Aortic Aneurysm

 What is an aortic aneurysm?

An aortic aneurysm is a stretched and bulging section in the wall of the aorta. The aorta is the large blood vessel that carries oxygen-rich blood from the heart to the rest of the body. A bulging aorta is weakened and can burst, or rupture, resulting in life-threatening bleeding.

The two types of aortic aneurysms are abdominal aortic aneurysm and thoracic aortic aneurysm. This classification is based on where the aneurysm occurs along the aorta.

  • The thoracic section of the aorta travels through the chest and supplies oxygen-rich blood to the upper body. See an illustration of a thoracic aortic aneurysm.
  • The abdominal section of the aorta continues through the abdomen and supplies oxygen-rich blood to the lower body. See an illustration of an abdominal aortic aneurysm.

Aneurysms can develop in any section of the aorta, but they are most common in the abdominal section.

What causes an aortic aneurysm?

The wall of the aorta is very elastic and can normally stretch and then shrink back as needed to adapt to blood flow. However, some medical conditions-most commonly, hardening of the arteries (atherosclerosis) and high blood pressure-weaken the artery walls. These factors, along with the wear and tear that naturally occurs with aging, result in a weak aortic wall that may stretch and bulge outwards.

What are the symptoms?

Aortic aneurysms rarely produce symptoms and are usually found during examinations done for other reasons. When symptoms occur, they most commonly include general complaints of abdominal or chest pain or discomfort, which can come and go or be constant.

In the worst case, an aneurysm can burst, or rupture, causing severe pain and bleeding. A ruptured aneurysm is a life-threatening condition, often leading to death within minutes.

Other complications can occur. Blood clots can break off from a thoracic aortic aneurysm, travel to the brain, and cause a stroke. Blood clots that break off from an abdominal aortic aneurysm can block blood flow to the abdomen or legs. These clots form because blood flow often slows in the bulging section of an aortic aneurysm.

How is an aortic aneurysm diagnosed?

Aneurysms are often diagnosed by chance during an X-ray, ultrasound, or echocardiogram done for other reasons. Aneurysms can also be found during a routine physical exam. In some cases, they are found during a screening test. Screening tests help your doctor look for a certain disease or condition before any symptoms appear.

Once an aneurysm is suspected, abdominal ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), or other tests will be done to pinpoint the aneurysm's location and size.

How is it treated?

Treatment of an aortic aneurysm is based upon its size and how fast it is growing. Surgery is needed for large or fast-growing aneurysms, or when symptoms are present. Typically the damaged portion of the blood vessel is replaced with a man-made graft.

Smaller aneurysms rarely rupture and are usually treated with high blood pressure medication, such as beta-blockers, to lower blood pressure and decrease stress on the aortic wall. If surgery is not done, you will have routine ultrasound tests to make sure the aneurysm is not getting bigger.

Even if your aneurysm does not grow or rupture, you may be at risk for heart problems. Your doctor may recommend that you increase exercise, eat a heart-healthy diet, and stop smoking. He or she may also prescribe medicines to help reduce high cholesterol.

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