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Cystic Medial Necrosis Definition, Symptoms, Causes, Treatment

The breakdown of muscles, elastin and collagen of blood vessels is known as cystic medial necrosis. It commonly involves aorta which supplies oxygenated blood to all parts of bodies. Aorta is the largest artery which is responsible mainly for supplying oxygenated blood to whole body from heart. As collagen, elastin and muscles surrounding blood vessels are responsible for the shape and structure of blood vessels. During cystic medial necrosis, when these structures get damaged, there is a possibility that blood may leaks out of blood vessels and blood flow regurgitation may occur.


Cystic medial necrosis in aorta is also referred as aortic dissection. It is a life threatening condition. Cystic medial necrosis is a histological finding. It is also termed as connective tissue disorder, because connective tissues i.e. elastin, collagen and muscles of blood vessels get damaged in cystic medial necrosis. This condition sometimes does not appear cystic and necrotic. Cystic medial necrosis is associated with three main medical conditions. These conditions are marfan's syndrome, ehlers danlos syndrome and annuloaortic ectasia. The microscopic features of cystic medial necrosis involve basophilic ground substance. Elastic lamina appears disruptive in media. Elastin stains are used to stain blood vessel sample for histological finding.

Cystic Medial Necrosis Definition, Symptoms, Causes, Treatment

Cystic Medial Necrosis Symptoms


Cystic medial necrosis is a life threatening condition which if not treated on time, can cause death. It is a histological finding and it's associated symptom involves severe chest pain. The symptoms become worse if it results in aortic dissection. Pain in chest involving both back and front side, vomiting, shock and dizziness are reported as symptoms. Excessive blood loss will lead to low blood pressure and sweating occurs as a result. Vomiting may have blood in it. Bloody stool is also reported as a result of cystic medial necrosis.

Cystic Medial Necrosis Causes


Cystic medial necrosis involves destruction or breakdown of muscles, elastin and collagen (collectively called as connective tissues). Sometimes connective tissue breakdown occurs as a result of any degenerative disease. Three main degenerative diseases are reported behind muscle, elastin and collagen breakdown. These diseases include marfan syndrome, Ehlers danlos syndrome and annuloaortic ectasia. Marfan syndrome is an autosomal dominant disorder. Under microscopic evaluation of marfan syndrome, aortic aneurysm is seen which is the ultimate cystic medial necrosis. Well ehlers danlos syndrome is a genetic defect and highly associated with aortic dissection I.e. cystic medial necrosis.

Cystic Medial Necrosis Treatment


Cystic medial necrosis can be treated in two ways i.e. medical and surgical way. In surgery, the destructive portion of aorta is replaced with a normal one i.e. Dacron graft. Aortic dissection is performed for type A and type B necrosis. Type A is for ascending aorta and type B is for descending aorta. It is preferred when medications are of no use anymore in treating cystic medial necrosis. Medications are prescribed at mild stage of cystic medial necrosis. Beta blockers are used initially and other drug classes involve calcium channel blockers, nitroprusside to relax vascular walls and ACE inhibitors.
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