A bulge in the wall of a main artery in the body, known as the aorta, is what constitutes an aortic aneurysm. This artery is responsible for carrying blood from the heart throughout the body.

Aneurysms in the aorta can manifest in various locations and can present either in a tubular or circular form.

Types of aortic aneurysms include:

Aortic aneurysms can develop in two main areas of the body:

The abdominal region and the chest.

An abdominal aneurysm of the aorta emerges in the section of the aorta that crosses through the abdominal region.

Thoracic aortic aneurysm forms along the part of the aorta that travels through the thoracic cavity.

Some individuals can experience both types of aortic aneurysms.

The presence of an aortic aneurysm heightens the likelihood of a tear occurring in the inner layer of the aortic wall, which is known as aortic dissection.

What is aortic aneurysm?

Aneurysm is a bulge of the aorta, the big artery that transports blood from the heart across the chest and torso.

There are two ways aneurysms can harm:

Blood pressure can tear the layers of the artery wall, letting flow between them. This is known as a dissection.

The aneurysm might suddenly burst, resulting in internal bleeding. This event is referred to as a rupture.

Dissections and ruptures are responsible for the majority of deaths caused by aortic aneurysms.

What is their prevalence?

Men and individuals assigned male at birth are 4 to 6 times more likely to have abdominal aortic aneurysms compared to women and individuals assigned female at birth.

Only approximately 1% of men aged 55 to 64 are affected by this condition.

As age advances, the occurrence of abdominal aortic aneurysms increases.

The probability of developing this condition rises by about 4% every decade of life.

In comparison to thoracic aortic aneurysms, abdominal aortic aneurysms are more commonly found.

This difference may be attributed to the thicker and sturdier wall of the thoracic aorta in contrast to the abdominal aorta.

What are causes of aortic aneurysm?

Aneurysms of the aorta usually manifest in the lower part of the aorta, though they can develop elsewhere.

1. Arteriosclerosis: arteriosclerosis arises from the accumulation of fatty deposits within blood vessels.
2. Hypertension.
3. Various vascular diseases.
4. Aorta infections.
5. Physical trauma is a potential factor contributing to the formation of abdominal aortic aneurysms.

High blood pressure can induce damage to and weakening of the aortic wall, while certain diseases provoke inflammation of blood vessels.

In rare instances, bacterial or fungal infections may result in abdominal aortic aneurysms. Additionally, incidents like car accidents could also trigger the occurrence of this medical condition.

What are symptoms of aortic aneurysm?

The early stages of aortic dilatation occur long before any noticeable symptoms of the condition manifest, with the specific manifestations varying based on the location and type of aneurysm.

1. Indications of an abdominal aortic aneurysm (AAA):

Distinctive signs of an abdominal aortic aneurysm comprise:

• Feeling a throbbing mass in the abdomen.
• Abdominal discomfort.
• Lower back pain.

2. Manifestations of thoracic aortic aneurysm:

Conversely, when the aortic aneurysm is situated in the thoracic region, symptoms typically emerge once the aneurysm has expanded significantly, exerting pressure on adjacent organs in the chest cavity.

Symptoms include:

• Thoracic pain.
• Persistent cough and wheezing.
• Changes in voice tone.
• Swallowing difficulties.
• Intense, sharp chest and upper back pain that radiates to the arms and abdominal region.

What are risk factors of aortic aneurysm?

Aortic aneurysms tend to develop due to various key risk factors which include:

– Gender: The condition is found more frequently in males.

– Aging: The likelihood of encountering aortic aneurysms rises as individuals grow older, with a prevalence rate of 5% – 7% in those aged over 60.

– Hyperlipidemia: This condition contributes to the accumulation of fat surrounding the aortic wall.

– Tobacco use: Smoking heightens the chances of developing this ailment.

– Certain medical conditions like:

– Disorders impacting the connective tissues of the aortic wall.

– Inflammation within the aortic wall.

– Aortic traumas.

– Genetic disorders such as Marfan Syndrome.

– Diabetes.

How to diagnose aortic aneurysm?

• Pain is usually a sign of an aneurysm but may not occur until it’s large or about to rupture and identifying symptoms and causes is very important.
• Many aneurysms are asymptomatic and discovered incidentally during routine or radiological imaging.
• A pulsating mass may be felt by the doctor, along with a gushing sound from blood rushing through the aneurysm.
• Obese patients may not detect large aneurysms.
• Rapid enlargement of an aneurysm nearing rupture can cause spontaneous pain or palpation.
• The X-ray can detect aneurysms with calcium deposits but provides limited information.
• Ultrasonography reveals aneurysm size and flow, often repeated to track enlargement.
• CT scans, especially with contrast, offer detailed sizing but are exposed to radiation.
• MRI is accurate but may not be as readily available.
• Ultrasonography screening may be recommended for certain high-risk individuals over 65, like smoking men with a family history.

What are complications of aortic aneurysm?

In the case of an aortic aneurysm diagnosis by a doctor, there is a possibility of experiencing severe complications.

These complications could involve:

1. Formation of Blood Clots:

– Clots can form in the area of an aneurysm, break loose, and travel to various parts of the body like the legs, kidneys, or other organs, potentially causing serious issues such as stroke.

2. Occurrence of Dissection:

– The aorta’s wall has three layers. Dissection occurs when a tear develops in the innermost layer, allowing blood to flow between the layers, and disrupting proper flow to organs.

3. Rupture:

– Rupture involves a tear through all three layers of the aortic wall, leading to blood leakage into the chest or abdominal cavity.

Immediate intervention is crucial as it can be fatal if left untreated.

What’s it like to have an aortic aneurysm?

Coping with Aortic Aneurysm Diagnosis and Surgery:

• Receiving a diagnosis of an aortic aneurysm can be overwhelming. Whether you’re under observation or have undergone surgery, concerns about your health may arise.
• It’s natural to experience a range of emotions during this time.

Managing Emotions:

– Don’t be surprised if you feel a mix of emotions post-diagnosis or surgery, such as sadness, anger, or heightened emotions. While these feelings are normal, if they persist beyond six weeks, it’s advisable to discuss them with your doctor.

Lifestyle Changes for Management:

– If your condition is being monitored, there are lifestyle adjustments you can make to slow the progression of the aneurysm and promote overall health, aiding in preparation for surgery and recovery. These include:

– Quitting smoking.

– Adhering to prescribed medication.

– Maintaining physical activity.

– Limiting alcohol consumption to a maximum of 1-2 drinks per day.

– Reducing sodium intake.

– Adopting a heart-healthy diet.

Seeking Support:

– Connecting with others who are living with an aortic aneurysm or have undergone aortic dissection may provide valuable insights and support during your journey.

What is aortic aneurysm treatment?

Treatment options for an aortic aneurysm are influenced by various factors such as the size of the aneurysm, its rate of growth, location in the aortic region, as well as your age and overall health condition. Upon diagnosis, your condition will be regularly monitored by a specialist.

In cases where the aneurysm is small and asymptomatic, a wait-and-watch approach with routine surveillance scans may be recommended by your doctor. Additionally, you might receive medication to manage your blood pressure and cholesterol levels, reducing potential complications.

When the risk of a rupture outweighs conservative management, surgical intervention becomes necessary. There are two main types of surgery to address an aortic aneurysm:

Open surgical repair:

Under general anesthesia, a surgical incision is made in the abdomen or chest to repair the aneurysm using a synthetic patch or graft.

Following the procedure, intensive care and hospitalization for a week are typical.

Endovascular aneurysm repair (EVAR):

Also known as an endovascular stent graft, this minimally invasive procedure involves inserting a stent graft through a small incision in the groin, without the need for large cuts in the abdomen or chest.

The stent graft is positioned within the aneurysm, promoting proper blood flow through the aorta.

Recovery usually takes around a month, with a shorter hospital stay compared to open surgery.

Post-surgery recovery is crucial, encompassing physical and emotional recuperation.

While resuming normal activities may take several weeks to months, the duration can vary depending on the type of procedure undergone.

Your medical team will guide you through the most suitable treatment plan tailored to your individual needs.

Why Can Kids Get an Aortic Aneurysm?

Children may be at higher risk of developing an aortic aneurysm if:

– They have a history of aneurysms, or have currently or previously had an aneurysm.

– A family member (parent or sibling) has a history of aneurysms.

– They suffer from health conditions that compromise the strength of the aorta, including coarctation of the aorta, Kawasaki disease, Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome, or tuberous sclerosis.

– Their aorta has been compromised due to injury from a catheter or other medical devices.

– They have experienced infections such as endocarditis (infection of the heart’s lining).

– They have undergone chest or abdominal surgery.

– They have sustained a full-body injury, like from a car accident or a fall from a tree or rooftop.

– They have incurred wounds in the chest or abdomen.

Finally:

An aortic aneurysm is a disease that is often without symptoms but can be very dangerous.

Surgery is commonly used to treat it, but there is still much to do in terms of finding hidden cases and identifying patients who are at high risk of artery tearing or bursting.

Understanding how the disease develops better might lead to new and more effective treatments, and help in finding a much-needed test to diagnose it.

By using whole-exome sequencing, scientists aim to pinpoint the mutations causing the condition, while better imaging and analysis techniques could go beyond just looking at the size of the aneurysm to make treatment decisions.

Additionally, advancements in endovascular procedures are expected to offer more choices for managing the disease, leading to better results in the future.

These improvements will allow for more personalized care for individuals dealing with this condition.