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mcdumbass
Adding on, hoarseness + difficulty swallowing means something is pushing on the recurrent laryngeal.
Murmur in the second right intercostal space = AR, AS, or Pulm regurg --> AR associated with thoracic aortic aneurysm, or at minimum, you can infer it's a cardiac etiology
+4
chadgas
The dyspnea, dysphagia, stridor, and cough are pretty indicative of a mediastinal mass. So expansion of the aorta can cause compression of the esophagus, trachea, recurrent laryngeal nerve, etc. depending on the severity of it.
+1
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bmalamet
You would not see a "viable pulsation above the manubrium, which you should not confuse with a "brisk carotid upstroke" associated with aortic stenosis.
+2
nbmeanswersownersucks
"brisk carotid upstroke" is the description of a normal carotid pulse. Aortic stenosis has a slowly rising/late peaking upstroke since the stenosis impedes flow out of the LV.
+9
overa
AS affects the LV first. it isn't until later in the disease progression that there will be a significant enough enlargement of the LA to cause impingement of the LA. By the time the problem was that bad there would also be pulmonary findings of backed-up pressure (in my not so expert opinion).
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305charlie94
Can anyone explain why the trachea is deviated in an aortic aneurysm? Made me think of a pneumothorax here
+3
thrawn
pneumothorax has mass effect to
+
leemax
severe chest pain -aortic aneurysm
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submitted by โmousie(272)
the pulsatile mass gave it away for me but looking back this patient has all the risk factors for AA - male smoker with HTN + deep chest pain and pulsatile mass = AA all day long