Aortic Aneurysm: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Aortic aneurysms are bulging or ballooning parts of the aorta, the largest artery in the body. Aortic aneurysms may occur anywhere along the aorta, but they are most commonly found in the abdominal or thoracic (chest) sections. The aorta carries oxygen-rich blood from the heart to the rest of the body.
Causes of Aortic Aneurysm
The exact cause of an aortic aneurysm is not known, but several factors may increase the risk of developing one, such as:
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Age: Aortic aneurysms are more common in people over 60 years old.
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Gender: Men are more likely than women to develop aortic aneurysms.
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Family history: Having a close relative who had an aortic aneurysm increases the risk of having one.
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High blood pressure: High blood pressure puts extra stress on the walls of the aorta, making them weaker and more prone to bulging.
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High cholesterol: High cholesterol can lead to the buildup of fatty deposits (plaques) in the arteries, which can damage and narrow them.
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Smoking: Smoking damages the blood vessels and increases the risk of atherosclerosis (hardening of the arteries), which can weaken the aorta.
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Infection: Some infections, such as syphilis or salmonella, can cause inflammation and damage to the aorta.
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Trauma: Injury to the chest or abdomen, such as from a car accident or a fall, can cause a tear or rupture in the aorta.
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Genetic disorders: Some genetic disorders, such as Marfan syndrome or Ehlers-Danlos syndrome, can affect the connective tissue that supports the aorta, making it more fragile and susceptible to aneurysms.
Symptoms of Aortic Aneurysm
An aortic aneurysm may not cause symptoms until it becomes large or ruptures. A ruptured aneurysm requires immediate medical attention.
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Sudden and severe pain in the chest, back, abdomen, or groin
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Dizziness, fainting, or loss of consciousness
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Difficulty breathing or shortness of breath
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Rapid heartbeat or low blood pressure
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Nausea, vomiting, or sweating
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Shock or collapse
Some aortic aneurysms may cause symptoms before they rupture, depending on their location and size. Some of the symptoms of an unruptured aortic aneurysm include:
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A pulsating feeling in the chest or abdomen
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Chest pain or pressure
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Back pain or abdominal pain
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Difficulty swallowing or hoarseness (if the aneurysm presses on the esophagus or the laryngeal nerve)
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Coughing or wheezing (if the aneurysm presses on the trachea or the bronchi)
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Leg pain, numbness, or weakness (if the aneurysm blocks the blood flow to the legs)
Diagnosis of Aortic Aneurysm
For people who are at high risk of developing an aortic aneurysm, a routine physical exam or a screening test, such as an ultrasound, may be used to detect it. Several tests may be ordered by the doctor to confirm the diagnosis and determine the size, location, and shape of the aneurysm:
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Abdominal ultrasound: A painless test that uses sound waves to create images of the abdominal aorta and its branches.
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Chest X-ray: A test that uses radiation to create images of the chest and the thoracic aorta.
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Computed tomography (CT) scan: A test that uses X-rays and a computer to create detailed images of the aorta and the surrounding organs and tissues.
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Magnetic resonance imaging (MRI) scan: A test that uses a powerful magnet and radio waves to create detailed images of the aorta and the surrounding organs and tissues.
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Angiography: A test that uses a dye injected into the bloodstream and X-rays to create images of the blood vessels.
Treatment of Aortic Aneurysm
There are two main types of treatment for aortic aneurysms, depending on the size, location, and growth rate of the aneurysm, as well as the patient's age, health, and preferences.
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As part of watchful waiting, ultrasound or other imaging tests are used to monitor the aneurysm and manage risk factors, such as lowering blood pressure and cholesterol levels, quitting smoking, and taking medications as prescribed. Aneurysms that do not cause symptoms and are small or slow-growing are usually recommended for this procedure.
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An aortic aneurysm can be repaired or replaced with a synthetic graft (a tube made of fabric or metal).
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An open surgery involves making a large incision in the chest or abdomen, clamping the aorta, removing the aneurysm, and sewing the graft in place. This is a major procedure that requires general anesthesia and a long recovery period.
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Endovascular surgery: This involves making a small incision in the groin, inserting a catheter (a thin tube) into the femoral artery, guiding it to the aneurysm, and inserting a stent graft (a tube with a metal mesh) inside it. By strengthening the wall of the aorta, the stent graft prevents blood from entering the aneurysm. This is a less invasive procedure requiring local anesthesia and a shorter recovery time.
Many factors influence the choice of surgery, including the size, shape, and location of the aneurysm, the patient's overall health, and the surgeon's availability and expertise. Before making a decision, the doctor will discuss with the patient the benefits and risks of both types of surgery.
Prevention of Aortic Aneurysm
An aortic aneurysm cannot be prevented completely, but the risk of developing one can be reduced by:
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Maintaining a healthy blood pressure and cholesterol level
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Quitting smoking and avoiding exposure to secondhand smoke
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Eating a balanced diet that is low in saturated fat, salt, and sugar, and high in fruits, vegetables, and fiber
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Exercising regularly and maintaining a healthy weight
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Limiting alcohol intake and avoiding illicit drugs
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Managing stress and practicing relaxation techniques
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Following the doctor’s advice and taking medications as prescribed
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Having regular check-ups and screening tests, especially if there is a family history of aortic aneurysms
Despite the seriousness of an aortic aneurysm, most people with one can live a normal, active life with proper diagnosis, treatment, and follow-up. Please consult your doctor if you have any questions or concerns about your aortic health.
