(AAA; Abdominal Aortic Aneurysm; Aneurysm, Abdominal Aortic; Thoracic
Aortic Aneurysm; Aneurysm, Thoracic Aortic)
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 and tends
to get bigger with time. The aorta is the body's largest artery. It
carries blood from the heart for delivery to the rest of the body. The
aorta travels through the chest (thoracic aorta) and the abdomen
(abdominal aorta). Abdominal aortic aneurysms are more common than
thoracic aortic aneurysms.
The greatest danger is that an aneurysm will rupture. This will cause
heavy, uncontrollable bleeding (hemorrhage). Aortic aneurysms can also
occur with aortic dissection. Dissection is defined as 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, eventually leading to
rupture of the vessel.
Aneurysms can develop anywhere, but are most common in the aorta, iliac
artery, and femoral artery.
Abdominal Aortic Aneurysm
Copyright © Nucleus Medical Media, Inc.
Atherosclerosis 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.
A risk factor is something that increases your chance of getting
a disease or condition. Risk factors for an aortic aneurysm
include the following:
High blood pressure
Inherited connective tissue defects ( Marfan syndrome,
Ehlers-Danlos syndrome )
Age: 60 or older
History of heart attack
Family members with aneurysms, particularly male
children of an affected mother
Great vessel arteritis (Takayasu’s disease)
Injury to the aorta, from either a motor vehicle
accident or a stab wound
Many aneurysms do not have symptoms and are detected during a
routine physical exam or during X-ray evaluation for another
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, constant pain occurring over hours or
Sudden onset of severe stabbing pain
Unusual sensation of pulsing in the abdomen
Cough, shortness of breath (thoracic aortic aneurysm)
Sudden blood pressure drop, fainting (upon rupture of
Coughing up blood
The doctor will ask about your symptoms and medical history, and
perform a physical exam. 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.
Tests may include:
Abdominal or chest X-ray
Abdominal or chest ultrasound
CT scan of the abdomen or chest — a type of X-ray that
uses a computer to make images of the inside of the body
MRI scan of the abdomen or chest — a test that uses
magnetic waves to make images of the inside of the body
Transesophageal echocardiography — the use of ultrasound
to study the heart and its vessels; a transducer, which
records the information, is swallowed by the patient
Aortography — the use of X-rays and injection of a
contrast dye to make images of the heart and the aorta
Cardiac catheterization — a tube-like instrument is
inserted into the heart through a vein or artery
(usually in the arm or leg) to detect problems with the
heart and its blood supply
Treatment includes surgery or stenting.
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.
When deciding whether to operate, the doctor will consider:
Your general health
The size of your aneurysm
Associated disease (eg, kidney failure, stroke)
If the aneurysm has ruptured or not
If you've had a recent heart attack
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 through a small incision
in the upper thigh into the aorta. Using X-ray, it is guided through the
aorta to the site of the aneurysm. 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 guidelines for preventing an aneurysm because the
cause is not known. However, you can reduce some of your risk
factors by following these recommendations:
Eat a healthful diet, one that is low in saturated fat
and rich in whole grains, fruits, and vegetables.
Don't smoke. If you smoke, quit.
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.
Maintain a healthy weight.
Begin a safe exercise program with the advice of your
Seek treatment for high blood pressure, syphilis, and
If you have Marfan syndrome, see your doctor regularly
for monitoring and CT scans.
American Heart Association http://www.americanheart.org/
The National Heart, Lung and Blood Institute http://www.nhlbi.nih.gov/health/
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