Cardiovascular Disability Updating the Social Security Listings (2010) / Chapter Skim
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14 Aneurysm or Dissection of the Aorta and Peripheral Arteries
14 Aneurysm or Dissection of the Aorta and Peripheral Arteries
Pages 209-218
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From page 209... ...
the inner intimal lining, (2) the medial layer containing connective tissue interspersed with smooth muscle cells, and (3)
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From page 210... ...
An aortic dissection should be distinguished from an "intramural hematoma," which lacks evidence of blood flow in a false lumen channel within the medial layer or evidence of a blood channel connection to the vessel lumen through an intimal tear. Intramural hematomas typically occur in the descending aorta of elderly individuals and are postulated to arise from a rupture of the small vessels in the outer layer that feed the aortic wall (the vasovasorum)
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From page 211... ...
This ongoing expansion of aneurysms serves as the basis for clinical practice guidelines that recommend annual noninvasive imaging tests to evaluate aortic dimension, such as a computed tomography (CT) or magnetic resonance imaging (MRI)
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From page 212... ...
In addition, patients with Marfan syndrome can exhibit other cardiovascular conditions, such as mitral regurgitation secondary to mitral valve prolapse or aortic regurgitation secondary to distortion of the valve cusps due to aortic dilation. Loeys-Dietz syndrome results from mutations in the transforming growth factor receptor Type I or II genes and is characterized by the triad of arterial tortuousity and aneurysms, hypertelorism (wide-set eyes)
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From page 213... ...
ACC/AHA guidelines currently recommend prophylactic surgical repair for asymptomatic patients with various forms of aortic disease, such as degenerative thoracic aneurysm, chronic aortic dissection, and mycotic aneurysm with an ascending aorta or aortic sinus diameter of 5.5 cm or greater. In certain subsets of high-risk patients with aortic disease, earlier intervention at smaller aortic dimensions (4 to 5 cm depending on the condition)
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From page 214... ...
For example, aortic dilation may compromise the normal function of the aortic valve and produce chronic aortic regurgitation that eventually results in heart failure. An arterial aneurysm can compress a peripheral nerve and induce neuropathic pain, numbness, or limb weakness, which could impair a patient's functional capacity.
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From page 215... ...
In high-risk patients with aortic disease and/or a genetic predisposition to aneurysm formation or aortic dissection (e.g., Marfan syndrome) , the standard medical management may include substantial restrictions in physical activity in adults and children with asymptomatic aortic aneurysms or dissections.
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From page 216... ...
to require the pres ence of chronic disabling symptoms due to the aneurysm or dissection. Disabling symptoms may be the result of the functional impairment to the heart, brain, peripheral nerves, or limbs due to the aneurysm or dissection.
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From page 217... ...
2002. Yearly rupture or dissection rates for thoracic aortic aneurysms: Simple prediction based on size.
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