The ABC’s of Aortic Aneurysms

By Joseph V. Lombardi, MD

Head, Division of Vascular and Endovascular Surgery, Director, Cooper Aortic Center

, The ABC’s of Aortic Aneurysms

You often here the word “aneurysm” and immediately think of something bursting and causing stroke or death. While this might be true in some cases, many aneurysms are treatable if caught early. Understanding what aneurysms are and how they are treated are first steps in preventing serious complications of your health.

An aneurysm is a weakened area of a blood vessel that expands or bulges. Many aneurysms occur in the aorta, the main artery moving blood from your heart to the rest of the body. Most aneurysms are caused by arteriosclerosis, or “hardening of the arteries” which weakens the aortic wall, while others can be the result of genetics or trauma. When an aneurysm expands to the point of rupture, severe internal bleeding can occur. If a ruptured aneurysm is not discovered and treated quickly, a patient may not survive.  In fact, once an aneurysm ruptures, the mortality can be as high as 90%.

Aortic aneurysms are most common in men over 60. Also, men and women with risk factors such as cigarette smoking,  high blood pressure and high cholesterol all contribute to the chances of developing a life-threatening aneurysm.  Furthermore, individuals with a first degree relative who have or had an aortic aneurysm have a 10-15% chance of developing one themselves.

There are several types of aortic aneurysms:

  • Abdominal Aortic Aneurysms (AAA) are located in the abdomen. The abdominal aorta supplies blood to the lower part of your body and a ruptured aneurysm in this location can cause life-threatening bleeding. An  abdominal  aortic  aneurysm  may  not  produce symptoms  and  can  be  discovered  accidentally  through ultrasound or CT scans when looking for other conditions. Sometimes, they can be detected by a physical exam revealing an abnormal prominent pulse in the abdomen. When symptoms do appear, they can be in the form of abdominal and back pain.
  • Thoracic Aortic Aneurysms (TAA) are a bulging, weakened area in the wall of the aorta which can rupture or dissect, potentially causing life-threatening bleeding. Many people with thoracic aortic aneurysms do not notice symptoms until there is a rupture, when chest or back pain may occur.
  • Thoracic Aortic  Dissection (TAD) is a tear causing a ballooning of the aortic wall, which can rupture. An aortic dissection can be life-threatening. Symptoms of an acute aortic dissection include constant chest and/or upper back pain, described as “tearing.” The pain may move from one place to another.  Quite often these symptoms can be identical to a heart attack making the diagnosis difficult for physicians.

Every second counts when it comes to aneurysm ruptures. Diagnosed early, aneurysms can be repaired by a board certified  vascular and endovascular surgeon. A good physical exam by your primary care doctor and proper screening for risk factors can make all the difference.

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