty).

A patient with aortic aneurysm development needs a term of surgical intervention to reduce bleeding and reanimation to come in for the treatment of vital important processes.

Diagnosis of aortic aneurysms

Physical examination for aortic aneurysms

Visual look. Visually, in case of aortic aneurysms, there is still little information. Whether the changes in the form of the thoracic cage are spared to the edge of the small and only in quiet areas, if the patient has lived with a great aneurysm of the thoracic aorta wants more rock. In case of aneurysm of the cranial aorta of great growths, it is possible to stimulate pulsation, as it is transmitted to the anterior cranial wall. In addition, when aneurysms are detected at the cranial stage, it is possible to stimulate the presence of violets - a sign of massive internal bleeding. However, this symptom may not appear on the anterior cranial stem (grow on the bots), since the aorta is rosted retroperitoneally (dragged out from the intestine, the slunk and the other organs in the back of the first leaf of the blood line), in
Percussion. Percussion of the field in the visualization of the empty body for the purpose of hearing the cordons of various organs. In case of aneurysm of the cranial aorta, it is possible in this way to increase the approximate size and growth of illumination. Often the area of dullness of the percussion sound is zbіgaєtsya behind the zone of the "vascular bundle". Todi, according to the percussion, the zone will be expanded. In addition, with a great aneurysm of the thoracic aorta, the heart can be destroyed or the middle of the cordon. In case of aneurysm of the crank aorta, the percussion is mensh informative, so as the vessel pass along the back wall of the crank empty space. Palpation in general will be more informative.
Palpation. Promatsuvannya thoracic emptying is practically unwise through the rib cage, so in the diagnosis of aneurysms of the thoracic aorta, palpation may not be vicious. In case of aneurysm of the same void empty, it is often possible to pulse pulsing to the beat of the heart. It’s worth talking about the manifestation of aneurysms, because when they are ill, they don’t develop. In addition, the pulse can be detected before palpation. If the frequency is equal to the pulse rate equal to in other hands for in sleepy arteries, you can talk about the appearance of aneurysms of the aortic arch. Weakened abo the daytime pulsation on the stehnic arteries (abo the frequency on young legs) Can be used for infrarenal aneurysm.
Auscultation. Vyslukhovvannya behind the aid of a stethophonendoscope (listener) є to complete the expansion and a valuable method of diagnostics. In case of aneurysm of the cranial aorta, pressing the stethoscope before the projection of the aneurysm, you can feel the murmur of the bloodstream. In case of aneurysm of the thoracic aorta, pathological changes can be abnormal - a metallic accent of a different tone over the aorta, a systolic murmur at the point of Botkin and in.
Vimiryuvannya vise. Most often, patients with aneurysms develop hypertension (pressure). In case of aneurysms of the aortic arch of great growths, the grip on the lower arms can be reduced (the increase is more than 10 mm Hg).

when revealed characteristic symptoms Before the hour of the physical conditioning of the doctor, sign up for the diagnosis of the diagnosis.

X-ray for aortic aneurysms

Ultrasound for aortic aneurysms

the invariably low parity;
painless and safe for the patient;
inadvertently rejecting the result;
the triviality of the whole 10 - 15 chilin;
the possibility of determining the form and size of aneurysms;
the possibility of aneurysm deterioration;
Possibility of assessing blood flow in the aorta and blood vessels;
The ability to form blood clots.

In general, the ultrasound scan is more widespread in the diagnosis of aneurysms of the cranial aorta. The cherevna stinka is thinner, and the picture, I will remove the likar, more precisely. With pre-existing aneurysms of the thoracic aorta, a number of heart pathologies and legends can also be detected, which is also important for treatment. The method of monitoring the organs of the thoracic empty space for additional ultrasound is called echocardiography (EchoKG).

MRI and CT for aortic aneurysms

vushni implanti and awakened the rumors of the apparatus;
the appearance of metal pins or plates for transfer operations;
the presence of a cardiac stimulator
Deyakі vidi prosthetic valves of the heart.

An important plus of MRI is that the procedure is given to allow assessment of the same blood flow in the vicinity of the vessels, and not only to correct the image of the aneurysm itself. Likarі to perceive the possibility of assessing the control of blood circulation and to perceive a number of other problems.

EKG for aortic aneurysms

laboratory analyzes

Change of leukocyte level. You may be spared in case of deyakim infections, such as in your own heart, є the cause of the development of aneurysms. The level of leukocytes is prone to increase in case of hostile infectious processes and to decrease - in chronic ones. With chronic also the growth of a part of non-segmented neutrophils in the leukocyte formulas.
Serpentine of blood. Pre-treatment of thrombocytes, factors of laryngeal disease and a number of other indicators often change, as thrombi can form in empty aneurysms.
Adjustment of cholesterol level. Hypercholesterolemia is called the adjustment of the level of cholesterol in the blood up to 5 mmol / l or more. Most often in case of atherosclerotic aortic involvement. By the way, it is also possible to talk about the adjustment of triglyceride levels or low levels of lipoprotein (naval cholesterol is normal).
In the analysis of blood, there may be houses of blood (microhematuria) in the vicinity of the fall, which appear in the case of a specific analysis.

However, all the changes are not necessarily viscous, they do not appear at all stages of ailments, and not at all patients.

Treatment of aortic aneurysms

fixation of the disease є, mabut, the most important entry for the prevention of the development of aneurysms, as well as for the correction of an increase in diameter as well as aneurysm of the thoracic aorta;
normalization of the arterial grip (including for additional medication);
normalization of masi tila, if necessary, for an additional doctor;
dotrimannya children with low cholesterol for the prevention of atherosclerosis;
vidmova from serious physical navantages;
prevention of psycho-social stress (right up to the intake of sedatives).

I’ll look at what causes the aortic aneurysm to be diagnosed, but it’s possible to know it and come in prophylactically. Їх viznachaє and I will explain to the patient the license for the situation.

Likas with aortic aneurysms

With a small diameter of the pathological dilyanka in the aorta (up to 5 cm) during the dynamic care of the patient with an aneurysm of the thoracic aorta.
In case of important concomitant illnesses, when the surgery is performed, the risk of self-aneurysm changes. The state of health of the coronary blood flow, the state of health of the cerebral blood flow, the heart failure of the II - III stages are presented to the number of patients.
At the period of training before the operational engagement.

For the skin patient, the treatment is clear, the scheme of treatment in the fallowness of the type and development of illnesses, as well as in the incidence of symptoms and scarg of the ailment. However, there is a small group of drugs, which are most often indicated.

drugs that can change heart rate (heart rate is very fast);
preparations for lowering the arterial vise;
drugs that lower cholesterol levels.

For a decrease in heart rate, beta-adrenergic blockers are most often used to inject into the innervation of the heart. When contraindicated to the intake of beta-blockers, verapamil may be indicated from a group of calcium channel blockers. It is necessary to increase the heart rate of pre-beats in khilina. The price is often reduced the cost of the aorta and the decrease in the speed of the aorta.

Warehouse i form vipusku

Dose and receive mode

Tablets 10 mg, 40 mg

Pochatkova dose of 20 mg, average dose for doba.

Tablets 25 mg, 50 mg, 100 mg

50 or 100 mgraza for doba.

Tablets 2.5 mg, 5 mg, 10 mg

Dobova dose is 2.5 to 10 mg per dose.

Tablets 2.5 mg, 5 mg, 10 mg

2.5 mg, 5 mg or 10 mg 1 time per dobu.

Tablets 40 mg, 80 mg

mg 3 times for doba.

The arterial vise may need to be reduced to reduce the tension in the aortic station. At the same time, I mark the blockers of calcium channels, ingibitori ACE (ingibitori of angiotensin converting enzyme). For the skin patient, the drug is taken from the same group, as it is most beautiful to go to the yoma itself. In some cases, a combination of drugs is possible. To lay down the signs of all the reasons for hypertension.

Warehouse i form vipusku

Dose and receive mode

Tablets 5 mg і 10 mg

Dobova dose of 5 mg or 10 mg as a single dose.

Tablets 5 mg, 10 mg, 20 mg

For 5 mg, 10 mg, 20 mg 2 times for dobu.

Tablets 5 mg, 10 mg, 20 mg

For 5 mg, 10 mg, 20 mg one time.

Tablets 2.5 mg, 5 mg, 10 mg

2.5 mg, 5 mg, 10 mg once a day.

Tablets 2 mg, 4 mg, 8 mg, 10 mg

Pomg 1 time for doba.

Atherosclerosis is a factor in the risk of rapid development of aneurysms, with a weakening of the wall of the vessel. Nowadays, you can tweak the progress of the process. Vikoristovuyutsya preparations from the group of statins, fibrati, sequestrant acids. The drug for the treatment of a specific patient is vibrated with a drug, based on the results of analyzes.

Warehouse i form vipusku

Dose and receive mode

Tablets 10 mg, 20 mg, 40 mg

Help for 1 time, take one time in the evening.

Tablets 10 mg, 20 mg, 40 mg

Help for 1 time in the evening.

Tablets 10 mg, 20 mg, 40 mg

Help 1 time in the evening.

Tablets of 145 mg, 160 mg, 200 mg, 250 mg

Per mg 1 time per doba.

g in good luck.

In case of early accelerated aortic aneurysms or abnormalities in the patient, there may be some drugs. For example, as an aortic aneurysm was found on the basis of systemic infections, a necessary course of treatment with antibiotics, which is effective against the microbe-anemic. You can also recognize the development vitamіnnі complexes, Preparations for the improvement of the vertebral column, lyki against the establishment of thrombi. However, there is no single standard of education. The specialist is interested in the situation, when it comes to the debris, and when it comes to the patient. Samolіkuvannya vysheperepolіchennymi drugs without the consultation of a doctor is even more important. Incorrect dosage can be accelerated by the development of aneurysms, or by giving an overload on the internal organisms.

Surgery for aortic aneurysm

hospitality of blood circulation in the vessels of the heart;
lack of blood circulation of the II or III stage;
Serious problems with blood circulation in the cerebral vessels (in the presence of apparent neurological problems);
inability to adequately revascularize as a minimum glib arteries stegna (due to the operation if there is a lack of blood circulation).

Transfer of myocardial infarction with stable electrocardiogram for three months neurological damage) Do not lie until contraindicated. Such patients may undergo surgery to see aneurysms.

I will detail the details mental systems(Spirography);
assessment will be nirok, with the mark of viciousness of admitted nirk's lack;
obov'yazkovyu є assessment of the range of blood-bearing vessels of the lower edges, as well as coronary arteries and arteries of a small blood circulation;
the value of sensitivity to antibiotics, which are recognized as a intestinal stick(The microorganisms are the most frequently clicked on to the operational speed).

Regardless of the type of aneurysms, antibiotic therapy is indicated for a long time (call in 24 years before the operation) as a preventive measure for fasting surgery. For the addition of sufficient concentration of antibiotics in the blood, to prevent the proliferation of pathogenic (ailments) bacteria.

Classically surgical involvement. For the classics involved in a large-scale solution empty operationі from the backward anesthesia і wide rosette tissue I’ll see a picture of the aorta with an aneurysm and replace it with a prosthesis. As a result, blood flow through the aorta will increase. The great minus of such an operation is trauma. Visoky risik accelerated before the hour and went to the operation. Navigate at a time when the patient is on the go, as a rule, it is necessary to renew and spend more time.
Endovascular surgery. Due to endovascular surgery, there is a similarity of methods, for which there is no large-scale tissue distribution. All the necessary tools are brought to aneurysm through the small vessels (often through the stegnova artery). Regularly of the type and size of aneurysms, there are few options available. In order to educate the judge, they will set up a special change of sieve, which will help them grow up and grow up. In case of small aneurysms of small size, it should be pushed in for an hour until the “seal” of the arm. In the Danish hour іsnu to finish wide range manipulation through endovascular access. However, all the stinks will come off, as a rule, with small misechkuvaty aneurysms, if there is a lot of serious damage to the rosé.

I’m talking about the development of aneurysms, cutting out any of those accelerated, or breaking up, on the thought of likars, even very high, to see only because of the surgical procedure. There is a wider access to the aorta, allowing you to overlook the problem and look around at the weakness of the judgment, as well. It is also a classic surgery є a single variant of treatment for great and giant spindle-like aneurysms.

Narodne lykuvannya aortic aneurysm

Nastya green crop. Insist one tablespoon of dredged crop in 400 ml of sprinkle. Qiu portions divided into 3 parts and vipiti with a stretch to finish.
Anastasis to the grief. Fruit a hearty gulp of good hanging and detailing. To prepare the infusion, you need two tablespoons of the trimmed powder. Pour 300 ml of the powder into the sprinkle and infuse it with a stretch. Growth in three parts and live for 30 hilin before the end of the day.
Nastya levkoyny jaundice. Tsey nastiy prepare from two tablespoons of jaundice. Fill in 150 ml of boiled water. Vipivati 15 ml 5 times a day. You can add tsukor in the preparation of nastiy for polishhennya relish.
Vidvar elder. For the preparation of a large variety, you need the root of the Siberian elderberry. Zakip'yatiti 200 ml of water, add some elderberry roots, give a boil on a small water with a stretch of 15 chilines. Take a fire and insist 30 khilin. Otrimaniy v_dvar process, pouring into dishes. Vipivati for one tablespoon 3 times a day.

It is necessary to be careful not to destroy the most important effect - the hope of developing aneurysms from the recommended diseases. When zasosuvannі zasobіv folk medicine More likely to deprive the timchasov of the symptoms of sickness, such as zadishka or embryos. It is absolutely unacceptable to indulge in phytoreception. Outside the lіkuvannya, you can guarantee only a quick turn-up until a surgical treatment.

Prognosis for aortic aneurysms

The form of aneurysms. As a rule, the most favorable rosy aneurysms. The best prognosis is most often for spindle-like reference aneurysms, signs of such diseases.
The reason for the knowledge. Aneurysms, which have appeared on the atherosclerosis, grow more and more. With syphilis, the forecast is worse, so yak a sickness, yak got to the wall of the aorta, even on new stage, I can be the enemy of the organization. In the case of incapacitated people with good fabrics the forecast is generally rotten, so it’s not really effective treatment.
Aneurysm size. aneurysms big size most often they experience more symptoms and may become sickly before breaking. The forecast for them will be better.
Vіk paciєnta. Atherosclerotic aneurysms tend to develop in people over 40 years of age. At the same time, they can buty ailments - ischemic ailment heart, problems with nirkami or pechinkoyu and ін. All the possible ways can be used to guide the absolute contraindications to surgical treatment. Forecast, zoosumіlo, googling.
The stage of the ailment. Many aneurysms, which have been accepted as a stretch of the last days, may have a better prognosis, so it is more important for drug users to assess the threat of an explosion. Pidgostri aneurysms may have a shorter prognosis.
Aneurysm growth. It is important to say that aneurysms are not safe - thoracic or cranial aorta. In both cases, the risk is most often brought to the death of the patient. An important factor is those, such as aortic glands, damaged by an aneurysm. It’s a lot of things to zoom in and out about the foldability of surgical involvement (especially, since it’s about prosthetics). The highest prognosis will be for multiple aortic aneurysms, rosted in the chest, and in the deep empty.

In general, aneurysm of the aorta without surgical treatment gets involved with a bad prognosis. The very manifestation of aneurysms leads to the possibility of developing a fatal internal bleeding. Possibilities and prophylactic methods and drug therapy not indiscriminate. As soon as the patient has successfully carried out surgery, the prognosis is friendly. I will revisit aneurysms, for the sake of speeding up the operation is possible, or the stench cannot be imagined as such a serious problem. In general, the forecast will be more likely to be found from the patient himself (who will be summarily vikonuvati rozorodzhennya likariv).

What is the problem with aortic aneurysm?

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You can add your comments and advice to the full statute for clarifying the Rules of Discussion.

A beating in the breasts is one of the most frequent reasons for the brutalization behind lykarskoy assistance. The reason for the pain in the breasts can be clear, but often atypical. Falls, if the patient is skipping on the beads in the breasts, are the most difficult to diagnose.

The differential diagnostic range in such types of cases is supra-wide, including, including, incapacitation, which is a harmless threat to life, such as myocardial infarction with an infarction and without an ST segment, unstable angina, thromboembolism legendary arteryі aortic aneurysm.

Aortic aneurysm (RAA) is a foldable problem in terms of primary diagnosis. The reason for this is that the frequency of this pathology is low, so the variability of clinical manifestations is high.

Without the stagnation of cardio-surgical methods in the early term, the prognosis is extremely unpleasant, and the two-life vision does not outweigh 20%, so the diagnostics of the RAA is of no use to those who have chosen them.

Under the term "aortic aneurysm" Mayut on uvaz Raptovo coverage vnaslidok other reasons a defect in the middle of the aorta with further penetration of blood through the defect in the degenerative change of the middle membrane, the establishment of hematoma and later development of the wall of the aorta.

The dissection (dissection) is carried over to the distal, to the proximal side. A hematoma can develop along the course of the aorta and clog one of the aortic arteries, repairing along the aortic arch and ending with intestinal arteries.

Retrograde dissection can affect the coronary artery. Most often the rights of the coronary artery are involved. Retrograde enlargement can cause damage to one or more stools of the aortic valve and its deficiency.

The grave canal grows into the last half of the middle sheath of the aorta. The name of the aorta becomes the whole of the cob. Tse є the cause of frequent aortic changes in patients with aneurysm.

The dissection of aneurysms of the aortic arch is seen most often in the middle of the empty space, the opening of the lower aorta - in the left pleural empty space, the cranial aorta - in the extra-urethral cell. Thus, the parietal pericardium is attached to the viscous part of the aorta, without the middle proximal to the opening of the brachiocephalic stool, opening up to the lateral part of the aorta can lead to the tamponade of the pericardium.

Classification of aortic ballooning aneurysms

Classification of aortic ballooning aneurysms is based on the localization of the proximal opening of the inner aortic sheath and the length of the aortic wall opening. Oscillations of the development of the inner sheath of the aorta can theoretically be found in any segment and in many cases, the options for the development of the aorta can be achieved in a variety of ways.

However, in practice, the dissection of the inner sheath is most often seen in the anterior stage of the upper part of the aorta on the cordon of the proximal and middle third, as well as in the cob segment of the lower part of the aortic distal artery of the key.

The very principle is based on a simple and widely expanded Stanford Classification There are several types of shaping:

type A- the development of these is located in the viscid aorta with the lesions of the arch, or the lower aorta, or without them;
type B- the nipple is located in the lower aorta, when it expands proximally and distally.

For the purpose of predicting ailments and making conservative and operational tactics in the classroom, modification is made Classification M. DeBakey:

type I- the opening of the inner sheath is localized in the upper part of the aorta, and the opening of the stem expands to the celiac part of the aorta;
type II- the opening of the inner shell is localized in the upper part of the aorta, the shaping ends with a small mouse proximal to the brachiocephalic stool;
type III- the opening of the inner sheath of the aorta is located in the cob of the lower part of the thoracic aorta, distal of the arm of the left subclavicular artery.

Classification of aortic aneurysms

According to the first classifications, five classes of aortic dissection are seen.

Up to the 1st class, the classical aortic shaping with the shape of the grave and true strokes is recognized without insight into the results of them,
up to 2 - intramural hematoma or hemorrhage,
up to the 3rd - penetrating appearance of atherosclerotic plaque of the aortic stink in the case of a nadrivu and capsule,
up to the 4th - not very large areas or parts of aortic dissection according to the results of the diagnosis
up to the 5th - iatrogenic or post-traumatic dissection of the aorta (for example, we will open the aorta in it for catheterization of the heart with a catheter).

Razriv іntimi, which is an ear of aneurysm, appear in the upper part of the aorta in approximately 70% of cases. In 10% of cases, it is found in the dusa, in 20% - in the lower part of the thoracic aorta. In okremikh vipadkah sposterіgaєt nadriv іntimi cranial aorta.

Dissection (shaping) of the aorta can be gastrointestinal (up to 2 types) and chronic (more than 2 types).

wideness RAA rate in the middle yak 1 per 10,000 hospitalized pre-hospital stage). Given pathologyє the cause of 1.1% of all raptor deaths and 3-4% of all raptor deaths heart-and-heart disease; Appear in 1 drop per 400 autopsies.

Before drunk bureaucrats Sharing of the aorta to be diagnosed as a disease, to support cystic degeneration of the media:

trivially arterial hypertension,
congenital defects with the resulting tissue (syndromes of Marfan, Ehlers - Danlos, Turner),
polycystic ailment nirok,
abduction vik (60-70 years);
vrodzheni wadi sertsya (coarctation of the aorta, bicuspid or one-stool valve);
atherosclerosis of the aorta;
vagіtnіst;
trauma to the breast,
stronger physical stress;
systemic vasculature (especially often granulomatous, giant cell artery);
chemical and toxic water (drugs, for example, cocaine);
iatrogenic causes.

key picture

The most common symptoms in RAA are the ear of raptor pain with blisk of maximum intensity, localization of pain in the chest, more in the back. To be described by the patients as it is even more intense or unbearable, the most intense, as if the stench was seen, if it was a gostra or a ditch.

In the significant part of the patients, there may be more symptoms of the ST segment, for example, the T wave.

With the proximal type of enlargement, the murmur of aortic regurgitation can be heard.

In case of proximal and distal type of enlargement, an asymmetry of the pulse (lowering of the pulse, either visibility) and arterial vise on the upper or lower edges may occur.

Some of the patients may experience neurological damage.

Secondary (most often the posterior lower) myocardial infarction, dressings with extended expansion on the coronary artery arms, are surprisingly rare.

Until I get sick, I may go to the RAA cool picture, Introduce:

gostry coronary syndrome;
aortic insufficiency without dissection (enlargement);
aortic aneurysm without dissection (rosharuvannya);
kistkovo-myazov;
pericarditis;
pukhlina middle;
pleurisy;
thromboembolism of the leg artery;
cholecystitis.

The appearance of the RAA can be seen, even if the patient has a bile; be in confusion with obscurity (syncope); b_l in the presence of symptoms of heart failure; b_l in the presence of symptoms of a lesion of the central nervous system (stroke); heart failure without pain syndrome; symptoms of a lesion of the central nervous system (stroke) without pain syndrome; changes on the roentgenograms of the organs of the breast without pain syndrome; heart rate without pain syndrome.

good advice working groupЄvropeyskogo tovaristva kardіologіv for pіdtverdzhennya dіagnozu, refined type rozsharuvannya (lokalіzatsіya, protyazhnіst) dіagnostiki that clarify tyazhkostі aortalniynedostatnostі i dіagnostiki ekstravazatsії (perіaortalnaya abo mediastinal hematoma, pleural abo perikardіalny vipіt) perevagu slіd vіddavati transthoracic EhoKG s away transezofagealnoy EhoKG i vnutrіshnosudinnim SPL multіspіralnoy computer tomography abo magnetic resonance tomography.

Angiography can be performed to determine the anatomical substrate in case of planned percutaneous involvement in hemodynamically stable and unstable patients, but not routinely. Chest x-ray does not provide additional information.

come in

Below are presented cob clinical and diagnostic visits, which should be carried out at adolescence on the RAA, according to the recommendations of the group of experts of the European Association of Cardiologists.

Take a detailed anamnesis and take a second look (if possible).

Prevention of venous access, blood analysis (OAC, CPK, troponin I (T), D-dimer, hematocrit, lipid).

EKG in 12 entries.

Monitoring arterial vise and EKG.

Znebolyuvannya (morphin).

Decrease in systolic arterial vise, besides β-adrenergic blockers (propranolol, metoprolol, esmolol), with contraindications - calcium antagonism.

Transport in VRIT.

In case of important arterial hypertension, there is an additional vasodilator.

Transthoracic (transesophageal) EchoKG.

All patients with aortic aneurysms are shown surgical treatment.

cool butt

We present a key butt of the well-known diagnostics of the RAA at the presentation of the peculiarities of overcoming the ill-gotteness of that key picture.

Patient A., 59 years old. Skarg is dumb at the moment of hopefulness. Earlier, the heart-and-death disease could not stand.

Forward, 3 days before the burrowing in the hospital, the Vinicla is prickly, piercing the bile of peaceful intensity in the area of the heart and between the shoulder blades without a ring. physical options and in a collapse, intensified with palpation, it took a few years for self-administration of analgesics. The repeated attack has developed in advance of one hopeful in the stationary.

I consulted a neurologist, I was told about vertebral thoracalgia. An EKG was carried out, changes were detected (negative T waves in III and aVF connections), from the drive of some patients, the woman was sent to the hospital with the diagnosis: “IXC. Posterior-phrenic myocardial infarction ".

In case of objectival obstezhennі zvertav on themselves respect there is an intense dіastolic noise, lingering over the aorta and along the right edge of the sternum.

W urahuvannyam GOSTR character i trivalostі bolyu in grudnіy klіttsі in poєdnannі of viyavlenimi Find our aortalniynedostatnostі, іmovіrno GOSTR rozvinulas (not bulo vіdomostey about іsnuvav ranіshe porotsі sericite, mezhі sericite in furrows normalized, boule vіdsutnі Find our hronіchnoї sertsevoї nedostatnostі) bulo vislovleno stewed about nayavnіst PAA viskhіdnogo viddilu aorta.

The patient Bula was hospitalized in VRIT, deplanned for infusion of esmolol, to carry out transthoracic and, if necessary, transesophageal EchoCG.

After 10 mins, when the necessary ailment, the raptus lost its evidence, it was diagnosed that the blood circulation was corrected (electromechanical dissociation). Reanimation come in unsuccessful.

Diagnosis: “Viscid aortic aneurysm. Hemopericardium. Heart tamponade ".

In the pathological anatomical dilution, a slight expansion of the viscid aorta was revealed with the supravalvular growth and blood in the emptying of the pericardium.

P. V. Dolotovskaya, I. V. Graifer, S. V. Ofremov, N. V. Furman