Aortic Aneurysm: Example

00:01 Hello I am Joseph Alpert with advanced vascular medicine. The topic for this discussion is aortic aneurysms. Let's start with a case example. We have a 65-year-old man, who suffers a sudden onset of severe abdominal pain. His physical examination is abnormal. His temperature is normal but his heart rate is quite high as you can later see this is a very high heart rate for him at 110 beats per minute. He normally runs a heartbeat of 60 to 80. His respirations are 25 and that is also an increased number of breaths per minute. Normally his respirations run somewhere between 12 and 18. His blood pressure is slightly elevated at 145/100 not surprising for somebody who is having pain. He has diminished pulses in his lower extremities and when you feel the abdomen you feel a mass in the centre of the abdomen which increases with each systole. He has a fasting blood glucose measurement of 180 to 220 mg/dl and this is quite abnormal with a normal value being generally under 110 for a man of this age and he has had this abnormal blood sugar for more than 20 years and has not had it taken care of. So what would you say the medical diagnosis is? For me first of all the patient is diabetic. Secondly, it appears that there has been some sort of abdominal catastrophe and since diabetics are at increased risks for artherosclerosis it is likely he has an atherosclerotic abdominal aortic aneurysm which has ruptured. In fact his previous exams at the doctor’s office showed that he had a heart rates between 60 and 80 beats per minute, respiratory rate between 12 and 18, and sugars that were much more normal in the past although still abnormal more than 105 to 110.