Your Healthy Aorta

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Your Healthy Aorta Your Healthy Aorta The Aorta: Aortayour4facts The aorta is the main blood vessel 1) Know your diagnosis from the heart channelling blood to “Love the heart of Diseases of the aorta often result in all the organs of the body. It has 5 an aneurysm or swelling of the your Aorta” segments which include: a) the aorta. Aneurysms increase the risk aortic root, b) the ascending aorta, of tear, dissection of rupture c) the aortic arch, d) the descending depending on the size, following thoracic aorta and e) the abdominal which patients may need emergency aorta. Blood is pumped at 5 surgery. Planned surgery may be litres/min through this system at required to prevent an emergency rest, increasing up to 25 litres/min life threatening presentation. in exercise. Blood pressure may Commonest diseases underlying double during exercise and exceed aneurysms include: familial 300mmHg. As such the artery is predisposition, connective tissue exposed to the extremes of high your4 facts disorders (Marfan Syndrome, Ehlers Aorta blood flow, high blood pressure and Danlos Syndrome, Loeys-Dietz fluctuations in blood borne 1) Know your diagnosis Syndrome and Turners Syndrome), metabolites, toxins and infections. Bicuspid Aortic Valve Syndrome as 2) Know your numbers The aorta is therefore vulnerable to well as infection, inflammation and life threatening disease. It is trauma. Other factors such as 3) Know your choices important to know about your aorta diabetes hypercholesterolemia, and look after your aorta. 4) Know your treatment hypertension are important. Aortayour4 facts Aortayour4 facts Aortayour4 facts 2) Know your numbers 3) Know your choices 4) Know your treatments During your follow-up appointments Make the correct choices to help Medical drug treatments are very and scans there will be a range of keep your aorta healthy. Be important in protecting the numbers which become important proactive with the management of aneurysm and all patients should be to you and indicate when you might your blood pressure and visit your on a B-blocker if possible. Further need surgery. The commonest general practitioner. Stop smoking drugs may be required to control trigger for surgery on an aortic and make healthy dietary choices. blood pressure. In the event of you aneurysm is a diameter of 5.5cm. Check your cholerserol and get requiring intervention this will Factors that may reduce the treatment if required. Make sure either be surgical repair, a stent threshold (5.0cm) include Bicuspid that if you have diabetes, your within the vessel or a combination Aortic Valve, genetic predisposition glucose levels are controlled. While of both. Operations often take many or connective tissue disorder. The you need to stay active you should hours with hospital recovery over trigger may be lowered (4.0cm) if avoid doing things that raise your weeks. Recovery at home may take you require heart surgery on other blood pressure such as weight months. Your surgeons will discuss diseases such as valves or coronary lifting, moving heavy objects or the risks and benefits of different arteries. Other factors that may pushing your self to exhaustion. Day treatments with you in Clinic. lower the number include to day activities should not pose a Thoracic Aortic Aneurysm Service. Liverpool symptoms. risk to you. Exercise is important. Heart and Chest, www.lhch.nhs.uk .
Recommended publications
  • Thoracic Aorta
    GUIDELINES AND STANDARDS Multimodality Imaging of Diseases of the Thoracic Aorta in Adults: From the American Society of Echocardiography and the European Association of Cardiovascular Imaging Endorsed by the Society of Cardiovascular Computed Tomography and Society for Cardiovascular Magnetic Resonance Steven A. Goldstein, MD, Co-Chair, Arturo Evangelista, MD, FESC, Co-Chair, Suhny Abbara, MD, Andrew Arai, MD, Federico M. Asch, MD, FASE, Luigi P. Badano, MD, PhD, FESC, Michael A. Bolen, MD, Heidi M. Connolly, MD, Hug Cuellar-Calabria, MD, Martin Czerny, MD, Richard B. Devereux, MD, Raimund A. Erbel, MD, FASE, FESC, Rossella Fattori, MD, Eric M. Isselbacher, MD, Joseph M. Lindsay, MD, Marti McCulloch, MBA, RDCS, FASE, Hector I. Michelena, MD, FASE, Christoph A. Nienaber, MD, FESC, Jae K. Oh, MD, FASE, Mauro Pepi, MD, FESC, Allen J. Taylor, MD, Jonathan W. Weinsaft, MD, Jose Luis Zamorano, MD, FESC, FASE, Contributing Editors: Harry Dietz, MD, Kim Eagle, MD, John Elefteriades, MD, Guillaume Jondeau, MD, PhD, FESC, Herve Rousseau, MD, PhD, and Marc Schepens, MD, Washington, District of Columbia; Barcelona and Madrid, Spain; Dallas and Houston, Texas; Bethesda and Baltimore, Maryland; Padua, Pesaro, and Milan, Italy; Cleveland, Ohio; Rochester, Minnesota; Zurich, Switzerland; New York, New York; Essen and Rostock, Germany; Boston, Massachusetts; Ann Arbor, Michigan; New Haven, Connecticut; Paris and Toulouse, France; and Brugge, Belgium (J Am Soc Echocardiogr 2015;28:119-82.) TABLE OF CONTENTS Preamble 121 B. How to Measure the Aorta 124 I. Anatomy and Physiology of the Aorta 121 1. Interface, Definitions, and Timing of Aortic Measure- A. The Normal Aorta and Reference Values 121 ments 124 1.
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  • Blood Vessels
    BLOOD VESSELS Blood vessels are how blood travels through the body. Whole blood is a fluid made up of red blood cells (erythrocytes), white blood cells (leukocytes), platelets (thrombocytes), and plasma. It supplies the body with oxygen. SUPERIOR AORTA (AORTIC ARCH) VEINS & VENA CAVA ARTERIES There are two basic types of blood vessels: veins and arteries. Veins carry blood back to the heart and arteries carry blood from the heart out to the rest of the body. Factoid! The smallest blood vessel is five micrometers wide. To put into perspective how small that is, a strand of hair is 17 micrometers wide! 2 BASIC (ARTERY) BLOOD VESSEL TUNICA EXTERNA TUNICA MEDIA (ELASTIC MEMBRANE) STRUCTURE TUNICA MEDIA (SMOOTH MUSCLE) Blood vessels have walls composed of TUNICA INTIMA three layers. (SUBENDOTHELIAL LAYER) The tunica externa is the outermost layer, primarily composed of stretchy collagen fibers. It also contains nerves. The tunica media is the middle layer. It contains smooth muscle and elastic fiber. TUNICA INTIMA (ELASTIC The tunica intima is the innermost layer. MEMBRANE) It contains endothelial cells, which TUNICA INTIMA manage substances passing in and out (ENDOTHELIUM) of the bloodstream. 3 VEINS Blood carries CO2 and waste into venules (super tiny veins). The venules empty into larger veins and these eventually empty into the heart. The walls of veins are not as thick as those of arteries. Some veins have flaps of tissue called valves in order to prevent backflow. Factoid! Valves are found mainly in veins of the limbs where gravity and blood pressure VALVE combine to make venous return more 4 difficult.
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  • Fetal Descending Aorta/Umbilical Artery Flow Velocity Ratio in Normal Pregnancy at 36-40 Weeks of Gestational Age Riyadh W Alessawi1
    American Journal of BioMedicine AJBM 2015; 3(10):674 - 685 doi:10.18081/2333-5106/015-10/674-685 Fetal descending aorta/umbilical artery flow velocity ratio in normal pregnancy at 36-40 Weeks of gestational age Riyadh W Alessawi1 Abstract Doppler velocimetry studies of placental and aortic circulation have gained a wide popularity as it can provide important information regarding fetal well-being and could be used to identify fetuses at risk of morbidity and mortality, thus providing an opportunity to improve fetal outcomes. Prospective longitudinal study conducted through the period from September 2011–July 2012, 125 women with normal pregnancy and uncomplicated fetal outcomes were recruited and subjected to Doppler velocimetry at different gestational ages, from 36 to 40 weeks. Of those, 15 women did not fulfill the protocol inclusion criteria and were not included. In the remaining 110 participants a follow up study of Fetal Doppler velocimetry of Ao and UA was performed at 36 – 40 weeks of gestation. Ao/UA RI: 1.48±0.26, 1.33±0.25, 1.37± 0.20, 1.28±0.07 and 1.39±0.45 respectively and the 95% confidence interval of the mean for five weeks 1.13-1.63. Ao/UA PI: 2.83±2.6, 1.94±0.82, 2.08±0.53, 1.81± 0.12 and 3.28±2.24 respectively. Ao/UA S/D: 2.14±0.72, 2.15±1.14, 1.75±0.61, 2.52±0.18 and 2.26±0.95. The data concluded that a nomogram of descending aorto-placental ratio Ao/UA, S/D, PI and RI of Iraqi obstetric population was established.
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  • Inferior Phrenic Artery, Variations in Origin and Clinical Implications – a Case Study
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) E-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 7, Issue 6 (Mar.- Apr. 2013), PP 46-48 www.iosrjournals.org Inferior Phrenic Artery, Variations in Origin and Clinical Implications – A Case Study 1 2 3 Dr.Anupama D, Dr.R.Lakshmi Prabha Subhash .Dr. B.S Suresh Assistant Professor. Dept. Of Anatomy, SSMC. Tumkur.Karnataka.India Professor & HOD. Dept. Of Anatomy, SSMC. Tumkur.Karnataka.India Associate professor.Dept. Of Anatomy, SSMC. Tumkur.Karnataka.India Abstract:Variations in the branching pattern of abdominal aorta are quite common, knowledge of which is required to avoid complications during surgical interventions involving the posterior abdominal wall. Inferior Phrenic Arteries, the lateral aortic branches usually arise from Abdominal Aorta ,just above the level of celiac trunk. Occasionally they arise from a common aortic origin with celiac trunk, or from the celiac trunk itself or from the renal artery. This study describes the anomalous origin of this lateral or para aortic branches in the light of embryological and surgical basis. Knowledge of such variations has important clinical significance in abdominal operations like renal transplantation, laparoscopic surgery, and radiological procedures in the upper abdomen or invasive arterial procedures . Keywords: Abdominal Aorta, Celiac Trunk(Ct), Diaphragm, Inferior Phrenic Artery (Ipa), Retro Peritoneal, Renal Artery(Ra). I. Introduction The abdominal aorta begins from the level of 12th thoracic vertebra after passing through the Osseo aponeurotic hiatus of diaphragm. It courses downwards with Inferior vena cava to its right and terminates at the level of 4th lumbar vertebra by dividing in to two terminal branches.
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  • Superior Mesenteric Artery and Nutcracker Syndromes in a Healthy 14-Year-Old Girl Requiring Surgical Intervention After Failed Conservative Management
    ISSN 2377-8369 GASTRO Open Journal Case Report Superior Mesenteric Artery and Nutcracker Syndromes in a Healthy 14-Year-Old Girl Requiring Surgical Intervention after Failed Conservative Management David Wood, MRCPCH, MSc1; Andrew Fagbemi, FRCPCH2; Loveday Jago, MRCPCH2; Dalia Belsha, MRCPCH2; Nick Lansdale, FRCS, PhD3; Ahmed Kadir, FRCPCH, MSc2* 1Paediatric Registrar, Royal Manchester Children’s Hospital, Manchester, UK 2Paediatric Gastroenterology Consultant, Royal Manchester Children’s Hospital, Manchester, UK 3Paediatric Surgeon, Royal Manchester Children’s Hospital, Manchester, UK *Corresponding author Ahmed Kadir, FRCPCH, MSc Paediatric Gastroenterology Consultant, Royal Manchester Children’s Hospital, Manchester, UK; Phone. 07709732356; E-mail: [email protected] Article information Received: January 30th, 2020; Revised: February 17th, 2020; Accepted: February 24th, 2020; Published: February 28th, 2020 Cite this article Wood D, Fagbemi A, Jago L, Belsha D, Lansdale N, Kadir A. Superior mesenteric artery and nutcracker syndromes in a healthy 14-year-old girl requiring surgical intervention after failed conservative management. Gastro Open J. 2020; 5(1): 1-3. doi: 10.17140/GOJ-5-132 ABSTRACT This case report presents the diagnosis of superior mesenteric artery and nutcracker syndromes in a previously fit and well 14-year- old girl. Although these two entities usually occur in isolation, despite their related aetiology, our patient was a rare example of their occurrence together. In this case the duodenal compression of superior mesenteric artery syndrome caused intractable vom- iting leading to weight loss, and her nutcracker syndrome caused severe left-sided abdominal pain and microscopic haematuria without renal compromise. Management of the superior mesenteric artery syndrome can be conservative by increasing the weight of the child which leads to improvement of retroperitoneal fat and hence the angle of the artery.
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  • Normal and Variant Origin and Branching Pattern of Inferior Phrenic Arteries and Their Clinical Implications: a Cadaveric Study
    International Journal of Research in Medical Sciences Thamke S et al. Int J Res Med Sci. 2015 Jan;3(1):282-286 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 DOI: 10.5455/2320-6012.ijrms20150151 Research Article Normal and variant origin and branching pattern of inferior phrenic arteries and their clinical implications: a cadaveric study Swati Thamke1*, Pooja Rani2 1Department of Anatomy, UCMS & GTB Hospital, Delhi, India 2Department of Anatomy, PGIMS, Rohtak, Haryana, India Received: 6 December 2014 Accepted: 18 December 2014 *Correspondence: Dr. Swati Thamke, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Inferior phrenic arteries, which constitute the chief arterial supply to the diaphragm, are generally the branches of abdominal aorta, however, variations in their mode of origin is not uncommon. Very less information is available regarding the functional anatomy of the inferior phrenic artery in anatomy textbooks. Methods: The present study was conducted utilizing 36 formaline-fixed cadavers between 22 years to 80 years over a period of 5 years. The frequency and anatomical pattern of the origin of the right and left inferior phrenic arteries were studied. Results: On the right side, the inferior phrenic artery arose independently from abdominal aorta in 94.4% cases and on the left side in 97.2% cases.Other sources of origin were seen in 5.55% cases.
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  • An Arteriographic Study of Mesenteric Arterial Disease I Large Vessel Changes
    Gut, 1967, 8, 206 Gut: first published as 10.1136/gut.8.3.206 on 1 June 1967. Downloaded from An arteriographic study of mesenteric arterial disease I Large vessel changes A. P. DICK, R. GRAFF, D. McC. GREGG, N. PETERS1, AND M. SARNER5 From Addenbrooke's Hospital, Cambridge EDITORIAL COMMENT This is an important study of large vessel changes causing chronic arterial insufficiency of the intestines. Symptoms of intestinal ischaemia have not been seen in this series in patients in whom the cross-sectional area of the arteries was greater than two-thirds of the normal. Arteriography is demonstrated as a valuable procedure in assessing the possibility of intestinal ischaemia as a cause of symptoms. The diagnosis ofarterial insufficiency ofthe intestines describing some of the abnormal findings which may as the cause of abdominal pain can be a matter of be demonstrated on mesenteric arteriography. considerable difficulty. A classical story of cramping, The physiological background of the clinical upper and central abdominal pain, worse after meals, problem of intestinal ischaemia has been well re- particularly if large or if followed by exercise, is by viewed by Hedberg and Kirsner (1965). Practical no means always obtained. Other features recorded importance is lent to the present study by the as occurring in this syndrome, such as chronic numerous reports of the successful treatment of both and of and diarrhoea, a malabsorption syndrome relief acute chronic intestinal ischaemia which have http://gut.bmj.com/ pain by assuming the knee-elbow position, are so appeared in the past 10 years. These include surgical seldom observed as to be of little diagnostic help.
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  • A Review of the Distribution of the Arterial and Venous Vasculature of the Diaphragm and Its Clinical Relevance
    Folia Morphol. Vol. 67, No. 3, pp. 159–165 Copyright © 2008 Via Medica R E V I E W A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl A review of the distribution of the arterial and venous vasculature of the diaphragm and its clinical relevance M. Loukas1, El-Z. Diala1, R.S. Tubbs2, L. Zhan1, P. Rhizek1, A. Monsekis1, M. Akiyama1 1Department of Anatomical Sciences, School of Medicine, St. George’s University, Grenada, West Indies 2Section of Pediatric Neurosurgery, Children’s Hospital, Birmingham, AL, USA [Received 14 January 2008; Accepted 25 April 2008] The diaphragm is the major respiratory muscle of the body. As it plays such a vital role, a continuous arterial and venous blood supply is of the utmost importance. It is therefore not surprising to find described in the literature a complex system of anastomoses that contributes to the maintenance of this muscle’s life-preserving contraction. Understanding the anatomy of the dia- phragm and any divergence in its vasculature is literally vital to humanity. In the light of this, we review the literature on the blood supply to the diaphragm, with specific emphasis on the recent description of the inferior phrenic vessels and the superior phrenic artery, summarize the clinical significance of the dia- phragmatic vasculature and suggest future avenues of study to further expand on this current body of knowledge. (Folia Morphol 2008; 67: 159–165) Key words: diaphragm, hepatocellular carcinoma, inferior phrenic artery, superior phrenic artery INTRODUCTION aneurysm, transcatheter arterial embolism, and di- In view of the diaphragm’s current standing as gestive pathologies.
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  • The Aorta, and Pulmonary Blood Flow
    Br Heart J: first published as 10.1136/hrt.36.5.492 on 1 May 1974. Downloaded from British HeartJournal, I974, 36, 492-498. Relation between fetal flow patterns, coarctation of the aorta, and pulmonary blood flow Elliot A. Shinebourne and A. M. Elseed From the Department of Paediatrics, Brompton Hospital, National Heart and Chest Hospitals, London Intracardiac anomalies cause disturbances in fetal flow patterns which in turn influence dimensions of the great vessels. At birth the aortic isthmus, which receives 25 per cent of the combinedfetal ventricular output, is normally 25 to 30 per cent narrower than the descending aorta. A shelf-like indentation of the posterior aortic wall opposite the ductus characterizes thejunction of the isthmus with descending aorta. In tetralogy ofFallot, pulmonary atresia, and tricuspid atresia, when pulmonary blood flow is reduced from birth, the main pul- monary artery is decreased and ascending aorta increased in size. Conversely in intracardiac anomalies where blood is diverted away from the aorta to the pulmonary artery, isthmal narrowing or the posterior indentation may be exaggerated. Analysis of I62 patients with coarctation of the aorta showed 83 with an intracardiac anomaly resulting in increased pulmonary bloodflow and 21 with left-sided lesions present from birth. In contrast no patients with coarctation were found with diminished pulmonary flow or right-sided obstructive lesions. From this evidence the hypothesis is developed that coarctation is prevented whenflow in the main pulmonary artery is reduced in thefetus. http://heart.bmj.com/ The association of coarctation with left-sided establishing the complete intracardiac diagnosis in I62 obstructive lesions such as mitral and aortic stenosis patients with coarctation.
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  • Differentiation of Aortic Adventitia Cells
    DIFFERENTIATION OF AORTIC ADVENTITIA CELLS Bradley Ellis, Benjamin Green, MS, Thomas G. Gleason, MD, Julie A. Phillippi, PhD Department of Bioengineering University of Pittsburgh Department of Cardiothoracic Surgery UPMC INTRODUCTION pericytes that were untreated. A two-tailed student’s t-test was Aortic Aneurysms are a debilitating group of diseases that used in order to determine whether or not there was a are responsible for over 17,000 deaths a year in the United statistically significant difference between the cell lineages States alone [1]. Thoracic aortic aneurysms are a subset of (p < 0.05). aortic aneurysms that occur when there is a ballooning of the aorta as the artery passes through the chest. If left untreated METHODS this ballooning can lead to a tear in the aortic wall (dissection) The study was designed to differentiate pericyte cells into or a rupture, which lead to patient death [1]. Recent studies one of two blood vessel cell lineages, either endothelial cells or have shown that one of the major underlying causes of thoracic SMCs. The study was performed twice on two separate cell aortic aneurysms is tissue degeneration of the aorta caused by lines taken from bicuspid aneurysmal patients. The patients inefficient repair of the artery [2]. In order to better understand had undergone surgery to repair dissected thoracic aortic thoracic aortic aneurysms it is necessary to understand the aneurysms, and agreed to have their tissue harvested for study. underlying causes of this tissue degeneration. Upon reception, the harvested aortic tissue was separated and Progenitor cells have been shown to play an important role adventitia cells were grown in culture.
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  • What Are the Basic Properties of the Blood Flow in the Human Body?
    Topic of today: Blood flow 1. Design of cardiac array 31545 Medical Imaging systems 2. Basic observations about flow in the human body Conservation of mass Lecture 5: Blood flow in the human body • Conservation of energy • Viscosity • Turbulence • Jørgen Arendt Jensen 3. Pulsating flow and its modeling Department of Health Technology Section for Ultrasound and Biomechanics 4. Pulse propagation and influence of geometric changes in vessels Technical University of Denmark September 13, 2021 5. Questions on Exercise 2 Reading material: JAJ, ch. 3, pages 45-61 1 2 Design an array for cardiac imaging Clean kitchen :) Penetration depth 15 cm and 300 λ Assume distance between ribs is maximum 3 cm The elevation focus should be at 8 cm 1. What is the element pitch? 2. What is the maximum number of elements in the array? 3. What is the lateral resolution at 7 cm? 4. What is the F-number for the elevation focus? 3 4 Human circulatory system Pulmonary circulation through the lungs What are the basic properties of the blood flow Systemic circulation to the organs in the human body? Type Diameter [cm] Arteries 0.2 – 2.4 Arteriole 0.001 – 0.008 Capillaries 0.0004 – 0.0008 Veins 0.6 – 1.5 5 6 Arteries and veins in the body Physical dimensions of arteries and veins Internal Wall Young’s diameter thickness Length modulus Vessel cm cm cm N/m2 105 Ascending aorta 1.0 – 2.4 0.05 – 0.08 5 3 –· 6 Descending aorta 0.8 – 1.8 0.05 – 0.08 20 3 – 6 Abdominal aorta 0.5 – 1.2 0.04 – 0.06 15 9 – 11 Femoral artery 0.2 – 0.8 0.02 – 0.06 10 9 – 12 Carotid artery 0.2 – 0.8 0.02 – 0.04 10 –20 7 – 11 Arteriole 0.001 – 0.008 0.002 0.1 – 0.2 Capillary 0.0004 – 0.0008 0.0001 0.02 – 0.1 Inferior vena cava 0.6 – 1.5 0.01 – 0.02 20 – 40 0.4 – 1.0 Data taken from Caro et al.
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  • How Your Heart Works
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