10: Systemic vascular disease

Published on 02/03/2015 by admin

Filed under Internal Medicine

Last modified 22/04/2025

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TOPIC 10 Systemic vascular disease

Topic Contents

Aortic wall thickness 95
Aortic dissection 95

Classification 96
DeBakey 96
Stanford classification 96
Secondary hypertension 96

Aortic wall thickness

Measurement of aortic wall thickness can be used to assess cardiovascular risk. Aortic mean average wall thickness is increased by atheromatous disease which preferentially affects the aortic media. Aortic mean average wall thickness also increases with age, is higher in males and non-Caucasian races.

Men: mean average wall thickness 2.32 mm
Women: mean average wall thickness 2.11 mm.

Aortic dissection

image

Figure 10.1 Anatomical classification of thoracic aortic dissection.

Classification

DeBakey

Type 1 Involvement of ascending and descending aorta with extensive distal extension.
Type 2 Involvement restricted to ascending aorta. Typically seen in Marfan’s syndrome.
Type 3 Involvement restricted to descending aorta, distal to left subclavian artery.

Stanford classification

Type A (proximal) Involvement of ascending aorta (DeBakey types 1 & 2)
Type B (distal) No involvement of ascending aorta (DeBakey type 3).

Secondary hypertension

Table 10.1 Anatomical classification of thoracic aortic dissection

Causes Marker Normal range
Kidney disease Blood  
Creatinine Men: 45–90 μmol/L (0.5–1.0 mg/dl)
  Women: 60–110 μmol/L (0.7–1.2 mg/dl)
Urine output    
GFR Men: < 70 ml/min/m2
  Women: < 60 ml/min/m2
Cushing’s syndrome Dexamethasone suppression test  
Cortisol N/A  
ACTH N/A  
Phaeochromocytoma 24-hour urine  
  Epinephrine 0.5–20 μg/24 hours
  Norenephrine 15–80 μg/24 hours
  Dopamine 65–400 μg/24 hours
  Renin 20–100 mU/L
Conn’s syndrome Low renin <20
  Aldosterone/renin ratio >750
Hyperthyroidism TSH 0.3–3.0 mIU/L
  Thyroxine (T4) 4–11 μg/dl
  T3 130–220 ng/dl

GFR = glomerular filtration rate, ACTH = adrenocorticotrophic hormone, TSH = thyroid stimulation hormone.

[/level-membership-for-internal-medicine-category][not-level-membership-for-internal-medicine-category]

TOPIC 10 Systemic vascular disease

Topic Contents

Aortic wall thickness 95
Aortic dissection 95

Classification 96
DeBakey 96
Stanford classification 96
Secondary hypertension 96

Aortic wall thickness

Measurement of aortic wall thickness can be used to assess cardiovascular risk. Aortic mean average wall thickness is increased by atheromatous disease which preferentially affects the aortic media. Aortic mean average wall thickness also increases with age, is higher in males and non-Caucasian races.

Men: mean average wall thickness 2.32 mm
Women: mean average wall thickness 2.11 mm.

Aortic dissection

image

Figure 10.1

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