Aortic ring dilation

Introduction The proximal aorta and aortic roots widen, causing aortic regurgitation.

Cause

About 50% of patients with aortic annulus have horse syndrome or mutations in the disease; the rest are idiopathic. Stage III syphilis is an uncommon cause of aneurysms, and aneurysms caused by syphilis are typically found in the aortic roots and ascending aorta. Most of the traumatic aneurysms follow the blunt chest trauma, and their typical location is in the ascending aorta, where the aorta is fixed behind the thorax. But these are pseudoaneurysms, that is, they are hematomas caused by blood leaking from the torn aortic wall. Often appear on chest X-ray after severe blunt chest injury.

an examination

Related inspection

CT scan of chest radiograph

Thoracic aortic aneurysms are usually seen on chest X-rays. CT and MRI are particularly helpful in confirming the extent and size. Transthoracic ultrasound can accurately measure the size of the ascending aortic aneurysm, but not for the descending aorta. Esophageal ultrasonography can accurately measure both. Most of the indications for thoracic aortic aneurysm before ablation are aortic contrast angiography or magnetic resonance aorta angiography.

For syphilitic aneurysms, serum tests, especially the fluorescence T. pallidum antibody adsorption test and the Treponema pallidum immunoassay, were mostly positive.

Differential diagnosis

The disease can be diagnosed according to clinical and examination, without identification. However, the most important clinical problem is to distinguish the cause of aneurysm. The most important need to identify is atheromatous plaques and thrombosis. Aortic angiography does not identify atherosclerotic plaques and thrombi, and transesophageal echocardiography (TEE) provides a high-quality real-time image of the descending thoracic aorta, which accurately measures the size and extent of the tumor, showing blood in the tumor. The smog-like echo formed by slow flow and stagnant blood detected detective thrombi and atheromatous plaques and found compression of adjacent organs.

Because of the formation of thrombus, the old and new are different, but in a multi-layered manner, the newly formed thrombus is hypoechoic, and there is a sense of wandering, the echo in the center of the thrombus is weak, the echo around is strong, and it seems to have a capsule-like structure, while the atheroma The pathological changes of the plaque are mainly in the intima of the artery. The lesion protrudes into the lumen. The plaque can be hemorrhagic due to necrosis, forming an anechoic zone. When the atheromatous plaque ruptures itself or is broken by external force, the endometrium is interrupted. Complex plaques, therefore, the free surface of the plaque is irregular, with intimal rupture and ulcer formation, in stark contrast to the multi-layered changes in the thrombus and the surrounding echo-like envelope-like structure.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.