​Pathology - Aortic Aneurysm

​Pathology - Aortic Aneurysm
Linked to atherosclerosis, coronary artery disease (CAD), physical injury, genetic risk, and degeneration of the middle layer of arterial walls (cystic medial necrosis)
More commonly observed in males over the age of 50.

Pathology Artery: Typically located in the descending aorta below the renal arteries, although it can also occur in the thoracic aorta. It develops in areas where the arterial wall weakens (such as when atherosclerotic plaque destroys the media layer) or in localized dilations of arteries and veins. These dilations often take the form of saccular outpouchings that are frequently filled with atherosclerotic plaque or thrombus.

Symptoms and signs 
Typically, an abdominal aortic aneurysm (AAA) does not show any symptoms until it bursts. In such cases, it may cause a pulsating, painless mass in the upper abdomen. However, when the AAA ruptures, it leads to intense ripping abdominal agony that spreads to the back and low blood pressure. Individuals afflicted with ascending thoracic aneurysms may experience aortic insufficiency or suffer from chest pain.
Complications may arise from the blockage of renal iliac and/or mesenteric arteries due to the presence of thrombus emboli, or from the occurrence of rupture.
Imaging: Dual-channel lumen of the aorta.

Therapy 

Surgical intervention is recommended for asymptomatic patients with an aneurysm that is rapidly increasing in size and exceeds 5.0 cm. Ruptured aneurysms require prompt surgical repair. Blood pressure should be managed using b-blockers and ACE-inhibitors. Smoking cessation is advised, and lipid-lowering medication should be pursued.
Men aged over 65 with a history of tobacco use are advised to undergo a single screening abdomen ultrasonography to detect any potential abnormalities. 
Tertiary syphilis is linked to the development of syphilitic aneurysm. The blood flow to the aorta (vasa vasorum) is interrupted, leading to the development of an aneurysm in the ascending aorta or aortic arch. This aneurysm has a distinct look resembling the bark of a tree and is associated with aortic valve insufficiency.