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Aortic Aneurysm: Treatment, symptoms, advice and help

About aortic aneurysm

Abdominal aortic aneurysm is a disorder of the aorta which is the main artery exiting from the heart. As the name suggests a section of the aorta in the abdominal area bulges out due to weakness in the vessel wall. The course of the aorta extends from chest to abdomen. It is more commonly seen in the abdominal region than chest. Aortic aneurysm of the chest is called ‘thoracic aortic aneurysm’ and aneurysm in abdominal region is known as ‘abdominal aortic aneurysm’.

Aortic aneurysm: Incidence, age and sex

Abdominal aortic aneurysm is most common in individuals more than 60 years of age. There is a significant male preponderance.

Signs and symptoms of aortic aneurysm: Diagnosis

The clinical features of an aortic aneurysm depend upon the site of aneurysm. Thoracic aortic aneurysm if small may present only with pain in the chest or the neck. A larger size of aneurysm may compress on windpipe resulting in cough and shortness of breath. Difficulty in swallowing may be experienced if aneurysm compresses the food pipe. Aneurysm may compress on nerves resulting in hoarseness of voice or drooping of eyelids. Swelling in the neck may be seen if the aneurysm compresses upon the blood vessels. Occasionally no clinical symptoms are seen.

Abdominal aortic aneurysm is usually silent and is not diagnosed until it has markedly increased in size. Occasionally, the patient might complain of mild pain in the belly or the lower back. In most cases, it is an accidental diagnosis either during physical examination which can reveal a pulsating mass near the navel, or during some imaging investigations like ultrasound, CT scan.

Causes and prevention of aortic aneurysm

Aorta is the major blood vessel which carries blood from the heart to various organs of the body. In some people, the wall of the aorta gets damaged and loses its flexibility. This process of damage is called atherosclerosis which is due to the deposition of cholesterol and fatty material in the arterial wall. Certain risk factors like diabetes, high blood pressure, high blood cholesterol, obesity and smoking augment atherosclerosis which precedes aortic aneurysm. An infection called syphilis may also predispose to this condition. A family history of aortic aneurysm is a potential risk factor.

It is best to incorporate lifestyle modifications to thwart risk factors which can lead to abdominal aortic aneurysm. The following are some tips which can help in the prevention of abdominal aortic aneurysm:

  • Regular physical exercise to trim down excess weight.
  • Appropriate dietary habits not only to shed excess weight but also reduce blood cholesterol and lipids.
  • Cessation of smoking
  • Keeping blood pressure under control with adequate treatment.
  • Regular screening with ultrasonography if there is a positive family history of aortic aneurysm.

Aortic aneurysm: Complications

The most alarming complication of abdominal aortic aneurysm is its rupture leading to heavy bleeding inside abdomen. The chances of rupture are increased with the growing size of the aneurysm. Rupture is suspected when one encounters sudden, sharp pain in the lower abdomen especially in a patient with history of aortic aneurysm. The pain is accompanied by sweating, breathlessness, palpitations, nausea and vomiting. This is a medical emergency and the patient needs to be rushed to the hospital without any delay. Other complications include congestive heart failure, heart attack or sudden death.

Aortic aneurysm: Treatment

The treatment of aortic aneurysm includes both non surgical and surgical modalities. The non surgical modalities include lifestyle modifications which help in curbing the potential risk factors. It is recommended to regularly monitor the aortic diameter thereby preventing rupture.

Surgical treatment is considered only when the size of the aneurysm exceeds 5 cm as this is an indication of impending rupture, and needs to be surgically managed. Aneurysm can be managed either by a major surgical procedure in which part of affected vessel wall is replaced with an artificial graft or by ‘endovascular surgery’ which is minimally invasive. It is done through an artery, in the leg, which joins the aorta in the abdomen. A stent graft is passed through a leg artery and into the aorta where it will get replaced with the affected portion.