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The size cut off for aortic aneurysm is crucial to its treatment. A thoracic aorta greater than 4.5 cm is generally defined as aneurysmal, while a size greater than 5.5 cm is the distinction for treatment, which can be either endovascular or surgical, with the former reserved for pathology at the descending aorta. [12] [13]
Aortic aneurysms are often encountered during an X-ray, ultrasound, or echocardiogram done for other reasons. [3] IAA may also be found during a routine physical exam by feeling for bulges in the abdominal area. If an aortic aneurysm is suspected, medical history will be considered along with a physical examination.
An aortic aneurysm is an enlargement (dilatation) of the aorta to greater than 1.5 times normal size. [1] Typically, there are no symptoms except when the aneurysm dissects or ruptures, which causes sudden, severe pain in the abdomen and lower back. [2] [3] The etiology remains an area of active research.
Repeat ultrasounds should be carried out in those who have an aortic size greater than 3.0 cm. [51] In those whose aorta is between 3.0 and 3.9 cm this should be every three years, if between 4.0 and 4.4 cm every two years, and if between 4.5 and 5.4 cm every year.
The aorta normally has three small pouches that sit directly above the aortic valve (the sinuses of Valsalva), and an aneurysm of one of these sinuses is a thin-walled swelling. Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left (< 5%) coronary sinus. [ 1 ]
The aortic wall dilatation at the commissural level causes the cusps to effectively shorten and prevent them from converging during systole, which results in aortic valve incompetence. The arch is typically spared from the aneurysmal process, though it may involve the entire ascending aorta. The ectatic aorta may experience dissections.
Abdominal aortic aneurysms are commonly divided according to their size and symptomatology. An aneurysm is usually defined as an outer aortic diameter over 3 cm (normal diameter of the aorta is around 2 cm), [ 17 ] or more than 50% of normal diameter that of a healthy individual of the same sex and age.
Measurements in this view can be used to quantify the heart: Left ventricular size and wall thickness; Left atrial linear dimension (as opposed to area) Left ventricular outflow tract diameter (used to calculate aortic valve area by the continuity equation) Aortic annulus, sinus of Valsalva, and aortic root sizes; Color doppler of all four valves
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