Monday, March 30, 2015

Aortic Aneurysm

Aortic Aneurysm Though aneurysm can occur in any blood vessel of the body, it often develops in aorta. Aorta is the largest blood vessel artery in the body that transports oxygenated blood from the heart to all parts of the body. Obviously since it carries volumes of blood each minute, weak spots can develop in the artery. Aortic aneurysm can develop either in thoracic cavity or abdominal cavity. The weakened area of the artery forms a bulge resembling a bag like structure which is filled with blood. In rare cases, this bag ruptures tearing away the arterial wall to empty the blood into the tissue.


Thoracic aortic aneurysm can develop in the upper portion of the chest and abdominal aneurysm can occur in any part of the abdomen. Generally aortic aneurysm of small size does not cause any threat. But if its size is large there are more chances for the aneurysm to rupture and dissect the artery wall. Sometimes plaque like substance gets accumulated in the site of aneurysm which would further weaken the wall of artery. There is chance for the formation of blood clot or thrombosis which can dislodge from the original spot causing complications. Large sized aneurysm can exert pressure to the neighboring organs causing pain.


Causes :



  • Exact cause of aortic aneurysm is not known.

  • Building up of plaque like particles (atherosclerosis) can harden the arteries and they become stiff and eventually bulge and break.

  • Having high blood pressure and increased cholesterol level can cause formation of aortic aneurysm.

  • People with connective tissue problems like Marfan syndrome are at risk of developing aortic aneurysm.

  • Individuals with leakage in heart valves have high risk of getting thoracic aortic aneurysm. People with prolonged infection like syphilis or salmonella can develop aortic aneurysm.

  • Local trauma or injury to the artery during vehicle accident can cause weak spots on the artery which gradually develops into aneurysm.


Symptoms :


Generally small sized aortic aneurysms show no symptoms. Aneurysms can cause symptoms only if the size is large or it has ruptured. In such cases, it can cause chest pain, pain in the shoulder or arms, shortness of breath, repeated cough, hoarseness in voice, difficulty in swallowing, and in severe cases shock or even stroke.


You should seek immediate medical attention if you have severe chest pain, back pain with shortness of breath. If the thoracic aneurysm has ruptured inside it can cause symptoms like trouble in breathing, sudden intense chest pain, reduced blood pressure, loss of consciousness and difficulty in speaking and even paralysis.


Tests :


Small aneurysms often go undetected and sometimes get noticed during other medical tests. Your doctor can diagnose aortic aneurysm by chest X-ray, echocardiogram and CT scan. In case if aneurysm runs in your family, you can screen for thoracic or abdominal aneurysm by doing regular imaging tests and echocardiogram.


Treatment :


It is enough for you to keep a wait full watch if you are diagnosed with small sized aortic aneurysm. Your doctor may do regular screening and echo test to check if the aneurysm has grown bigger in size. No medications are required to be given. For streamlining blood pressure your doctor may prescribe angiotensin inhibitors like Diovan or Olmesartan and Beta blockers like metoprolol. Statins like atorvastatin or lovastatin are effective in controlling cholesterol level in blood.


If the size of aneurysm is large (more than 6 cm) your doctor may consider operating it. It can be done through various procedures. In open heart surgery the surgeon would remove the damaged portion of the aorta and replace it with graft. In endovascular surgery, a synthetic graft is attached to one end of the catheter which is sent through one of the major arteries of your leg into the damaged aorta. Subsequently this graft is placed at the weak spot and tied with suitable pins. This graft would prevent further bulging of aneurysm and rupturing. Depending on the factors like age, health condition and complications of aneurysm, your doctor would decide whether you are suitable for surgery.


Lifestyle Changes :


You should follow the instructions of your doctor with regard to exercise and diet, once you are detected with aortic aneurysm. Do not lift heavy weight or engage in vigorous exercise since it can put additional pressure on the weak spots of aneurysm.


You need to keep blood pressure under control by taking regular medications prescribed by your doctor. If you are smoking or drinking quit these habits. Take cholesterol free diet and include plenty of fresh fruits and vegetables daily. Go for regular screening tests as advised by your doctor.


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