Thoracic aortic aneurysm screening: Difference between revisions
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==Overview== | ==Overview== | ||
Screening for TAA is not recommended in the general population. However, certain population substrates, such as those with history of [[Marfan's syndrome]], [[Turner's syndrome]], [[Ehlers-Danlos type IV syndrome]], [[familial thoracic aortic disease syndromes]], and patients with [[bicuspid aortic valve]] should have imaging study to screen for TAAs. First-degree relatives of people with thoracic aortic aneurysm or dissection should have aortic imaging to identify asymptomatic disease. | |||
==Surveillance== | |||
People diagnosed with Marfan syndrome should immediately have an echocardiogram to measure the aorta, and followed up 6 months later to check for aortic enlargement.<ref>{{cite journal |author=Hiratzka LF, Bakris GL, Beckman JA, ''et al.'' |title=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 |journal=J. Am. Coll. Cardiol. |volume=55 |issue=14 |pages=e27–e129 |year=2010 |month=April |pmid=20359588 |doi=10.1016/j.jacc.2010.02.015 |url=http://content.onlinejacc.org/cgi/content/full/j.jacc.2010.02.010v1 }}</ref> | |||
==ACC/ AHA Guidelines - Recommendations for Screening Tests (DO NOT EDIT)== | ==ACC/ AHA Guidelines - Recommendations for Screening Tests (DO NOT EDIT)== | ||
Revision as of 23:10, 21 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 screening On the Web |
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Directions to Hospitals Treating Thoracic aortic aneurysm screening |
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Risk calculators and risk factors for Thoracic aortic aneurysm screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: {{AN}]
Overview
Screening for TAA is not recommended in the general population. However, certain population substrates, such as those with history of Marfan's syndrome, Turner's syndrome, Ehlers-Danlos type IV syndrome, familial thoracic aortic disease syndromes, and patients with bicuspid aortic valve should have imaging study to screen for TAAs. First-degree relatives of people with thoracic aortic aneurysm or dissection should have aortic imaging to identify asymptomatic disease.
Surveillance
People diagnosed with Marfan syndrome should immediately have an echocardiogram to measure the aorta, and followed up 6 months later to check for aortic enlargement.[1]
ACC/ AHA Guidelines - Recommendations for Screening Tests (DO NOT EDIT)
| Class I |
| 1. An electrocardiogram should be obtained on all patients who present with symptoms that may represent acute thoracic aortic dissection. |
| a.Given the relative infrequency of dissection-related coronary artery occlusion, the presence of ST-segment elevation suggestive of myocardial infarction should be treated as a primary cardiac event without delay for definitive aortic imaging unless the patient is at high risk for aortic dissection (Level of Evidence: B) |
| 2.The role of chest x-ray in the evaluation of possible thoracic aortic disease should be directed by the patient's pretest risk of disease as follows: |
| a. Intermediate risk: Chest x-ray should be performed on all intermediate-risk patients, as it may establish a clear alternate diagnosis that will obviate the need for definitive aortic imaging (Level of Evidence:C) |
| b. Low risk: Chest x-ray should be performed on all low-risk patients, as it may either establish an alternative diagnosis or demonstrate findings that are suggestive of thoracic aortic disease, indicating the need for urgent definitive aortic imaging. (Level of Evidence:C) |
| 3.Urgent and definitive imaging of the aorta using transesophageal echocardiogram, computed tomographic imaging, or magnetic resonance imaging is recommended to identify or exclude thoracic aortic dissection in patients at high risk for the disease by initial screening (Level of Evidence: B) |
| Class III (No Benefit) |
| 1. A negative chest x-ray should not delay definitive aortic imaging in patients determined to be high risk for aortic dissection by initial screening.(Level of Evidence: C) |
References
- ↑ 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". J. Am. Coll. Cardiol. 55 (14): e27–e129. doi:10.1016/j.jacc.2010.02.015. PMID 20359588. Unknown parameter
|month=ignored (help)