DISSECTING ABDOMINAL AORTIC ANEURYSM

Precipitating Factors: Predisposing Factor: Precipitating Factors: Different parts of aorta

Age 85 years old Hypertension
Genetic Predisposition have different embryonc origin
Atherosclerosis

Progressive deterioration of Production of enzymes that

aorta structural integrity break down elasting and
on aorta
↑ pressure
and other vessel walls
over life span collagen proteins
Infrarenal aorta has poorly
developed vasa vasorum
Aorta suscpetible to
Degradation of aortic Biomechanical
(dedicated blood supply to
damage connective tissue stress on vessels
the vessel wall

Obstruction of blood
Loss of smooth muscle cells & Destruction of elastin in flow causing blood
thinning of Tunica media and clotting factors
Tunica media
to accumulate Infrarenal aorta relies
solely on diffusion from
↓ aortic tensile strength Thrombus formation aortic blood that crosses
(ability to withstand stretching) the abdominal aorta
Dislodged thrombus
↑ Diameter and rapid expansion of the travels to different
Aorta expands and dilates
aorta causing intima tears ➝blood organ vasculature
due to internal pressure causing obstruction &
dissects aortic intima from the media
↓ organ perfusion

Dissection propagates along aortic wall Blood entering the dissected aorta Acute limb ischemia
& extends into branches off aorta expands the aorta, compressing manifested by pulseless
impeding blood flow to all tissues adjacent structures cool extremity
supplied by that branch
Compressed structures are pain Infrarenal aorta more prone
Malperfusion syndromes sensitive and triggers relays pain to ischemia and has
signals to CNS Abdominal Aortic Aneurysm impaired repair potential
BP difference of Weaker pulse
Acute onset of "Ripping" chest pain
>20 mmHg between in one arm that radiates to the thorax or abdomen
both arms