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Aortic Aneurysm - Causes, Symptoms, Diagnosis, and Treatment

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Aortic Aneurysm - Causes, Symptoms, Diagnosis, and Treatment

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An aortic aneurysm can occur anywhere in the body and can be missed during diagnosis. It can cause serious complications if ruptured. This article explains the aortic aneurysm in detail.

Medically reviewed by

Dr. Chopda Anand Manaklal

Published At September 17, 2021
Reviewed AtMay 30, 2024

What Is Meant by Aortic Aneurysm?

The aorta, the largest artery in the body, functions to transport blood and oxygen from the heart to various body parts. Resembling a curved candy cane, it consists of the ascending aorta leading away from the heart and the descending aorta into the abdomen. Aneurysms can occur in any artery, including the aorta. An aortic aneurysm develops due to a weakening in the aortic wall, leading to the formation of a balloon-like bulge caused by the pressure of blood flowing through the artery. This bulge is referred to as an aortic aneurysm.

How Is Aortic Aneurysm Caused?

The exact causative factor has not been known yet, but many factors are known to be related to this condition. One of the explained pathophysiology's is damaged arteries due to blockages caused by fatty deposits, etc., which makes the heart put extra effort and pump harder than usual to push out blood crossing the fatty deposits in the artery. Thus, the increased pressure within the arteries can damage the arteries more. The following conditions are known to be associated with aortic aneurysm:

1. Atherosclerotic Disease:

This condition has shown the development of an aortic aneurysm as a sequela. Patients suffering from atherosclerotic disease have fatty deposits or plaque accumulation in their arteries. Plaque acts as a barrier and, thus, prevents the free flow of blood within the arteries.

2. High Blood Pressure:

Another major causative factor for an aneurysm is increased blood pressure. It is a measure of the amount of force of circulating blood on the walls of arteries. If the pressure rises above the normal level, it can cause weakening or enlargement of the blood vessels.

The normal blood pressure level is 120/80 mm Hg, which can range between 110/70 - 140/90 mm Hg.

If there is a constant rise in blood pressure levels, it increases the risk of various disorders of the heart, blood vessels, and circulation.

What Are the Different Types of Aneurysms?

As mentioned earlier, aneurysms can occur anywhere in the body, and they are classified based on their anatomical location as follows;

1. Aorta:

The aorta is known to be the largest blood vessel in the body. It starts at the left ventricle of the heart, goes down the abdomen, and finally splits to reach both legs. The aorta is considered to be the most common site for arterial aneurysms.

  • The aneurysms involving the chest cavity are known as thoracic aortic aneurysms.

  • The aneurysm involving the abdomen is called an abdominal aortic aneurysm. These are the most commonly observed types.

  • Both the chest and abdomen can be affected simultaneously by the damaged artery in rare cases.

2. Brain:

Aneurysms can be found in the brain, and they can vary in size. More commonly, they occur in blood vessels that lie deep inside the brain. Sometimes, they can be asymptomatic, and thus, the diagnosis could be missed. Some patients develop bleeding due to aneurysms in the brain.

3. Various Other Sites:

Various other sites that can be affected due to aneurysms are the artery behind the knee and arteries of the spleen, intestines, etc.

What Are the Symptoms Associated With Aortic Aneurysm?

Signs and symptoms associated with an aneurysm depend on the anatomic location and type. Some may even be asymptomatic. Many aneurysms start showing symptoms only after they rupture. Aneurysms presenting near the body surface can cause swelling and pain. There are also chances for the development of a large mass.

When an aneurysm ruptures, it shows the following signs and symptoms:

  • Bleeding at the site.

  • Raised heart rate

  • Dizziness or light-headedness.

  • Pain.

If not managed at a proper time, it can lead to serious complications and even death.

What Are the Risk Factors of Aortic Aneurysm?

If the person possesses certain characteristics, they are at a higher risk of developing an aortic aneurysm:

  • Being over the age of 65.

  • Being male or assigned male at birth.

  • Smoking.

  • Having high blood pressure.

  • Having family members with aortic aneurysms.

  • Being born with a heart valve defect known as a bicuspid aortic valve.

Additionally, individuals with certain connective tissue disorders such as Marfan syndrome (Marfan syndrome is a genetic disorder that affects the body's connective tissue, leading to a range of skeletal, cardiovascular, and ocular abnormalities), Loeys-Dietz syndrome (Loeys-Dietz syndrome is a rare genetic disorder that affects the connective tissue and can lead to aortic aneurysms, arterial tortuosity, and other cardiovascular abnormalities), vascular Ehlers-Danlos syndrome (Vascular Ehlers-Danlos syndrome is a rare genetic disorder characterized by a defect in the production of collagen, leading to fragile blood vessels and a high risk of arterial and organ rupture), and Turner syndrome (Turner syndrome is a genetic disorder in females characterized by the absence of one X chromosome, leading to short stature, delayed puberty, and infertility) are at higher risk of thoracic aortic aneurysms.

How Can Aortic Aneurysm Be Diagnosed?

When the person visits the physician, they will be asked about the signs and symptoms, personal history, family history, etc. Following that, a physical examination will be carried out. The various tools that are used to examine depend on the location of the aneurysm. The person will most probably be referred to a cardiothoracic or vascular surgeon for further diagnosis. Various commonly used examination tools for checking aneurysms in the body are computed tomography scans (CT) and ultrasounds.

How Can Aortic Aneurysm Be Treated?

The treatment depends on the anatomical location and type of the aneurysm. One preferred treatment is an endovascular stent graft, which is done in cases of aneurysms in the chest or abdomen area. It is a minimally invasive procedure that is preferred over surgical management. Surgical management involves open surgery, where the repair and reinforcing of blood vessels are involved. Also, the stent decreases the chances of scarring, infection, and various other issues.

Various other treatment modalities available are medications to treat high blood pressure and increased cholesterol. Certain beta-blockers can also be used to maintain or lower blood pressure. Maintaining or lowering the blood pressure can prevent the rupture of the aneurysm.

What Are the Complications for Aortic Aneurysm?

If diagnosed with an aortic aneurysm, there is a risk of serious complications, including:

  • Blood Clots: Formation of small clots within the aneurysm area that may detach and travel to various organs such as the legs, kidneys, or other organs, potentially leading to significant issues like stroke.

  • Dissection: Occurs when there is a tear in the innermost layer of the aortic wall, allowing blood to flow between the layers and disrupting proper blood flow to organs.

  • Rupture: A tear through all three layers of the aortic wall, leading to the leakage of blood into the chest or abdominal cavity. If not promptly treated, it can be fatal.

What Is the Outlook for Individuals Diagnosed With an Aortic Aneurysm?

Through attentive monitoring and appropriate treatment, healthcare providers can assist in effectively managing an aortic aneurysm. Ideally, healthcare teams can detect and address an aortic aneurysm before it reaches the point of rupture. In the event of a ruptured aortic aneurysm, it is crucial to seek immediate medical attention. Without prompt intervention, a ruptured aortic aneurysm can result in fatality. Both open and endovascular surgeries have proven successful in treating ruptured aortic aneurysms.

Conclusion:

Aortic aneurysms can occur anywhere in the body and are mostly asymptomatic but may show signs and symptoms if they rupture. It is necessary to get annual checkups done to prevent any serious complications. Online medical platforms have made contacting a specialist easy, especially during this pandemic time. To learn more about aortic aneurysms, consult a specialist online.

Frequently Asked Questions

1.

Is an Aortic Aneurysm a Serious Medical Condition?

An aortic aneurysm is a condition wherein the aorta, or the blood vessel's walls, enlarges in certain portions, giving it a balloon-like appearance. Aortic aneurysms can be inconspicuous, small, and large. The small ones resolve quickly and are not fatal on most occasions. In contrast, large aortic aneurysms can be highly fatal, necessitating immediate medical intervention.

2.

Is It Possible to Survive an Aortic Aneurysm?

Aneurysms are associated with mechanical trauma and damage to the walls of the blood vessels. Studies show that small and inconspicuous aneurysms do not lead to fatality. However, the larger ones can lead to several problems. If provided with timely treatment, people can survive aneurysms without impairing their quality of life.

3.

What Happens in an Aortic Aneurysm?

An aortic aneurysm is a medical condition wherein the walls of the aorta, a primary blood vessel, are damaged because of balloon-like enlargement in specific regions. This enlargement can result in the separation or formation of splits and cuts within the vessel walls. Following this disruption, blood leaks between several blood vessel layers, leading to life-threatening consequences and death.

4.

Which Factors Can Trigger an Aortic Aneurysm?

The following factors can precipitate an aortic aneurysm: 
 - Family history. 
 - Genetic mutations. 
 - Tobacco abuse. 
 - Physical injury. 
 - High, uncontrolled blood pressure.
 - Atherosclerosis
 - Obesity.
 - Vasculitis.
 - Bacterial Infections.
 - Kidney diseases.
 - Inflammation of the blood vessels.
 - Increased blood cholesterol. 

5.

What Is the Life Expectancy of an Individual, Diagnosed With an Aortic Aneurysm?

The life expectancy and survival rate largely depend on the type and treatment time employed to manage an aortic aneurysm. Several studies reveal that in the case of an intact aortic aneurysm, about 65 percent of patients can expect a healthy five-year life expectancy. On the flip side, in the case of a ruptured aortic aneurysm, about 40 percent of the individuals live up to five years following the diagnosis and treatment.

6.

How Can an Aortic Aneurysm Be Treated?

An aortic aneurysm can be treated under two primary modalities - medicines and surgery. The medicines help control the flow of blood and help regulate blood pressure, thereby reducing the chances of wear and tear to the vessel wall. In contrast, surgery helps repair the damage on the vessel wall. The various types of surgeries include the following - 
 - Open chest surgery. 
 - Aortic root surgery. 
 - Endovascular aortic aneurysm repair.

7.

Can People Recover Completely, Following an Aortic Aneurysm?

Yes, people can recover entirely following an aortic aneurysm. If the treatment is immediate, without warranting any further damage, the path of recovery is smoother. Based on the patient's type, location, and general well-being, doctors choose between drug and surgical therapy to manage aneurysms effectively. In some cases, they can employ both types of therapy.

8.

Are Aneurysms Fatal?

Aneurysms can be fatal, provided they are large, or they burst since they can lead to the pooling of blood. They can also result in severe complications, such as stroke and coma. They can also be fatal if timely medical intervention is not made to manage them. However, well-treated and small aneurysms do not prove to be fatal.

9.

Are There Any Warning Signs of an Aortic Aneurysm?

Knowing the warning signs associated with aortic aneurysms can help detect and treat them early. A few of the warning signs are as follows - 
 - Decreased blood pressure. 
 - Pain in the chest, abdomen, flank, and lower back. 
 - Rapid pulse.
 - Fainting spells. 
 - Nausea. 
 - Shortness of breath. 

10.

What Should People Refrain From Doing in the Case of an Aortic Aneurysm?

In the event of an aortic aneurysm, people should refrain from any task that can be strenuous in any form. Exerting excess force can result in the aortic aneurysm bursting, resulting in a fatality. Hence, people should avoid gymming, lifting weights, kickboxing, etc. They should rest adequately, allowing the blood vessels to heal without warranting any further damage.

11.

How Fast Does an Aortic Aneurysm Grow?

The rate of growth of aortic aneurysms varies according to their size. Generally, it has been observed that the smaller aortic aneurysms usually grow slowly and silently, with a rate of 3 millimeters per year, unlike the larger aneurysms, which grow rapidly, having no fixed rate of growth.

12.

Do Aortic Aneurysms Require Major Surgery?

Not all aortic aneurysms require primary surgical methods to manage them effectively. The patient's size, location, and general health are essential factors that help doctors decide whether to proceed with surgical methods. Smaller aneurysms usually do not require surgery since they resolve with time.

13.

Can Aneurysms Lead to a Painful Death?

Usually, aneurysms that result in death do not cause pain. In most cases, patients or sufferers do not even realize the occurrence of an aneurysm, as the usual symptoms can be prevalent, such as a mild headache, chest pain, and bouts of fainting spells. However, in the case of an abdominal aortic aneurysm, severe abdominal pain can be elicited following the rupture of the aneurysm.

14.

Can Stress Lead to the Occurrence of an Aortic Aneurysm?

Yes, stress can precipitate an aortic aneurysm. Depression, anxiety, fear, and psychic stress are prevalent triggering factors that can precipitate aneurysms. These conditions lead to elevated blood pressure and poor eating and sleeping habits, which in turn affect the blood cholesterol levels, thereby leading to the formation of an aortic aneurysm.
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Dr. Chopda Anand Manaklal
Dr. Chopda Anand Manaklal

Cardiology

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