What is Abdominal Aortic Aneurysm?

What is an abdominal aortic aneurysm? Why does it happen? Is it a serious situation? What are the symptoms? How is it treated? You can find the answers to all these questions and much more below.

What is an abdominal aortic aneurysm?

An abdominal aortic aneurysm is an enlarged area below the main artery that supplies blood to the body (the aorta). The aorta starts from your heart and runs through the center of your 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 quickly it grows, treatment can range from watchful waiting to emergency surgery.

What causes an abdominal aortic aneurysm?

Aneurysms can develop anywhere along the aorta, but most aortic aneurysms occur in the part of your aorta in your abdomen. A number of factors may play a role in the development of an aortic aneurysm, including:

  • Hardening of the arteries (atherosclerosis): Atherosclerosis occurs when fat and other substances build up in the lining of a blood vessel.
  • High blood pressure: High blood pressure can damage and weaken the walls of the aorta.
  • Blood vessel diseases: These are diseases that cause inflammation of the blood vessels.
  • Infection of the aorta: Rarely, a bacterial or fungal infection can cause abdominal aortic aneurysms.
  • Trauma: For example, being involved in a car accident can cause abdominal aortic aneurysms.

Who is at risk?

Abdominal aortic aneurysm risk factors include:

  • Tobacco use: Smoking is the strongest risk factor. It can weaken the aortic walls, increasing the risk of developing not only aortic aneurysm, but also rupture. The more and more tobacco you smoke or chew, the greater your risk of developing an aortic aneurysm.
  • Age: These aneurysms are most common in people 65 years of age and older.
  • Being male: Men develop abdominal aortic aneurysms more often than women.
  • Being white: People who are white are more at risk than other people.
  • Hereditary predisposition: Having a family history of aortic aneurysm increases your risk of developing this condition.
  • Other aneurysms: Having an aneurysm in another major blood vessel, such as the artery behind the knee or the aorta in the chest, can increase your risk of abdominal aortic aneurysms.
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What are the symptoms of abdominal aortic aneurysm?

Abdominal aortic aneurysms often grow slowly without symptoms, making them difficult to detect. Some aneurysms never rupture. Many start small and stay small; others expand over time and some quickly.

If you have an enlarging abdominal aortic aneurysm, you may notice:

  • Deep, persistent pain in your abdomen or side of your abdomen
  • Back pain
  • A pulse near your belly button

When should you see a doctor?

If you have pain, especially if the pain is sudden and severe, you should seek immediate medical attention.

How is an abdominal aortic aneurysm diagnosed?

Abdominal aortic aneurysms are often found during an exam for another reason or during routine medical tests, such as an ultrasound of the heart and abdomen.

To diagnose an abdominal aortic aneurysm, doctors will review your medical and family health history and perform a physical exam. If your doctor suspects you have an aortic aneurysm, special tests can confirm it, such as:

  • Abdominal ultrasound: This test is most commonly used to diagnose abdominal aortic aneurysms. You lie on the table while a technician moves a wand (transducer) around your abdomen. Ultrasound uses sound waves to send images to a computer screen.
  • Computed tomography: This painless test can provide your doctor with clear images of your aorta and detect the size and shape of an aneurysm. During a CT scan, you lie on a table inside a donut-shaped machine. The scan produces X-rays to create cross-sectional images of your body. Contrast dye can be injected into your blood vessels, which makes your arteries more visible in pictures.
  • Magnetic resonance imaging: In this test, you stand on a moving table that slides into a machine. Magnetic resonance imaging uses a magnetic field and pulses of radio wave energy to take pictures of your body. A dye may be injected to make your blood vessels more visible.

Abdominal aortic aneurysm screening

Being male and smoking significantly increase the risk of abdominal aortic aneurysms. Scan recommendations vary, but in general:

  • Men aged 65-75 years who have never smoked should have a one-time screening using abdominal ultrasound.
  • For men aged 65 to 75 who have never smoked, doctors will usually decide the need for an abdominal ultrasound based on other risk factors, such as a family history of aneurysms.
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There is insufficient evidence to determine whether women aged 65-75 years who smoke or have a family history of aortic aneurysms would benefit from screening for abdominal aortic aneurysms. Depending on the risk factors, the doctor may be asked whether an ultrasound scan is necessary. Women who have never smoked usually do not need to be screened for this condition.

How is an abdominal aortic aneurysm treated?

The goal of the following possible treatments is to prevent rupture (rupture) of the aneurysm. Which treatment you have depends on the size of your aortic aneurysm and how fast it is growing.

medical monitoring

Your doctor may recommend this option if your abdominal aortic aneurysm is small and you don’t have symptoms. You will have regular appointments to check if your aneurysm is growing, and treatment to manage other medical conditions, such as high blood pressure, that can worsen your aneurysm.

You may need regular imaging tests to check the size of your aneurysm. You may need to have an abdominal ultrasound at least six months after the aneurysm is diagnosed and at regular follow-up exams.

Operation

Repair is usually recommended if your aneurysm is larger, 4.8 to 5.6 centimeters, or is growing rapidly. Also, your doctor may recommend surgery if you have symptoms such as stomach pain or if you have a leaking, tender, or painful aneurysm.

Depending on several factors, including the location and size of the aneurysm, your age, and other conditions you have, repair options may include:

  • Open abdominal surgery: This involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft) that is stitched in place. Full recovery is likely to take a month or more.
  • Endovascular repair: This less invasive procedure is used more often. Doctors add a synthetic graft to the end of a thin tube (catheter) inserted through an artery in your leg and threaded into your aorta. The graft – a woven tube covered with a metal mesh backing – is inserted into the aneurysm site, expanded and secured in place. It strengthens the weakened section of the aorta to prevent rupture of the aneurysm. Endovascular surgery is not an option for about 30 percent of people with aneurysms. After endovascular surgery, you will need regular imaging tests to make sure the repair is not leaking.
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Long-term survival rates are similar for both endovascular surgery and open surgery.

Lifestyle and home remedies

For an abdominal aortic aneurysm, your doctor will likely recommend that you avoid heavy lifting and vigorous physical activity so as not to increase blood pressure excessively, which can put more pressure on your aneurysm.

Stress can increase your blood pressure, so you should try to avoid conflict and stressful situations. If you are going through a particularly emotional time in your life, you should let your doctor know because your medications may need to be adjusted to prevent your blood pressure from getting too high.

Can abdominal aortic aneurysm be prevented?

To prevent an aortic aneurysm or prevent an aortic aneurysm from getting worse, do the following:

  • Not using tobacco products: Stop smoking or chewing tobacco and avoid secondhand smoke as well.
  • Eating healthy: Focus on eating a variety of fruits and vegetables, whole grains, poultry, fish, and low-fat dairy products. Avoid saturated fat, trans fat and salt.
  • Keeping your blood pressure and cholesterol under control: If your doctor has prescribed medication, take it as directed.
  • Exercising regularly: Try to do at least 150 minutes of moderate aerobic activity per week. If you are not active, start slowly. You can talk to your doctor about what types of activities are right for you.

If you’re at risk for an aortic aneurysm, your doctor may recommend other measures, such as medications to lower your blood pressure and relieve stress on weakened arteries.

Complications of abdominal aortic aneurysm

The negative effects of an aneurysm in one or more layers of the aortic wall (aortic dissection) or ruptured (ruptured) 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.

When your aortic aneurysm ruptures (ruptures), signs and symptoms may include:

  • Sudden, intense and persistent back or abdominal pain that can be described as a tearing sensation
  • low blood pressure
  • rapid heart rate

Aortic aneurysms put you at risk of developing a blood clot in that area. If a blood clot comes loose from the inner 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.

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