What are the best tests for following an abdominal aortic aneurysm?

Repeat abdominal ultrasound is the best because it allows accurate and simple evaluation of the size of the aortic aneurysm. Other tests that can successfully resolve this are MRI, CT, aortography, and digital subtraction angiography.

When should abdominal aneurysms be repaired?

All patients with abdominal aortic aneurysms 6 cm in diameter should have surgical repair. However, the management of patients with smaller aneurysms is controversial and is a subject of ongoing research. Some advise earlier operation to improve long-term prognoses, but no study has yet adequately defined how early.

How does cardiovascular syphilis affect the aorta?

A rare disease in the present day, cardiovascular syphilis, or lues disease, was once prevalent, accounting for 10% of all cardiac deaths. This disease typically presents as an aneurysm of the ascending aorta. The cornerstone of diagnosis is a history of syphilis and serologic confirmation that the patient has the disease.

What are the basic anatomic features and functions of the pericardium?

The pericardium consists of two layers of tissue: an outer fibrous layer (parietal pericardium) composed of collagen and elastin fibers, and an inner serous membrane (visceral pericardium) composed of a thin layer of mesothelial cells. The space between the two pericardial layers normally contains 15-50 ml of clear fluid.

There are ligamentous attachments from the pericardium to the sternum, veterbral column, and diaphragm which help to keep the heart fixed in place during changes in body position. The tough outer layer serves as a barrier to the spread of infection and neoplastic processes to the heart. In dog studies, the pericardium appears to provide a restraining effect during acute volume loading. Studies in humans who have undergone pericardiectomy also support the concept of a volume-restraining effect provided by the pericardium.

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