Abdominal Aortic Aneurysm

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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

During the routine physical examination, the doctor checks for a distinctive pulsating sensation in the abdomen.

Abdominal MRI

The imaging test uses computer-generated radio waves and a magnetic field for displaying the images of the abdominal structures.

Ultrasound

Ultrasound, which is the most common test, is a painless test for diagnosing an Abdominal Aortic Aneurysm. It utilizes sound waves for depicting the flow of blood through the abdominal structures.

Abdominal CT scan

This test involves the use of X-rays for creating cross-sectional images of the abdominal structures. The scan can help in detecting the shape and size of the aneurysm as it offers clear images.

Treatment options for Abdominal Aortic Aneurysm

The treatment options for an Abdominal Aortic Aneurysm may vary depending upon the size of the AAA.

Medical monitoring

Also called watchful waiting, this is a preferable method for small and asymptomatic aneurysms. It requires the patient to undergo imaging tests and checkup with the doctor, regularly.

Treatment of Large AAA

The surgical options are a choice when the aneurysm is around 2 inches or more in size. If you have a painful aneurysm or stomach pain, your doctor might recommend you to undergo the surgery. The location and size of the aneurysm determine the type of surgery for treating the aneurysms.

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

In open surgery, an incision is made into the stomach & replaces the enlarged abdominal aorta with a graft made up of synthetic material.

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.

FAQs

AAA is a swelling in the aorta that runs from the heart to the abdomen. Yes, it is a serious condition if the detection is late as bigger aneurysms have more chances of rupturing and can be life-threatening as well.
Yes, one can live a normal life with an abdominal aortic aneurysm by preventing the conditions that may cause rupturing of the aneurysm.
The warning signs of AAA are chest pain, back pain, loss of consciousness, headache, and coughing blood.
You must avoid fried foods, sugary drinks, packaged foods, dairy products, fatty meats, white carbohydrates, and Hugh cholesterol foods.
The most common symptom of Abdominal Aortic Aneurysm is discomfort or abdominal pain which may either be constant or come and go at irregular intervals.
Yes, some people may experience bowel problems if they are suffering from abdominal aortic aneurysms while others may not experience the same.
Many people have a smaller aneurysm that is present with no visible symptoms. However, many people have a larger aneurysm which may be easily felt in the stomach because of its size.
There are various trigger factors for Abdominal Aortic Aneurysm which include smoking high blood pressure, a traumatic injury to the brain, infection in the blood, fatty buildup on the walls of the blood vessels or atherosclerosis, blood infection, and use of cocaine or amphetamine.

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