The aorta is the body's largest artery. It carries blood from the heart and delivers it to the rest of the body. The aorta travels through the chest and the abdomen. An aortic aneurysm is a weak, bulging area in the wall of the aorta. The bulging develops from a weakness or defect in the aortic wall. It tends to get bigger with time.
The greatest danger is that an aneurysm will rupture. This will cause heavy, uncontrollable bleeding. Aortic aneurysms can also occur with aortic dissection. Dissection is a small tear in the aortic wall. Blood from the aneurysm can leak through this tear and spread between the layers of the aortic wall. This leads to eventual rupture of the vessel.
Aneurysms can develop anywhere. They are most common in the aorta (thoracic and abdominal), iliac artery, and femoral artery.
is frequently associated with aneurysm. However, it is not thought that this disease alone causes the growth of an aneurysm. It is believed that other factors, such as
high blood pressure
or connective tissue disorders, must be present for an aneurysm to form.
Aortic aneurysms are more common in adults over 60 years of age. Other factors that may increase your chances of an aortic aneurysm:
Family members with aneurysms, particularly male children of an affected mother
Great vessel arteritis, also known as Takayasu disease
Injury to the aorta, from either a motor vehicle accident or a stab wound
Many aneurysms do not have symptoms. They are detected during a routine physical exam or during x-ray evaluation for another disorder.
Symptoms may occur when the aneurysm grows or disrupts the wall of the aorta. Symptoms depend on the size and location of the aneurysm and may include:
Pain in the abdomen or in the lower back
Boring, gnawing, or constant pain occurring over hours or days
Sudden onset of severe stabbing pain
Unusual sensation of pulsing in the abdomen
Cough, shortness of breath
Coughing up blood
You will be asked about your symptoms and medical history. A physical exam will be done. Pain is the symptom that will most likely cause you to go to the doctor. Most aortic aneurysms are discovered during a routine physical exam.
Images of your heart may be needed. This can be done with:
Surgery to repair an aortic aneurysm is called
aneurysmectomy. It involves removing the portion of the aorta that contains the aneurysm and replacing it with a mesh graft.
With aneurysms of the thoracic aorta, the aortic valve may also be affected and need to be replaced or repaired. If the aneurysm involves important branches of the aorta, these vessels may either be repaired or bypassed.
Depending on where the aneurysm is located and how complex it is, stenting may be done. A stent-graft is a polyester tube covered by a tubular metal web. The stent-graft is inserted into the aorta. With the stent-graft in place, blood flows through the stent-graft instead of into the aneurysm, eliminating the chance of rupture.
There are no current guidelines for preventing an aneurysm because the cause is not known. However, you can reduce some of your risk factors:
that is low in saturated fat and rich in whole grains, fruits, and vegetables.
If you smoke, talk to your doctor about ways to
The US Preventive Services Task Force recommends that men aged 65-75 who have ever smoked be screened once for abdominal aortic aneurysm with
ultrasound. This is a painless procedure that gives a picture of the abdomen using sound waves. Early detection of abdominal aortic aneurysm in this group has been shown to reduce mortality from this condition.
Screening for abdominal aortic aneurysm: recommendation statement. US Preventive Services Task Force website. Available at: https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/abdominal-aortic-aneurysm-screening. Updated June 2014. Accessed February 28, 2018.
7/21/2009 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114361/Abdominal-aortic-aneurysm-AAA: Thompson SG, Ashton HA, Gao L, Scott RA, Multicentre Aneurysm Screening Study Group. Screening men for abdominal aortic aneurysm: 10 year mortality and cost effectiveness results from the randomised Multicentre Aneurysm Screening Study. BMJ. 2009;338:b2307.
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