Abdominal Aortic Aneurysm (AAA) is the inflammation or swelling of the aorta which is the largest artery of the body. Large aneurysms are rare but are fatal if they burst. It runs from the heart to the abdomen through the chest and is the largest vessel in the human body. A rupture of the AAA can cause bleeding that may be life-threatening.
Types of Abdominal Aortic Aneurysm
The size and the speed of growth of an Aneurysm are the key factors for the classification.
- Small (<5.5 cm): These are slow-growing Abdominal Aortic Aneurysms with a comparatively lesser risk of rupturing than the larger aneurysms. Regular abdominal ultrasounds are often helpful in monitoring these aneurysms.
- Large (>5.5 cm): These are fast-growing Abdominal Aortic Aneurysms that have high chances of rupturing. There might be internal bleeding due to rupture followed by other major complications. The larger the size of the aneurysm, the higher the chances of treating the same through the surgery.
Symptoms of Abdominal Aortic Aneurysm
In most cases, a small abdominal aortic aneurysm shows no symptoms. However, a larger AAA may cause pain or a pulsating feeling in the abdomen & persistent back pain. As it grows slowly without showing any visible symptoms, it is often difficult to detect an Abdominal Aortic Aneurysm. While some aneurysms stay small without any rupture, many others grow large.
They may notice a few symptoms if they have an Abdominal Aortic Aneurysm that continues to enlarge. These symptoms may include back pain, deep and persistent pain in the abdomen, and a pulsating feel near the belly button. It also includes clammy skin, nausea, shock, and vomiting.
A ruptured abdominal aortic aneurysm may cause:
- Dizziness
- Sweaty skin
- Rapid heartbeat
- Shortness of breath
- Loss of consciousness
Causes & risk factors of Abdominal Aortic Aneurysm
- Age: Increasing age is a risk factor for abdominal aortic aneurysms.
- Gender: AAAs are most common in men aged over 65.
- Smoking: Tobacco contains substances that damage the aortic wall.
- Atherosclerosis: In atherosclerosis, there is the narrowing of the arteries due to the accumulation of plaque. These plaques cause the widening of the aorta so that the blood keeps on flowing leading to the weakening of the aorta.
- High blood pressure: It increases the pressure on aortic walls. This may weaken the walls of the aorta and cause damage to the same.
- Family history: Having a family history of AAA may increase the risk of developing it.
- Infection in the aorta: A fungal or bacterial infection may cause an Abdominal Aortic Aneurysm.
- Blood vessel diseases: Some diseases may cause inflammation in the blood vessels.
- Trauma: An injury or trauma may also cause an Abdominal Aortic Aneurysm.
Risk factors for Abdominal Aortic Aneurysm
- Family history: If you have a family history of an Abdominal Aortic Aneurysm, you are at an increased risk of developing the condition.
- Tobacco use: Tobacco consumption can increase your chances of developing an Abdominal Aortic Aneurysm.
- Color complexion: People with white or fair color complexion have a risk of developing abdominal aortic aneurysms.
- Other types of aneurysm: If you have an aneurysm in some other blood vessel, it may increase your risk for Abdominal Aortic Aneurysm.
Diagnosis of Abdominal Aortic Aneurysm
Routine physical examination
Abdominal MRI
Ultrasound
Abdominal CT scan
Treatment options for Abdominal Aortic Aneurysm
Medical monitoring
Treatment of Large AAA
Endovascular surgery
During endovascular surgery, a small incision is made in the groin through which a graft made of metal mesh is inserted & advanced to the swollen aorta. This graft is sealed to the aortic wall at both ends which reduces the risk of bursting.
Open surgery
Treatment of small or medium AAA
For a small (3.0-4.4cm) or medium (4.5-5.4cm) aneurysm, surgery may not be recommended as it may not benefit the patient. The patient is called for regular check-ups (every year in case of a small aneurysm and every three months in case of a medium aneurysm) & scans to monitor the size of the aneurysm.
The patient is advised to prevent the aneurysm from getting bigger, which is done by:
- Stopping smoking
- Eating a balanced diet
- Maintaining a healthy weight
- Regular exercise
Complications of Abdominal Aortic Aneurysm
A ruptured aneurysm or aortic dissection (or tear) in the layers of the Aortic wall are the major complications. The larger the size and speed of growth of the aneurysm, the higher are the chances of Aneurysm rupture which may cause bleeding, which is life-threatening.
You will realize a ruptured aneurysm if you have low blood pressure, sudden and continuous abdominal pain, or a faster pulse. A tearing sensation or back pain also signifies the rupture of an aneurysm.
Prevention Of Abdominal Aortic Aneurysm
There are various ways of preventing and worsening Abdominal Aortic Aneurysm. These, does not limit to but, may include:
- Quitting the consumption of tobacco and smoking may help prevent aneurysms.
- Maintain normal blood pressure and cholesterol by following the instructions of the doctor.
- Eating a healthy and balanced diet that includes fruits and vegetables is also helpful.
- Exercising regularly with the right activities advised by the doctor may also help prevent aneurysms.