Aortic Aneurysm

Last updated date: 11-Jun-2023

Originally Written in English

Aortic Aneurysm

An aortic aneurysm is a bulging in the wall of the main blood vessel (aorta) that transports blood from the heart to the rest of the body. Aortic aneurysms can develop in any part of the aorta and be tube-shaped (fusiform) or circular (saccular).

The aorta is the body's biggest artery and the major vessel that transports oxygen-rich blood from the heart to every region of the body. The thoracic aorta is the segment of the aorta that runs via the chest. On the other hand, the abdominal aorta is the part of the aorta that travels through the belly.

 

Types of Aortic Aneurysm 

The two types of aortic aneurysm include; 

  • Thoracic aortic aneurysm 

A weakened spot in the major blood vessel that supplies blood to the body is called a thoracic aortic aneurysm. Blood pushing against the vessel wall could make the aorta inflate like a balloon when it is weak (aneurysm). 

Aortic aneurysm dissection can happen as a result of a ruptured aneurysm. A dissection is a rip in the aorta's wall that can lead to life-threatening bleeding or death. Also, aneurysms that are large and fast-growing may burst. On the other hand, aneurysms that are small and steadily growing might never rupture.

Treatment options range from watchful waiting to emergency surgery. This depends on the size, cause, and rate of progression of the thoracic aortic aneurysm. At times, a surgical operation might be necessary. 

  • Abdominal aortic aneurysm 

An inflated part in the lower area of the primary vessel that carries blood to the body is known as an abdominal aortic aneurysm. The aorta is a blood vessel that goes from the heart towards the chest and belly. A ruptured abdominal aortic aneurysm can lead to life-threatening hemorrhage because the aorta is the body's major blood vessel. 

Treatment options range from watchful waiting to an emergency operation, based on the size and rate of growth of the aneurysm.

 

Signs and Symptoms of Aortic Aneurysm 

The common symptoms and signs and thoracic aortic aneurysm include; 

  • Pain or tenderness within the chest 
  • Coughing 
  • Hoarseness 
  • Shortness of breath 
  • Back pain 

If you have an abdominal aortic aneurysm, you may notice the following symptoms; 

  • Ongoing deep pain within the abdomen or the abdomen side 
  • A pulse around the bellybutton 
  • Back pain 

Usually, aortic aneurysms are difficult to identify since they grow slowly and often without any symptoms. Some aneurysms are never going to burst. While many begin small and remain that way, some grow with time. Thus, it's difficult to tell how rapidly an aortic aneurysm will grow.

 

When to See a Doctor 

Unless there is a tear or a rupture, most patients with aortic aneurysms have no symptoms. A rupture or dissection is normally a medical emergency. Therefore for immediate help, dial 911 or contact your local emergency number. 

You may experience the following symptoms if an aneurysm ruptures or one or more artery wall layers tears;

  • A sharp and abrupt pain that radiates downwards from the upper back
  • You're experiencing pain in the chest, neck, jaw, or arms.
  • Breathing difficulty

 

Causes of Aortic Aneurysm 

Causes of Aortic Aneurysm

The major cause of an aorta aneurysm is the aortic wall deteriorating as a result of damage or an injury. Most health issues and lifestyle practices, such as high blood pressure and smoking, can put you at risk for aortic wall damage. 

In most cases, a bulge forms in the area where the wall is damaged and weakened. The aorta wall will keep on weakening as the bulge expands if left untreated. Also, if it grows too big, the aortic aneurysm could rupture. 

 

Risk Factors of Aortic Aneurysm 

You might be at a high risk of getting an aortic aneurysm due to factors such as; 

Age:

As you age, the chances of developing an aortic aneurysm also increase. An abdominal aortic aneurysm is more common among adults aged 65 and above. 

Genetics and family history: 

A thoracic aortic aneurysm occurs due to a number of family or hereditary diseases. Some of them include Ehlers–Danlos syndrome, Loeys–Dietz syndrome, Marfan syndrome, Turner's syndrome, and bicuspid aortic valve (BAV).

Abdominal aortic aneurysms can as well run in families. At least one in every ten patients with abdominal aortic aneurysms has a family history of the condition. People with a first-degree relative (a parent, sister, brother, or child) with the illness have a 1 in 5 chance of getting an abdominal aortic aneurysm. 

Health conditions:

Certain health conditions can contribute to aortic aneurysms. Some of them include chronic obstructive pulmonary disease, high blood pressure, cardiovascular diseases, infection, high cholesterol, kidney problems, and obesity. 

Lifestyle habits:

Certain lifestyle choices raise your chances of developing an aortic aneurysm. Some of them include; 

  • Cigarette smoking: This raises the chances of developing an aortic aneurysm, particularly an abdominal aortic aneurysm. Furthermore, an abdominal aortic aneurysm can grow more rapidly and is more likely to rupture if you are a regular smoker.
  • Use of cocaine and other stimulants 
  • Lifting weights

Gender: 

Unlike women, men are at a high risk of developing aortic aneurysms. On the other hand, an already existing aortic aneurysm has a higher possibility of rupture while small in women than men. 

 

Aortic Aneurysm Diagnosis 

Aortic Aneurysm Diagnosis

The healthcare provider diagnoses abdominal aortic aneurysm when the abdominal aorta is about 3 centimeters or more in diameter. They can also diagnose a thoracic aorta aneurysm depending on your age, gender, and the area measured in the thoracic aorta. 

The following tests and procedures will be done during aortic aneurysm diagnosis; 

Physical examination:

Your healthcare provider is likely to perform the following to diagnose aortic aneurysm during a physical test; 

  • Feel the abdomen to check for an abdominal aortic aneurysm 
  • Check the pulse in the legs and arms to determine if it’s weaker than usual 
  • Listen to the heart for murmur, softer sounds, and any changes in the flood flow that could indicate an aneurysm. 
  • Check for signs and symptoms of health conditions that can contribute to aortic aneurysm. 

Imaging tests and procedures:

The doctor can order one or more of the following imaging tests to diagnose or verify an aortic aneurysm; 

Computerized tomography (CT) scan: The doctor can determine an aneurysm's location, size, and shape using this technique. If you suffer an abrupt back or abdominal discomfort, if you already have an aortic aneurysm, or if the doctor feels a pulsing bulge in the abdomen during an examination, this might be the first test you undergo. CT scans can reveal details about the whole aorta making it easy to diagnose the problem. 

Magnetic resonance imaging (MRI): This creates images of the body using a magnetic field and radio waves. An MRI scan can be used to diagnose an aortic aneurysm and assess its size as well as location.

Echocardiogram: This technique captures real-time pictures of the heart, including the ascending aorta using sound waves. It helps determines the efficiency of the heart chambers and valves.

Ultrasound: Provides details about the location and size of both thoracic and abdominal aortic aneurysm. 

 

Aortic Aneurysm Treatment 

Treatment for an aortic aneurysm is determined by the underlying cause, size, and location of the aneurysm, as well as the risk factors. Doctors can address small aortic aneurysms with medication or healthy lifestyle modifications. The aim is to halt or slow down the aneurysm's growth and reduce the risk of rupture and dissection.

The doctor will also address the medical diseases that increase the risk of rupture or dissection. They can include coronary heart disease, high blood pressure, chronic kidney disease, or high blood cholesterol. Large aortic aneurysms, on the other hand, may require surgery to repair. 

Medications:

The healthcare provider can recommend the following medications to address aortic aneurysm;

  • Aspirin, if you have cardiovascular concerns.
  • Blood pressure medications to control blood pressure, limit the growth of aneurysms, and reduce the risk of rupture. Angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and angiotensin receptor blockers (ARBs) are examples of these medications.
  • Statins to lower cholesterol levels and to block or reduce the progression of aortic aneurysm. 

Surgery and other procedures:

Your doctor may suggest aortic aneurysm surgery to repair the issue depending on the size, rate of growth, and cause. In most cases, aortic aneurysm rupture or dissection may necessitate rapid surgical repair. Examples of the standard surgical procedures include; 

  • Open surgical repair
  • Endovascular aneurysm repair 

Lifestyle changes:

The healthcare provider may advise you to make the following heart-healthy lifestyle changes:

  • Cease smoking to reduce or slow down the aortic aneurysm's progression.
  • Practice a heart-healthy diet to help lower elevated blood pressure and cholesterol levels.
  • Managing stress to aid in the management of high blood pressure, particularly in the case of thoracic aortic aneurysms. The doctor may also advise you to avoid strenuous exercise and powerful stimulants like cocaine.

 

Conclusion 

An aortic aneurysm is characterized by a balloon-like bulging within the aorta. The aorta is the major artery that transports blood from the heart via the chest and torso. Sometimes, an aortic aneurysm can rupture or dissect; this is a life-threatening situation that normally causes death. 

Treatment of an aortic aneurysm usually depends on the location, underlying cause, shape, and degree of growth. The doctor can thus recommend medications, lifestyle changes, or even surgery in severe cases.