The Most Common Cause Of An Abdominal Aortic Aneurysm
An abdominal aortic aneurysm is sometimes called a silent killer because many people who die from aneurysms do not know they have them beforehand. An abdominal aortic aneurysm is detectable in some cases, however. Here is everything you need to know about the symptoms and causes of abdominal aortic aneurysm.
What Questions Should I Ask My Doctor If I Have An Abdominal Aortic Aneurysm
You may want to ask your doctor:
- How big is the aneurysm?
- How can I reduce my risk of an aneurysm rupture?
- Is the aneurysm getting larger? If so, how quickly is it growing?
- What are the chances that the aneurysm will rupture?
A note from Cleveland Clinic
An abdominal aortic aneurysm is a potentially life-threatening condition. It develops when the wall of the main artery in your body develops a weak spot and bulges outward. If it ruptures, you can have massive internal bleeding. Its essential to find aneurysms before they rupture. Ask your doctor if youre a candidate for AAA screening and report any signs or symptoms right away.
Abdominal Aortic Aneurysm Causes
An abdominal aortic aneurysm is caused by a weakness in the wall of the aorta. The number one risk factor for this medical issue is smoking. Smokers die four times more often from a ruptured aneurysm than non-smokers. Men are more likely to have an abdominal aortic aneurysm than women. Family history is another major risk factor, as are high blood pressure and old age. Talk to your doctor if you have any of these risk factors. Most people who experience an abdominal aortic aneurysm have more than one risk factor, generally, smoking combined with other factors.
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How Do Medical Professionals Diagnose Abdominal Aortic Aneurysms
Physical examination can be the initial way the diagnosis of abdominal aortic aneurysm is made. The health care professional may be able to feel a pulsatile mass in the center of the abdomen and make the clinical diagnosis. In obese patients with a large girth, physical exam is less helpful. In very thin patients, the aorta can often be seen to pulsate under the skin and this may be a normal finding. Listening with a stethoscope may also reveal a bruit or abnormal sound from turbulence of blood within the aneurysm.
In most cases, X-rays of the abdomen show calcium deposits in the aneurysm wall. But plain X-rays of the abdomen cannot determine the size and the extent of the aneurysm.
Ultrasonography usually gives a clear picture of the size of an aneurysm. Ultrasound has about 98% accuracy in measuring the size of the aneurysm and is safe and noninvasive.
CT scan of the abdomen is highly accurate in determining the size and extent of the aneurysm and its location in the aorta. To help plan repair, if needed, it is important to know whether the aneurysm is above or below where the renal arteries branch off to go to the kidneys and whether the aneurysm extends towards the chest or down into the iliac arteries into the legs. CT scans require dye to be injected to evaluate the blood vessels . People with kidney disease or dye allergies may not be candidates for CT. MRI/MRA may be an alternative.
Abdominal Aortic Aneurysm Shapes
The more common shape is fusiform, which balloons out on all sides of the aorta. A bulging artery isnt classified as a true aneurysm until it increases the arterys width by 50 percent.
A saccular shape is a bulge in just one spot on the aorta. Sometimes this is called a pseudoaneurysm. It usually means the inner layer of the artery wall is torn, which can be caused by an injury or ulcer in the artery.
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Watch Out 5 Warning Signs And Symptoms That Might Indicate Aortic Aneurysm
An aortic aneurysm is an abnormal enlargement or bulging of the wall of the aorta which is a major blood vessel that carries blood from heart to body. Aortic aneurysms include:
- Abdominal aortic aneurysm: occurs along the part of the aorta that passes through the abdomen.
- Thoracic aortic aneurysm: occurs along the part of the aorta that passes through the chest cavity.
If a ruptured aortic aneurysm could not be accurately diagnosed and effectively treated in time, it can cause life-threatening internal bleeding which leads to the increased chances of sudden death. Therefore, the notification of warning signs and symptoms of aortic aneurysm remains essentially important.
5 warning signs and symptoms that aortic aneurysm might be suspected include:
1) Chest tenderness or chest pain, dizziness or light-headedness, back pain, coughing up blood and loss of consciousness due to the ruptures.2) Sudden or intense abdominal pain, pulsating enlargement or tender mass in an abdomen caused by a bulge of aortic wall in the abdominal areas.3) Breathing difficulties such as shortness of breath related to the compression of the trachea caused by a bulge of aortic wall in the chest cavity.4) Swallowing difficulties caused by extrinsic compression of the esophagus due to the wall enlargement of thoracic aorta.5) Hoarseness from the compression of recurrent laryngeal nerve which supplies all intrinsic muscles of the larynx .
How Is Aaa Open Repair Done
You will lie on your back on the operating table.
The anesthesiologist will monitor your heart rate, blood pressure, breathing, and oxygen level during the surgery. Once you are sedated, your doctor will insert a breathing tube through your throat into your lungs and connect you to a ventilator. This will breathe for you during the surgery.
A healthcare provider will insert a catheter into your bladder to drain urine.
A healthcare provider will clean the skin over the surgical site with an antiseptic solution.
Once all the tubes and monitors are in place, the doctor will make an incision down the center of the abdomen from below the breastbone to below the navel. Or, across the abdomen from underneath the left arm across to the center of the abdomen and down to below the navel.
The doctor will place a clamp on the aorta above and below the site of the aneurysm. This will temporarily stop the flow of blood.
The doctor will cut open the aneurysm sac and suture into place a long tube called the graft. This will connect both ends of the aorta together.
Your doctor will remove the clamps and he or she will wrap the wall of the aneurysm around the graft. Your doctor will then suture the aorta back together and close the chest with stitches.
Your provider will apply a sterile bandage.
After an open procedure, your doctor may insert a tube through your mouth or nose into your stomach to drain stomach fluids.
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When Should You Go To The Emergency Department For Aortic Aneurysm
Aortic aneurysm is a medical emergency. If you or someone you know is experiencing symptoms of aortic aneurysm, seek medical care immediately by calling 911 or activating the medical emergency system in your area.
Any time a person experiences chest pain or the sensation that something is “just not right” in the chest, consult a medical professional immediately. Have someone take the person to an emergency department do not let the person attempt to drive themselves.
- If a person notices a strong pulse sensation, or a pulsating bulge in the abdomen, they should seek a doctor right away.
- If the pain is new, severe, frightening, or feels to be tearing or ripping, one should go immediately to a hospital emergency department. Do not wait it out immediate treatment can be life saving for aneurysm/dissection as well as in other conditions that cause chest pain.
- If an aortic aneurysm ruptures, internal bleeding occurs. This is a medical emergency, because a person can bleed to death in a few minutes.
- Severe back, flank, or abdominal pain may be the only symptom of an enlarging aorta. Many other conditions can cause these symptoms, but an aortic aneurysm is the most serious of these conditions.
In The Hospital After Evar
A member of the surgical team may take you to the intensive care unit or a postanesthesia care unit . You will be connected to monitorsthat will display your heart activity, blood pressure, breathing rate, andyour oxygen level.
You will remain in either the ICU or PACU for a time and then moved to aregular nursing care unit.
Your nurse will give you pain medicine or you may have had an epidural.This is anesthesia that is infused through a thin catheter into the spacethat surrounds the spinal cord in the lower back. It causes numbness in thelower body, abdomen, and chest.
Your activity will be gradually increased as you get out of bed and walkaround for longer periods. You will start solid foods as you can handlethem.
Arrangements will be made discharge from the hospital. This may includeprescriptions for new medicines and directions for a follow-up visit withyour doctor.
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Can An Aortic Aneurysm Be Treated At Home
No. An aortic aneurysm is a medical emergency. Call 911 or go to the Emergency Department immediately if you suspect that you or someone with you is having an aortic aneurysm.
Do not try to treat an aortic aneurysm anyone at home or to wait and see if the symptoms will resolve. Aortic aneurysm requires immediate, expert medical attention and rapid diagnosis before ruptures, which can lead to death. Symptoms that suggest internal bleeding are:
- Severe chest
- Back pain
If You Have A Large Aaa
If you are diagnosed with an AAA that is 5.5cm or larger, you will be referred to a vascular surgeon , who may recommend an operation.
The surgeon will discuss treatment options with you, taking into account your general health and fitness, as well as the size of your aneurysm.
If it’s decided that surgery isnt suitable for you, its still possible to reduce the risk of the aneurysm bursting, and you will have regular scans to check its size in the same way people with small or medium aneurysms are treated.
See below for more information on treating small and medium aneurysms.
There are two surgical techniques used to treat a large aneurysm:
- endovascular surgery
- open surgery
Although both techniques are equally effective at reducing the risk of the aneurysm bursting, each has its own advantages and disadvantages.
The surgeon will discuss with you which is most suitable.
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How Can You Prevent An Aortic Aneurysm
No medicine can prevent an aortic aneurysm. However, measures can be taken that will help keep blood vessels healthy and strong.
- Eat a low-fat, low-cholesteroldiet.
- Get active: Take part every day in some activity that increases heart rate to the rate recommended for the patient’s age and overall condition. At least 30 minutes a day is ideal.
- Don’t smoke.
- Control blood pressure the above methods can help and if necessary, the doctor may prescribe medication.
If a person is found to have an aortic aneurysm less than 5 cm in size, it should be watched carefully by their primary care doctor. Regular ultrasound examinations will detect any growth or other changes in the aneurysm.
Some experts recommend screening for all individuals older than 55 years.
- Screening would detect many aortic aneurysms that otherwise go unrecognized because they cause no symptoms.
- Ultrasound examination of the abdomen is more than 80% accurate in screening for the existence of abdominal aortic aneurysm. Physical exam may not detect an aneurysm.
What Are The Symptoms Of Abdominal Aortic Aneurysms
About 3 out of 4 abdominal aortic aneurysms don’t cause symptoms. An aneurysm may be found by X-ray, computed tomography scan, or magnetic resonance imaging that was done for other reasons. Since abdominal aneurysm may not have symptoms, it’s called the “silent killer” because it may rupture before being diagnosed.
Pain is the most common symptom of an abdominal aortic aneurysm. The pain associated with an abdominal aortic aneurysm may be located in the abdomen, chest, lower back, or groin area. The pain may be severe or dull. Sudden, severe pain in the back or abdomen may mean the aneurysm is about to rupture. This is a life-threatening medical emergency.
Abdominal aortic aneurysms may also cause a pulsing sensation, similar to a heartbeat, in the abdomen.
The symptoms of an abdominal aortic aneurysm may look like other medical conditions or problems. Always see your doctor for a diagnosis.
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What Is An Aneurysm
An aneurysm occurs when an arterys wall weakens and causes an abnormally large bulge.
Arteries are blood vessels that carry blood from the heart to the rest of the body, while veins bring blood back to the heart and lungs. This bulge can rupture and cause internal bleeding. Although an aneurysm can develop in any part of your body, theyre most common in the:
- Brain. Aneurysms in the brain are called cerebral aneurysms. These often form in the blood vessels that lie deep within the brain. They also may not present any symptoms. You may not even know you have an aneurysm. Cerebral aneurysms may affect 3 to 5 percent of people during their lifetime.
- Aorta. Aneurysms in the chest cavity are called thoracic aortic aneurysms. Abdominal aortic aneurysms are the most common type. In rare cases, arterial damage can affect both the chest and abdomen.
The aorta is the largest blood vessel in the body. It begins at the left ventricle of the heart and travels down the abdomen where it splits off into both legs. The aorta is a common site for arterial aneurysms.
Other more common areas where an aneurysm may occur include the:
- legs
What Are The Symptoms Of Aortic Aneurysm
Symptoms of a thoracic aortic aneurysm include painful swallowing and shortness of breath. The main sign of an abdominal aneurysm is pain in the back, legs and buttocks. Sometimes, aneurysms don’t have any symptoms at all. Aortic aneurysms are typically found during physicals at a doctor’s office.
When an aneurysm bursts, you might experience lightheadedness, dizziness, sharp pain in the chest, back, or abdomen, decreasing blood pressure, loss of breath, or loss of consciousness.
As with any emergency, immediate treatment is essential if an aneurysm bursts. In a heart-related emergency, call 911 and request the ambulance take you to the nearest CHI St. Luke’s Health emergency room. If you currently have an aortic aneurysm, make an appointment with a cardiologist at Baylor St. Luke’s Medical Center, which US News & World Report recognized as a 2018 high-performing hospital in abdominal aortic aneurysm repair.
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Questions To Ask Your Doctor
- If Ive had one AAA, am I likely to experience another?
- Are there any lifestyle changes I can make to avoid getting another AAA?
- Is watchful waiting safe? Is there a chance the AAA could burst?
- Are there any side effects from an AAA that I should be watching for?
- What should I do if my pain gets worse?
- Should I visit a specialist?
Abdominal Aortic Aneurysm Repair
AAA – open Repair – aortic aneurysm – open
Open abdominal aortic aneurysm repair is surgery to fix a widened part in your aorta. This is called an aneurysm. The aorta is the large artery that carries blood to your belly , pelvis, and legs.
An aortic aneurysm is when part of this artery becomes too large or balloons outward.
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What Are The Symptoms
You might not even know you have this condition because it often doesnât have any symptoms. Some aneurysms start out small and get bigger gradually. Others grow quickly, and some never grow at all.
If yours is growing, you may feel:
- Pain deep inside, or on the side of, your abdomen
- Sudden, severe back pain
- A pulsating feeling in your abdomen
If you have any of these signs, see your doctor immediately or call 911.
What Causes An Aneurysm
Although the exact cause of an aneurysm is unclear, certain factors contribute to the condition.
For example, damaged tissue in the arteries can play a role. Blockages, such as fatty deposits, can harm the arteries. These deposits can trigger the heart to pump harder than necessary to push blood past the fatty buildup. This added stress due to the increased pressure can damage the arteries.
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What Are The Types Of Abdominal Aortic Aneurysms
AAAs are usually classified by their size and the speed at which theyre growing. These two factors can help predict the health effects of the aneurysm.
Small: or slow-growing AAAsgenerally have a much lower risk of rupture than larger aneurysms or those that grow faster. Doctors often consider it safer to monitor these with regular abdominal ultrasounds than to treat them.
Large: or fast-growing AAAsare much more likely to rupture than small or slow-growing aneurysms. A rupture can lead to internal bleeding and other serious complications. The larger the aneurysm is, the more likely that it will need to be treated with surgery. These types of aneurysms also need to be treated if theyre causing symptoms or leaking blood.
Treatment for an abdominal aortic aneurysm may vary depending on your overall health and the size, exact location, growth rate, and type of aneurysm.
Treatment options may include :
- Open abdominal surgery. This procedure is used to remove damaged areas of your aorta. Its the more invasive form of surgery and has a longer recovery time, but may be necessary if your aneurysm is very large or has already ruptured.
- Endovascular surgery. This is a less invasive form of surgery than open abdominal surgery. It involves using a graft to stabilize the weakened walls of your aorta.
- Monitoring. For a small AAA thats less than 5.5 centimeters wide, your doctor may decide to monitor it regularly with imaging instead of performing surgery.