Date: 18 Mar 2016
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An aneurysm is an abnormal bulge in the wall of an artery. Normally, the walls of arteries are thick and muscular, allowing them to withstand a large amount of pressure. Occasionally, however, a weak area develops in the wall of an artery. This allows the pressure within the artery to push outwards, creating a bulge or ballooned area called an "aneurysm."
Aneurysms can form in any blood vessel, but they occur most commonly in the aorta ( aortic aneurysm). The aorta is the largest artery in the body. It carries blood from the heart to the rest of the body. Aortic aneurysms can occur in two main places:
Abdominal aortic aneurysms occur in the part of the aorta that passes through the middle to low abdomen.
Thoracic aortic aneurysms occur on the aorta as it passes through the chest cavity. These are less common than abdominal aneurysms.
Small aneurysms generally pose no threat. However, aneurysms increase the risk for:
Atherosclerotic plaque formation at the site of the aneurysm. This causes further weakening of the artery wall.
A blood clot may form at the site and dislodge, increasing the chance of stroke.
Increase in the size of the aneurysm, causing it to press on other organs. This may cause pain.
Aneurysm rupture. Because the artery wall thins at this spot, it is fragile and may burst under stress. The rupture of an aortic aneurysm is a catastrophic, life-threatening event.
What Causes Aortic Aneurysms?
Aortic aneurysms may be caused by:
Atherosclerosis, or hardening of the arteries, which weakens arterial walls
Hypertension ( high blood pressure)
Local injury to the artery
Congenital abnormality. A number of conditions, such as Marfan syndrome are present at birth and can cause weakness of the artery walls.
Syphilis use to be a common cause of thoracic aneurysms, but that is no longer as common.
What Are the Symptoms of an Aortic Aneurysm?
Aortic aneurysms often cause no symptoms at all. But if present, symptoms include:
Tearing pain in the chest, abdomen, and/or middle of the back between the shoulder blades.
Thoracic aneurysms may cause shortness of breath, hoarseness, brassy cough (due to pressure on the lungs and airways), and difficulty swallowing (pressure on the esophagus)
Rupture of an aneurysm can cause loss of consciousness, stroke, shock, or a heart attack
If you are experiencing sudden unexplained chest, abdominal, or back pain, or any of the other symptoms mentioned above, seek medical attention.
How Are Aortic Aneurysms Diagnosed?
The diagnosis of an aortic aneurysm is difficult because often there are no symptoms. A doctor may find one incidentally during an exam. A thoracic aneurysm may cause a heart murmur. An abdominal aneurysm feels like a pulsating mass in the stomach.
If one is detected, it must be monitored. Aneurysms become dangerous and more prone to rupture when they are more than 5 cm wide. Tests to detect them include:
Angiography (dye test to look at the aorta)
Magnetic resonance imaging (MRI)
Computed tomography ( CT scan)
How Are Aortic Aneurysms Treated?
Small aortic aneurysms that aren't causing any symptoms are monitored over time until they become large and at a higher risk for rupture.
When an aortic aneurysm is large or associated with symptoms, the weakened section of the vessel can be surgically removed and replaced with a graft of artificial material. If the aneurysm is close to the aortic valve, valve replacement may also be recommended.
Repairing the aneurysm surgically is complicated and requires an experienced surgical team. However, neglecting an aneurysm presents a higher risk. The repair requires open-chest or abdominal surgery, general anesthesia and usually a minimum hospital stay of five days. If you've undergone surgery to repair an aneurysm, it is recommended you adopt the same heart-healthy lifestyle led by other heart surgery patients. Newer techniques for repairing abdominal and thoracic aneurysms may benefit higher-risk patients.
To prevent a potential aortic aneurysm, people with atherosclerosis in other parts of the body (coronary artery disease or carotid artery blockage) should get regular exams from their doctor.