An aneurysm in the lower part of the aorta can grow slowly and silently. Know the symptoms of this dangerous condition and how it is treated.
An abdominal aortic aneurysm is an enlarged area in the lower part of the major vessel that supplies blood to the body (aorta). The aorta runs from the heart through the center of the chest and abdomen.
The aorta is the largest blood vessel in the body, so a ruptured abdominal aortic aneurysm can cause life-threatening bleeding.
Depending on the size of the aneurysm and how fast it's growing, treatment varies from watchful waiting to emergency surgery.
Abdominal aortic aneurysms often grow slowly without noticeable symptoms, making them difficult to detect. Some aneurysms never rupture. Many start small and stay small. Others grow larger over time, sometimes quickly.
If you have an enlarging abdominal aortic aneurysm, you might notice:
If you have pain, especially if pain is sudden and severe, seek immediate medical help.
Aneurysms can develop anywhere along the aorta, but most aortic aneurysms occur in the part of the aorta that's in the belly area (abdomen). Several things can play a role in the development of an abdominal aortic aneurysm, including:
Abdominal aortic aneurysm risk factors include:
If you're at risk of an aortic aneurysm, your doctor might recommend other measures, such as medications to lower your blood pressure and relieve stress on weakened arteries.
Tears in one or more of the layers of the wall of the aorta (aortic dissection) or a ruptured aneurysm are the main complications. A rupture can cause life-threatening internal bleeding. In general, the larger the aneurysm and the faster it grows, the greater the risk of rupture.
Signs and symptoms that an aortic aneurysm has ruptured can include:
Aortic aneurysms also increase the risk of developing blood clots in the area. If a blood clot breaks loose from the inside wall of an aneurysm and blocks a blood vessel elsewhere in your body, it can cause pain or block blood flow to the legs, toes, kidneys or abdominal organs.
To prevent an aortic aneurysm or keep an aortic aneurysm from worsening, do the following:
Abdominal aortic aneurysms are often found when a physical exam is done for another reason or during routine medical tests, such as an ultrasound of the heart or abdomen.
To diagnose an abdominal aortic aneurysm, a doctor will examine you and review your medical and family history. If your doctor thinks that you may have an aortic aneurysm, imaging tests are done to confirm the diagnosis.
Tests to diagnose an abdominal aortic aneurysm include:
Abdominal ultrasound. This is the most common test to diagnose abdominal aortic aneurysms. An abdominal ultrasound is a painless test that uses sound waves to show how blood flows through the structures in the belly area, including the aorta.
During an abdominal ultrasound, a technician gently presses an ultrasound wand (transducer) against the belly area, moving it back and forth. The device sends signals to a computer, which creates images.
Abdominal CT scan. This painless test uses X-rays to create cross-sectional images of the structures inside the belly area. It's used to create clear images of the aorta. An abdominal CT scan can also detect the size and shape of an aneurysm.
During a CT scan, you lie on a table that slides into a doughnut-shaped machine. Sometimes, dye (contrast material) is given through a vein to make your blood vessels show up more clearly on the images.
Being male and smoking significantly increase the risk of abdominal aortic aneurysm. Screening recommendations vary, but in general:
There isn't enough evidence to determine whether women ages 65 to 75 who ever smoked cigarettes or have a family history of abdominal aortic aneurysm would benefit from abdominal aortic aneurysm screening. Ask your doctor if you need to have an ultrasound screening based on your risk factors. Women who have never smoked generally don't need to be screened for the condition.
The goal of abdominal aortic aneurysm treatment is to prevent an aneurysm from rupturing. Treatment may involve careful monitoring or surgery. Which treatment you have depends on the size of the aortic aneurysm and how fast it's growing.
A doctor might recommend this option, also called watchful waiting, if the abdominal aortic aneurysm is small and isn't causing symptoms. Monitoring requires regular doctor's checkups and imaging tests to determine if the aneurysm is growing and to manage other conditions, such as high blood pressure, that could worsen the aneurysm.
Typically, a person who has a small, symptomless abdominal aortic aneurysm needs an abdominal ultrasound at least six months after diagnosis and at regular follow-up appointments.
Surgery to repair an abdominal aortic aneurysm is generally recommended if the aneurysm is 1.9 to 2.2 inches (4.8 to 5.6 centimeters) or larger, or if it's growing quickly.
Also, a doctor might recommend abdominal aortic aneurysm repair surgery if you have symptoms such as stomach pain or you have a leaking, tender or painful aneurysm.
The type of surgery performed depends on the size and location of the aneurysm, your age, and your overall health. Abdominal aortic aneurysm surgery options may include:
Endovascular repair. This procedure is used most often to repair an abdominal aortic aneurysm. A surgeon inserts a thin, flexible tube (catheter) through an artery in the leg and gently guides it to the aorta. A metal mesh tube (graft) on the end of the catheter is placed at the site of the aneurysm, expanded and fastened in place. The graft strengthens the weakened section of the aorta to prevent rupture of the aneurysm.
Endovascular surgery isn't an option for everyone with an abdominal aortic aneurysm. You and your doctor will discuss the best repair option for you. After endovascular surgery, you'll need regular imaging tests to ensure that the grafted area isn't leaking.
Long-term survival rates are similar for both endovascular surgery and open surgery.
For an abdominal aortic aneurysm, a doctor will likely suggest avoiding heavy lifting and vigorous physical activity to prevent extreme increases in blood pressure, which can put more pressure on an aneurysm.
Emotional stress can raise blood pressure, so try to avoid conflict and stressful situations. If you're feeling stressed or anxious, let your doctor know so that together you can come up with the best treatment plan.
If you are at risk of an abdominal aortic aneurysm or having signs and symptoms of the condition, make an appointment with your family doctor. If you're having severe pain, seek emergency medical help.
Here's some information to help you get ready for your appointment.
When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet. Before certain tests, you might need to avoid drinking or eating for a short time.
Make a list of:
For an abdominal aortic aneurysm, questions to ask your doctor include:
Don't hesitate to ask other questions.
Your doctor is likely to ask you questions, including:
October 28th, 2021