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Aortic Aneurysm

Definition

An aortic aneurysm is a weak, bulging area in the wall of the aorta. The aorta is the body's largest artery. It carries blood from the heart for delivery to the rest of the body. The aorta travels through the chest (thoracic aorta) and the abdomen (abdominal aorta). Abdominal aortic aneurysms are more common than thoracic aortic aneurysms.

The greatest danger is that an aneurysm will rupture. This will cause heavy, uncontrollable bleeding (hemorrhage). A dissecting aneurysm means that the blood from the aneurysm is leaking and spreading between the layers of the aortic wall.

Causes

The cause of aneurysm is not known.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

High blood pressure
Smoking
Arteriosclerosis, atherosclerosis
Inherited connective tissue defects (Marfan's syndrome, Ehlers-Danlos syndrome)
Polyarteritis nodosa
Bacterial endocarditis
Syphilis
Age: 60 or older
History of heart attack
Obesity
Family members with aneurysms
Infectious aortitis
Great vessel arteritis
Injury to the aorta

Symptoms

Symptoms include:

Pain in the abdomen or in the lower back
Boring, gnawing, constant pain occurring over hours or days
Sudden onset of severe stabbing pain
Unusual sensation of pulsing in the abdomen
Cough, shortness of breath (thoracic aortic aneurysm)
Sudden blood pressure drop, fainting (upon rupture of aneurysm)

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Pain is the symptom that will most likely cause you to go to the doctor. Some aortic aneurysms are discovered during a routine physical exam.

Tests may include:

Abdominal or chest x-ray
Abdominal or chest ultrasound
CT scan of the abdomen or chest (best performed with an injection of contrast dye)
MRI scan of the abdomen or chest (may also utilize contrast dye)

Treatment

Treatment includes:

Surgery

Surgery to repair an aortic aneurysm is called aneurysmectomy. It involves removing the portion of the aorta that contains the aneurysm and replacing it with a mesh graft.

When deciding whether to operate, the doctor will consider:

Your age
Your general health
Your symptoms
The size of your aneurysm

Antibiotic Medication

If your aneurysm is infected, you will be given antibiotics prior to surgery.

Prevention

There are no guidelines for preventing an aneurysm because the cause is not known. However, you can reduce some of your risk factors by following these recommendations:

Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits and vegetables.
Don't smoke. If you smoke, quit.
Maintain a healthy weight.
Begin a safe exercise program as recommended by your doctor.
Seek treatment for high blood pressure, syphilis, and other infections.