Aortic Aneurysms

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What Is the Aorta?

The aorta is the main blood vessel carrying oxygen-rich blood from the heart to various parts of the body. Over time, the aortic walls may lose their elasticity. When this happens, the weakened areas of the aortic wall bulge outward like a balloon. These abnormal bulges are known as aortic aneurysms. 

An aneurysm can develop in any part of the aorta. Depending on its location, the aneurysm can be classified as either an abdominal aortic aneurysm, which occurs in the section of the aorta passing through the abdomen or a thoracic abdominal aneurysm, which is caused by a weakening of the upper parts of the aorta.

Is an Aortic Aneurysm Life-threatening?

An aneurysm can expand over time. When it becomes too large, it can break open and bleed, resulting in death. A blood clot can also form in the aneurysm. Sometimes, small pieces of the blood clot break off and get stuck in the blood vessels of the brain or heart, causing a stroke or heart attack.

Symptoms of an Aortic Aneurysm

Aortic aneurysms do not have any initial symptoms and are often discovered on X-ray during routine health examinations. Symptoms start showing as the aneurysm grows, although large aneurysms have also been seen to be asymptomatic.

When an aneurysm ruptures, it causes sudden and deep pain. Patients may go into shock or lose their consciousness. This is a dangerous situation requiring emergency treatment.

Signs of an aneurysm may include:

  • A pain in the chest or abdominal, based on the location of the aneurysm 
  • An abdominal aortic aneurysm may cause a pulsing sensation in the stomach
  • A thoracic aortic aneurysm may cause shortness of breath and back pain

What Risk Factors Make One Susceptible?

Atherosclerosis

Diabetes

High cholesterol

High blood pressure

Smoking 

Family history

Diagnosis

Aortic aneurysms are discovered during routine checks and sometimes doctors receive symptomatic cases. Once an MRI or CT scan is ordered and the diagnosis is confirmed, more imaging tests are ordered to determine the location, size, and shape of the aneurysm. An angiogram (X-ray photograph of blood), transesophageal echocardiography (ultrasound of the heart), and intravascular ultrasound are common diagnostic tests for aneurysms.

Individuals at a high risk of aortic aneurysms should undergo abdominal aortic aneurysm screening. It is recommended for men and women aged 60-85 years, and all men and women above the age of 50 who have a family history of abdominal aortic aneurysms.

What Types of Treatment Can Be Done?

Medications

Aortic aneurysms less than 5 centimeters in size have a low chance of rupturing and may not need surgical treatment. Beta-blockers and calcium blockers may be prescribed to lower the risk of rupture.

Surgical Intervention

Surgical intervention may be necessary for aneurysms larger than 5 centimeters. Open surgery and endovascular repair are two options. An open surgical repair takes 3-5 hours and requires a hospital stay of 5-10 days.

Endovascular Repair

In endovascular repair, an incision is made in the groin area to access the arteries connecting to the aorta. A guidewire is threaded to the affected area, and then a stent graft inside a catheter is inserted to reinforce the weak areas of the aorta. The repair takes 1-3 hours, and patients can resume their normal activities 2-6 weeks after the procedure.