Aortic Aneurysm - Causes, Symptoms, Diagnosis, and Treatment

What Is Meant by Aortic Aneurysm?

The aorta, the largest artery in the body, functions to transport blood and oxygen from the heart to various body parts. Resembling a curved candy cane, it consists of the ascending aorta leading away from the heart and the descending aorta into the abdomen. Aneurysms can occur in any artery, including the aorta. An aortic aneurysm develops due to a weakening in the aortic wall, leading to the formation of a balloon-like bulge caused by the pressure of blood flowing through the artery. This bulge is referred to as an aortic aneurysm.

How Is Aortic Aneurysm Caused?

The exact causative factor has not been known yet, but many factors are known to be related to this condition. One of the explained pathophysiology's is damaged arteries due to blockages caused by fatty deposits, etc., which makes the heart put extra effort and pump harder than usual to push out blood crossing the fatty deposits in the artery. Thus, the increased pressure within the arteries can damage the arteries more. The following conditions are known to be associated with aortic aneurysm:

1. Atherosclerotic Disease:

This condition has shown the development of an aortic aneurysm as a sequela. Patients suffering from atherosclerotic disease have fatty deposits or plaque accumulation in their arteries. Plaque acts as a barrier and, thus, prevents the free flow of blood within the arteries.

2. High Blood Pressure:

Another major causative factor for an aneurysm is increased blood pressure. It is a measure of the amount of force of circulating blood on the walls of arteries. If the pressure rises above the normal level, it can cause weakening or enlargement of the blood vessels.

The normal blood pressure level is 120/80 mm Hg, which can range between 110/70 - 140/90 mm Hg.

If there is a constant rise in blood pressure levels, it increases the risk of various disorders of the heart, blood vessels, and circulation.

What Are the Different Types of Aneurysms?

As mentioned earlier, aneurysms can occur anywhere in the body, and they are classified based on their anatomical location as follows;

1. Aorta:

The aorta is known to be the largest blood vessel in the body. It starts at the left ventricle of the heart, goes down the abdomen, and finally splits to reach both legs. The aorta is considered to be the most common site for arterial aneurysms.

• The aneurysms involving the chest cavity are known as thoracic aortic aneurysms.

• The aneurysm involving the abdomen is called an abdominal aortic aneurysm. These are the most commonly observed types.

• Both the chest and abdomen can be affected simultaneously by the damaged artery in rare cases.

2. Brain:

Aneurysms can be found in the brain, and they can vary in size. More commonly, they occur in blood vessels that lie deep inside the brain. Sometimes, they can be asymptomatic, and thus, the diagnosis could be missed. Some patients develop bleeding due to aneurysms in the brain.

3. Various Other Sites:

Various other sites that can be affected due to aneurysms are the artery behind the knee and arteries of the spleen, intestines, etc.

What Are the Symptoms Associated With Aortic Aneurysm?

Signs and symptoms associated with an aneurysm depend on the anatomic location and type. Some may even be asymptomatic. Many aneurysms start showing symptoms only after they rupture. Aneurysms presenting near the body surface can cause swelling and pain. There are also chances for the development of a large mass.

When an aneurysm ruptures, it shows the following signs and symptoms:

• Bleeding at the site.

• Raised heart rate

• Dizziness or light-headedness.

• Pain.

If not managed at a proper time, it can lead to serious complications and even death.

What Are the Risk Factors of Aortic Aneurysm?

If the person possesses certain characteristics, they are at a higher risk of developing an aortic aneurysm:

• Being over the age of 65.

• Being male or assigned male at birth.

• Smoking.

• Having high blood pressure.

• Having family members with aortic aneurysms.

• Being born with a heart valve defect known as a bicuspid aortic valve.

Additionally, individuals with certain connective tissue disorders such as Marfan syndrome (Marfan syndrome is a genetic disorder that affects the body's connective tissue, leading to a range of skeletal, cardiovascular, and ocular abnormalities), Loeys-Dietz syndrome (Loeys-Dietz syndrome is a rare genetic disorder that affects the connective tissue and can lead to aortic aneurysms, arterial tortuosity, and other cardiovascular abnormalities), vascular Ehlers-Danlos syndrome (Vascular Ehlers-Danlos syndrome is a rare genetic disorder characterized by a defect in the production of collagen, leading to fragile blood vessels and a high risk of arterial and organ rupture), and Turner syndrome (Turner syndrome is a genetic disorder in females characterized by the absence of one X chromosome, leading to short stature, delayed puberty, and infertility) are at higher risk of thoracic aortic aneurysms.

How Can Aortic Aneurysm Be Diagnosed?

When the person visits the physician, they will be asked about the signs and symptoms, personal history, family history, etc. Following that, a physical examination will be carried out. The various tools that are used to examine depend on the location of the aneurysm. The person will most probably be referred to a cardiothoracic or vascular surgeon for further diagnosis. Various commonly used examination tools for checking aneurysms in the body are computed tomography scans (CT) and ultrasounds.

How Can Aortic Aneurysm Be Treated?

The treatment depends on the anatomical location and type of the aneurysm. One preferred treatment is an endovascular stent graft, which is done in cases of aneurysms in the chest or abdomen area. It is a minimally invasive procedure that is preferred over surgical management. Surgical management involves open surgery, where the repair and reinforcing of blood vessels are involved. Also, the stent decreases the chances of scarring, infection, and various other issues.

Various other treatment modalities available are medications to treat high blood pressure and increased cholesterol. Certain beta-blockers can also be used to maintain or lower blood pressure. Maintaining or lowering the blood pressure can prevent the rupture of the aneurysm.

What Are the Complications for Aortic Aneurysm?

If diagnosed with an aortic aneurysm, there is a risk of serious complications, including:

• Blood Clots: Formation of small clots within the aneurysm area that may detach and travel to various organs such as the legs, kidneys, or other organs, potentially leading to significant issues like stroke.

• Dissection: Occurs when there is a tear in the innermost layer of the aortic wall, allowing blood to flow between the layers and disrupting proper blood flow to organs.

• Rupture: A tear through all three layers of the aortic wall, leading to the leakage of blood into the chest or abdominal cavity. If not promptly treated, it can be fatal.

What Is the Outlook for Individuals Diagnosed With an Aortic Aneurysm?

Through attentive monitoring and appropriate treatment, healthcare providers can assist in effectively managing an aortic aneurysm. Ideally, healthcare teams can detect and address an aortic aneurysm before it reaches the point of rupture. In the event of a ruptured aortic aneurysm, it is crucial to seek immediate medical attention. Without prompt intervention, a ruptured aortic aneurysm can result in fatality. Both open and endovascular surgeries have proven successful in treating ruptured aortic aneurysms.

Conclusion:

Aortic aneurysms can occur anywhere in the body and are mostly asymptomatic but may show signs and symptoms if they rupture. It is necessary to get annual checkups done to prevent any serious complications. Online medical platforms have made contacting a specialist easy, especially during this pandemic time. To learn more about aortic aneurysms, consult a specialist online.