Cardiology>>>>>Aorta And Hypertension
Question 1#

A 40-year-old man is referred to the cardiology outpatient clinic from the ED where he had presented with a cough. A CXR had been performed and had demonstrated a widened mediastinum. A CT thorax was requested which demonstrated a 6.1 cm aneurysm in the ascending aorta. Therefore he was referred to you for further follow-up. 

Which one of the following is true regarding the pathophysiology of aortic aneurysms?

A. The presence of a bicuspid aortic valve doubles the risk of dissection
B. Bicuspid aortic valves account for 2% of all dissections
C. Dissection in patients with bicuspid aortic valves is due to post-stenotic dilatation of the ascending aorta
D. Previous surgery accounts for 2–4% of aortic aneurysms
E. Kawasaki syndrome tends to affect the coronary arteries of adults

Correct Answer is D


Bicuspid aortic valves have a 1% prevalence and are seen in 6–10% of all dissections. They have a ninefold higher risk of dissection. This is due to cystic medial degeneration, impaired fibrillin-1, and lymphocytic infiltration in the aortic wall, and not to post-stenotic dilatation of the ascending aorta as had initially been thought. Kawasaki syndrome causes circumscript aneurysm formation, classically in coronary arteries, and typically occurs in children.