An aortic aneurysm is a dangerous balloon-like bulge in the wall of your artery. This artery carries blood from your heart through your chest and abdomen.
A ruptured aneurysm can cause serious bleeding and may be fatal. Most aneurysms don’t cause any symptoms and are found only when doctors do imaging tests for other reasons. A healthy diet and lifestyle can help prevent aortic aneurysms from developing or getting larger.
Symptoms
The aorta is the main blood vessel that carries oxygen-rich blood from your heart to the rest of your body. Over time, an underlying weakness in the wall of this blood vessel can develop. This is called an abdominal aortic aneurysm. The exact cause isn’t fully understood. But some risk factors, such as age and hereditary traits, increase your chances of developing an aneurysm.
These aneurysms can be small or large, and they usually don’t cause symptoms until they rupture. When this happens, you might have a ripping or tearing pain in your belly or back. You might also have a pulsing sensation that feels like a heartbeat. Other symptoms might include trouble breathing (if the aneurysm rupts in your thoracic aorta) or a cough that doesn’t go away (if it irritates your esophagus).
A ruptured aortic aneurysm can cause severe internal bleeding and can be fatal. That’s why it’s important to see a doctor if you have any of these symptoms, even if you have an aortic aneurysm that isn’t causing any signs or symptoms.
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People who have a history of an aortic aneurysm in their family are more likely to develop one themselves. Other risk factors include smoking, high blood pressure, and disease of the blood vessels (such as atherosclerosis or inflammatory conditions such as Marfan syndrome).
One of the most common types of aortic aneurysm is the thoracic aortic aneurysm. It’s most often seen in people older than 60. These aneurysms tend to form in the aorta above the diaphragm.
To diagnose an aortic aneurysm, your doctor will review your medical history and do a physical exam. Your doctor will feel your abdomen and use a stethoscope to listen to your heart and blood flow. Your doctor will also order one or more diagnostic tests to examine your aorta and blood vessels, including an ultrasound, a computed tomography (CT) scan, and magnetic resonance imaging (MRI).
Treatment for an aneurysm depends on its size and whether it’s growing fast. A small aneurysm that isn’t getting larger may not need any treatment at all. Larger and faster-growing aneurysms can be treated with surgery to reduce your risk of a ruptured aneurysm.
Diagnosis
Aortic aneurysms are most common in the part of the aorta that runs from your heart to your abdomen. The most dangerous type, a ruptured aortic aneurysm, causes life-threatening internal bleeding.
Doctors usually diagnose an aortic aneurysm by looking at your body, listening to your heart and checking the pulse in your arms and legs. Then they use imaging tests such as ultrasound, computed tomography (CT), X-rays or magnetic resonance imaging (MRI).
Your health care provider may also ask about your family history of Marfan or Ehlers-Danlos syndromes, which increase your risk for an aneurysm. They will also ask you about your symptoms and when they started.
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You should always tell your health care providers about any new or changing symptoms. If you have a pulsing feeling in your belly or back that feels like it’s ripping or tearing, call 911 or your local emergency number right away. This is a medical emergency and only about 1 in 5 people survive when an abdominal aneurysm ruptures.
If your aneurysm is small and not causing any symptoms, your doctor may monitor it with regular scans. You may also be given medications to lower your blood pressure and cholesterol levels, which can reduce the chance of the aneurysm bursting.
For large, rapidly growing or symptomatic aneurysms, surgery is often recommended. Your doctor will discuss the best treatment option for you, taking into account your aneurysm’s size and location, its rate of growth, your age, whether you have a family history of aneurysms or other connective tissue disorders, and any other health conditions you have.
When an aortic aneurysm is repaired, it is typically done under general anesthesia. The surgeon makes a cut in your abdomen or chest and replaces the abnormal part of the aorta with a synthetic patch or graft. Doctors sometimes use endovascular techniques that do not require making a large cut. They are especially useful for treating aortic aneurysms in older adults. They can also be used for leaking or ruptured aneurysms, and to treat aneurysms caused by Marfan or Ehlers-Danlos Syndromes.
Treatment
Treatment options for an aortic aneurysm depend on its size and whether it’s growing quickly. If an aneurysm is small and hasn’t ruptured, your doctor may want to monitor it regularly with tests, such as CT scans, to see if it grows. Larger aneurysms have a greater risk of rupturing, so your doctor may recommend surgery to repair it.
When an aneurysm ruptures, it can cause life-threatening internal bleeding. It also can cause a blood clot that blocks blood flow to other parts of your body, such as your legs, feet, belly area or heart. You might feel sudden, severe pain in your belly or back that feels like ripping or tearing. You might have clammy skin and a rapid heart rate.
If an aortic aneurysm is large or growing fast, your doctor may recommend surgery to repair it. The type of surgery depends on the location and size of your aneurysm, how fast it’s growing and whether you have any other health conditions that increase your risk for complications, such as Marfan syndrome, Loeys-Dietz disease or vascular Ehlers-Danlos syndrome.
Your doctor will ask you about your family history of aneurysms and any symptoms you have, including those in the chest or abdomen. You’ll need to give a complete medical history and answer questions about your lifestyle and any medications you take.
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You might need to avoid heavy lifting and other strenuous physical activities. Your doctor may also tell you to avoid high-stress situations that can raise your blood pressure and make your aneurysm more likely to burst.
Some aneurysms can be treated with drugs, such as clot-dissolving medicines or angiotensin-converting enzyme (ACE) inhibitors. These medicines lower blood pressure and slow the growth of aneurysms.
Surgical repair is the most common treatment for aortic aneurysms. During open surgery, your surgeon will make a large cut in your stomach or chest and remove the part of your aorta with the aneurysm. Then he or she will sew in a tube called a graft, usually made of leak-proof polyester. Recovery from this type of surgery can take a month or more.
Recovery
The aorta is the main blood vessel that carries oxygen-rich blood from your heart to other parts of your body. It runs through your abdomen and into the lower part of your thorax (chest area). The pressure of blood pumping through the aorta can cause a weakness in the wall, making it bulge like a balloon. This is called an aortic aneurysm. If the aneurysm grows too large, it can rupture and cause life-threatening problems.
Aortic aneurysms usually develop slowly and don’t always cause symptoms. It may be years before they become so big that they can cause problems. It’s important to know about aortic aneurysms because they can be diagnosed and treated early. You should get screened for an aneurysm if you have a disease that makes you more likely to have one, such as Marfan syndrome, Loeys-Dietz syndrome or vascular Ehlers-Danlos syndrome.
If you have an aneurysm, you’ll probably have surgery to repair it. Your surgeon will remove the area of the aorta where it is enlarged and replace it with an artificial tube (graft). The graft will take the pressure off your aortic wall, so the aneurysm is less likely to burst.
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After your operation, you’ll be taken to ICU or HDU, where nurses will care for you. You’ll be on a drip to give you fluids and medicines, including pain-relief medicines. You’ll also have a catheter to drain urine from your bladder.
During recovery, you’ll have regular scans to check that the aneurysm hasn’t got any bigger. These will include CT and a type of ultrasound scan called a duplex scan, which shows how blood moves through your blood vessels. You might also have a MRI scan.
Once you’ve recovered, your doctor will help you to return to your normal activities. You’ll need to avoid strenuous activities, such as heavy lifting and contact sports, because these can put pressure on your aorta and make it more likely to rupture. You’ll also need to take medicine to reduce your blood pressure and cholesterol. You might also need to avoid alcohol and tobacco.
