Abdominal Aortic Aneurysm
by Swedish Staff and Contributors
You may not experience any symptoms with an abdominal aortic aneurysm. Abdominal aoritc aneurysms are often detected during a routine physical exam or during X-ray evaluation for another disorder.
Symptoms may occur when the aneurysm grows or disrupts the wall of your aorta – the largest artery in your body that carries blood from your heart to the rest of your body. Symptoms depend on the size and location of the aneurysm and may include:
- Abdominal or lower back pain
- Boring, gnawing, or constant pain that occurs over hours or days
- Severe stabbing pain that occurs suddenly
- Unusual sensation of pulsing in your abdomen
- Coughing, shortness of breath
- Trouble swallowing
- Coughing up blood
- Loss of weight
- Chest pain
An abdominal aortic aneurysm is a weak, bulging area in the wall of your aorta. Your aorta is a large artery that travels through your chest and abdomen carrying blood from your heart to other areas of your body. Bulging in the artery is the result of a weakness or defect in the aortic wall. This bulge tends to get bigger with time.
The greatest danger is that an aneurysm will rupture, causing heavy, uncontrollable bleeding. An aortic dissection, a small tear in the aortic wall, can also cause an aneurysm. Blood from the aneurysm can leak through the tear and spread between the layers of the aortic wall. This leads to eventual rupture of the vessel.
Aneurysms can develop anywhere, but are most common in the aorta, iliac artery, and femoral artery.
Abdominal Aortic Aneurysm
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Atherosclerosis, hardening of a blood vessel from a buildup of plaque (fatty deposits, cholesterol, and calcium), is frequently associated with an aneurysm. But this disease alone may not cause the growth of an aneurysm. Researchers believe that other factors, such as high blood pressure or connective tissue disorders, must be present for an aneurysm to form.
Your doctor will ask you about any symptoms you may be experiencing and your medical history. A physical exam will be performed. Pain is the symptom that will most likely cause you to go to the doctor. Most abdominal aortic aneurysms are discovered during a routine physical exam.
Your doctor may need pictures of your heart. This can be done with:
- Abdominal or chest X-ray—an image of structures in your body created using a small dose of radiation
- Abdominal or chest ultrasound—uses sound waves to create images of structures in your body
- Computed tomograpy (CT) scan of your abdomen or chest—a type of X-ray that uses a computer to make images of the inside of your body
- Magnetic resonance imaging (MRI) scan of your abdomen or chest—uses magnetic waves and computers to make two- and three-dimensional images of the inside of your body
- Aortography—involves placement of a catheter (thin tube) in your aorta and injection of contrast material while taking X-rays of your aorta
- Transesophageal echocardiography—an echocardiogram uses sound waves called ultrasound to look at the size, shape and motion of your heart. During a transesophageal echocardiography, the ultrasound device is put down your throat.
- Cardiac catheterization—a test that uses a catheter and X-ray machine to check your heart and its blood supply
Treatment for an abdominal aortic aneurysm includes surgery or stenting.
Surgery to repair an abdominal aortic aneurysm is called aneurysmectomy. The procedure involves removing the portion of your aorta that contains the aneurysm and replacing it with a mesh graft.
With aneurysms of the thoracic aorta, the aortic valve may also be affected and need to be replaced or repaired. If the aneurysm involves important branches of the aorta, these vessels may either be repaired or bypassed.
Your doctor will consider the following when deciding whether to do surgery:
- Your age, general health and your symptoms
- The size of your aneurysm
- Associated disease such as kidney failure or stroke (a brain injury caused by an interruption in blood flow)
- If the aneurysm has ruptured or not
- If you've had a recent heart attack
Depending on where your aneurysm is located and how complex it is, stenting may be done. A stent-graft is a tube composed of fabric supported by a metal mesh called a stent. The stent-graft is inserted into your aorta. With the stent-graft in place, blood flows through the stent-graft instead of into the aneurysm, eliminating the chance of rupture.
A risk factor is something that increases your chance of getting an abdominal aortic aneurysm. Risk factors include:
- High blood pressure
- Arteriosclerosis, atherosclerosis (hardening of a blood vessel from a buildup of plaque)
- Inherited connective tissue defects such as Marfan syndrome and Ehlers-Danlos syndrome
- Polyarteritis nodosa (a serious blood vessel disease in which small and medium-sized arteries become swollen and damaged)
- Bacterial endocarditis (an infection of the endocardium, a thin layer of membrane (tissue) that covers the inner surface of your heart)
- Syphilis (a sexually transmitted disease that if left untreated, can cause brain, nerve, tissue damage and death)
- Age: 60 or older
- History of heart attack
- A family history of aneurysms, particularly male children of an affected mother
- Infectious aortitis
- Great vessel arteritis, also known as Takayasu’s disease
- Injury to your aorta from either a motor vehicle accident or a stab wound
Because the cause is unknown, there are no guidelines for preventing an aneurysm. However, you can reduce some of your risk factors by following these recommendations:
- Eat a healthy diet that’s low in saturated fat and rich in vegetables, whole grains and fruits.
Don't smoke. If you smoke, quit.
The U.S. Preventive Services Task Force recommends that men aged 65-75 who have ever smoked be screened once for an abdominal aortic aneurysm with ultrasound. Early detection of an abdominal aortic aneurysm in this group has been shown to reduce mortality from this condition.
- Maintain a healthy weight.
- Talk to your doctor about a safe exercise program for you.
- Seek treatment for high blood pressure, syphilis and other infections.
- If you have Marfan syndrome, see your doctor regularly for monitoring and CT scans.
This content was created using EBSCO’s Health Library. Edits to original content made by Swedish.