Ballooning of a weakened section of vessel wall on the abdominal aorta, typically
below the level of the lumbar vertebrae, potentially causing dissection and/ or rupture of the aorta leading to profound shock and rapid mortality. Common risk factors: Cardiac (Family history, Male > 50yo, smoking, HT, diabetes, hyperlipidaemia, obesity, poor diet, sedentary lifestyle, IHD) Other factors: trauma, infection Weakening/ damage to endothelium of abdominal aorta. Nb. Possibly more susceptible to vessel wall damage than other areas of the descending aorta Tear in aorta tunica intima Blood enters between intima, media & adventitia layers Bulging in section of aorta wall (>3cm in diameter) = ANEURYSM
High pressure causes blood
to track causing false lumen between layers = DISSECTION Sudden & severe back, abdominal, flank tearing pain
Turbulent & altered blood
flow within artery
Vague abdominal &/ or back pain
Nerve stimulation causes
radiating groin or testicular pain
Thrombus formation
Pulsatile or palpable abdominal
mass (usually >4cm in diameter)
Pulsatile or palpable abdominal
mass (usually >4cm in diameter) Hypotension & associated tachycardia Nausea & vomiting (possibly due to hypotension and/ or pain stimulus) Complete rupture of artery wall Rapid & continuous haemorrhage into retroperitoneum Syncope (decrease cerebral perfusion) Profound shock & DEATH
Altered distal blood supply
Absent or uneven distal pulses Uneven distal skin colour & temperature Distal tissue ischaemia