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What is Aortic Aneurysm: Symptoms, Causes, Diagnosis, and Treatment

Definition & Overview

The heart provides every organ in the body with a constant supply of oxygen-rich blood through its main artery called the aorta. The aorta originates from the heart’s left ventricle, goes up about two inches (ascending aorta), curves over the heart (aortic curve), travels down the chest (descending aorta), and branches to the lower abdomen (abdominal aorta). Several arteries branch out from the aorta to supply blood to various areas of the body, such as the head, neck, arms, ribs, and chest structures.

In normal conditions, the aorta wall is elastic and it handles the rise and fall of blood pressure efficiently. The wall expands when there is heavy pressure and returns to its normal shape when the pressure has been relieved.

In some cases, the aortic wall loses its elasticity in some sections and a bulge called an aortic aneurysm develops. This weak section of the wall may burst or rupture at any given moment. If the wall bursts, bleeding will occur. This condition often results in death.

In other cases, the blood flow slows down in the weakened section, increasing the likelihood of the formation of a blood clot. If for some reason, the blood clot is dislodged, it can travel to the brain, which will result in a stroke.

Although aortic aneurysms can form anywhere along the aorta, they usually occur in the chest and abdominal areas. Aneurysms that form in the chest area are called thoracic aortic aneurysms, while those that form in the abdominal area are referred to as abdominal aortic aneurysms.

Aortic aneurysms are often undiagnosed because they don’t cause any symptoms. In fact, they are only discovered through a periodic checkup or when diagnosing other complaints.

Cause of Condition

Aortic aneurysms are often caused by different medical conditions. However, it’s important to note that although the following are known causes of the condition, they aren’t the only causes. In fact, in many cases, the exact cause of an aortic aneurysm is unknown. This means that even though a person is not at risk because of the absence of the conditions listed below, it is still possible for an aortic aneurysm to develop.

The two primary causes of aortic aneurysm are high blood pressure and atherosclerosis. The aortic walls are elastic, but when they are continuously being stretched to their limits due to high blood pressure, a bulge in a section of the wall can occur. Atherosclerosis is a condition wherein cholesterol covers the lining of the wall. In time, the cholesterol hardens and weakens the wall.

The following may also cause aortic aneurysm:

  • Diabetes
  • Accidents
  • Inflammatory aneurysm
  • Mycotic aneurysm
  • Cystic medial necrosis

It’s possible for anyone to develop aortic aneurysm, but statistically, it mostly affects men who are 55 years old and above. Other risk factors are high blood pressure, smoking, history of aortic aneurysm in the family, atherosclerosis, and diseases that weaken the blood vessels, such as the Marfan syndrome.

Key Symptoms

In most cases, aortic aneurysm does not display any symptoms while still in the early stages. It’s likely that the condition will produce symptoms, such as chest or back pains, when they become large or they rupture.

When the aorta ruptures, it produces symptoms that are similar to a heart attack. These include increased sweating, dizziness, rapid breathing, and a fast heart rate. Some people report that they experience an unusual feeling of fullness after only eating a minimal amount of food. Nausea and vomiting commonly occur as well. If blood clots form in the bulge, these can be dislodged and cause a stroke or a heart attack. In such cases, the symptoms of both conditions will be evident.

Aortic aneurysm is a life-threatening condition. It’s imperative that a person displaying any of the above symptoms receives immediate medical attention. Other symptoms that require emergency medical care are:

  • Loss of consciousness
  • Numbness or tingling sensation
  • Weakness
  • Confusion
  • Light-headedness

Who to See & Types of Treatment Available

Patients who are considered at higher risk of developing aortic aneurysm must undergo periodic physical examinations even if they don’t experience any of the above symptoms. This is because many aortic aneurysm cases are only discovered when the condition has reached the advanced stages or when it has already ruptured. Undergoing periodic physical exam will reduce the risk of the condition progressing into the advanced stages.

Meanwhile, patients who experience the above symptoms must see their family doctor right away. To make an accurate diagnosis, several tests will be performed and these include:

  • Electrocardiogram (ECG or EKG)
  • Ultrasound
  • X-ray
  • CT-scan
  • Magnetic Resonance Imaging (MRI)

If the tests indicate a high possibility of an aortic aneurysm, the doctor will work hand in hand with a surgeon and perform an emergency surgery if needed.

The primary treatment method for aortic aneurysm, whether abdominal or thoracic, is surgery. However, the doctor must decide whether the risks of surgery will outweigh the benefits. If the doctor decides that the risk of an aneurysm rupturing is still low, the patient will be prescribed with medications to lower the blood pressure.

If the doctor decides that surgery needs to be performed, the patient will be prepared for surgery. A large incision will be created in the chest or abdomen to gain access to the aneurysm. Blood flow in the aorta is redirected to an outside pump. The surgeon will remove the affected section of the aorta and replace it with an artificial blood vessel.

The majority of people who have undergone surgery or treatment for aortic aneurysm fully recover. After the treatment, they will be required to make some lifestyle changes, which includes a healthy diet, quitting smoking, and monitoring and controlling their blood pressure. Without these lifestyle changes, it is possible for another aortic aneurysm to form elsewhere on the aorta.

References:

  • Isselbacher EM. Diseases of the aorta. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 78.
  • Zivin JA. Hemorrhagic cerebrovascular disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 415.