Thoracic aortic aneurysm medical therapy: Difference between revisions
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(/* 2010 ACC/ AHA Guidelines - Recommendations for Medical treatment of patients with Thoracic aortic diseases (DO NOT EDIT){{cite journal |author=Hiratzka LF, Bakris GL, Beckman JA, et al. |title=2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM gui...) |
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
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|bgcolor="LightGreen" | '''1.''' Stringent control of hypertension, lipid profile optimization, smoking cessation, and other atherosclerosis risk-reduction measures should be instituted for patients with small aneurysms not requiring surgery, as well as for patients who are not considered surgical or stent graft candidates ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' | |bgcolor="LightGreen" |<nowiki>"</nowiki>'''1.''' Stringent control of hypertension, lipid profile optimization, smoking cessation, and other atherosclerosis risk-reduction measures should be instituted for patients with small aneurysms not requiring surgery, as well as for patients who are not considered surgical or stent graft candidates ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | ||
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Revision as of 15:47, 31 October 2012
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Thoracic aortic aneurysm Microchapters |
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Differentiating Thoracic Aortic Aneurysm from other Diseases |
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Diagnosis |
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Treatment |
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Special Scenarios |
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Case Studies |
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Thoracic aortic aneurysm medical therapy On the Web |
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Directions to Hospitals Treating Thoracic aortic aneurysm medical therapy |
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Risk calculators and risk factors for Thoracic aortic aneurysm medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
Medical therapy for patients with a thoracic aortic aneurysm includes aggressive blood pressure control, smoking cessation, and aggressive lipid management.
Medical Therapy
- 2 Large bore IV needles
- Adequate airway and breathing
- Urinary output monitoring
Emergency care
- Aggressive blood pressure control
- Aggressive fluid resuscitation
- Immediate cardiac surgery consultation
Medications
Follow up
2010 ACC/ AHA Guidelines - Recommendations for Medical treatment of patients with Thoracic aortic diseases (DO NOT EDIT)[1]
| Class I |
| "1. Stringent control of hypertension, lipid profile optimization, smoking cessation, and other atherosclerosis risk-reduction measures should be instituted for patients with small aneurysms not requiring surgery, as well as for patients who are not considered surgical or stent graft candidates (Level of Evidence: A)" |
2010 ACC/ AHA Guidelines - Recommendations for Blood pressure control in Thoracic aortic disease (DO NOT EDIT)[1]
| Class I |
| 1.Antihypertensive therapy should be administered to hypertensive patients with thoracic aortic diseases to achieve a goal of less than 140/90 mm Hg (patients without diabetes) or less than 130/80 mm Hg (patients with diabetes or chronic renal disease) to reduce the risk of stroke, myocardial infarction, heart failure, and cardiovascular death. (Level of Evidence: B) |
| 2.Beta adrenergic–blocking drugs should be administered to all patients with Marfan syndrome and aortic aneurysm to reduce the rate of aortic dilatation unless contraindicated. (Level of Evidence: B) |
| Class IIa |
| 1.For patients with thoracic aortic aneurysm, it is reasonable to reduce blood pressure with beta blockers and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers to the lowest point patients can tolerate without adverse effects. (Level of Evidence:B) |
| 2.An angiotensin receptor blocker (losartan) is reasonable for patients with Marfan syndrome, to reduce the rate of aortic dilatation unless contraindicated. (Level of Evidence:B) |
2010 ACC/ AHA Guidelines - Recommendations for Dyslipidemia in Thoracic aortic aneurysm (DO NOT EDIT)[1]
| Class IIa |
| 1. Treatment with a statin to achieve a target LDL cholesterol of less than 70 mg/dL is reasonable for patients with a coronary heart disease risk equivalent such as noncoronary atherosclerotic disease, atherosclerotic aortic aneurysm, and coexistent coronary heart disease at high risk for coronary ischemic events (Level of Evidence:A) |
2010 ACC/ AHA Guidelines - Recommendations for smoking cessation in Thoracic aortic disease (DO NOT EDIT)[1]
| Class I |
| 1. Smoking cessation and avoidance of exposure to environmental tobacco smoke at work and home are recommended. Follow-up, referral to special programs, and/or pharmacotherapy (including nicotine replacement, buproprion, or varenicline) is useful, as is adopting a stepwise strategy aimed at smoking cessation (the 5 As are Ask, Advise, Assess, Assist, and Arrange) (Level of Evidence: B) |
References
- ↑ 1.0 1.1 1.2 1.3 Hiratzka LF, Bakris GL, Beckman JA; et al. (2010). "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine". Circulation. 121 (13): e266–369. doi:10.1161/CIR.0b013e3181d4739e. PMID 20233780. Unknown parameter
|month=ignored (help)