An aortic aneurysm occurs when there is a weakness in the wall of your aorta. The blood pumping through the aorta causes pressure to build up and creates a bulge in the weak area of the aortic wall, which is known as an aortic aneurysm. In some cases, the aortic aneurysm will rupture or leak which leads to severe symptoms, but symptoms do not typically develop if the aneurysm stays intact.
There are two different types of aneurysms that occur in the aorta, which affect different parts of the body. An abdominal aortic aneurysm (AAA) is located below the chest and affects the portion of your aorta that passes through the abdomen. This type of aortic aneurysm occurs more often, and typically does not create any symptoms unless it ruptures.
The second type is called a thoracic aortic aneurysm (TAA) and is located in the chest, affecting the top of your aorta. Genetics can increase your risk of developing a thoracic aortic aneurysm, and this form is equally likely to affect both men and women.
Your family history and your lifestyle can create an increased risk of developing aortic aneurysms. These types of aneurysms occur most often in people who smoke, are over age 65, are men, have a family history of aortic aneurysms, or have high blood pressure. Inherited genetic diseases also increase the possibility of developing aortic aneurysms.
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There are many possible causes of aortic aneurysms, including inflammation arteries, injury to an aorta, and infections such as syphilis. Inherited genetic diseases, especially ones that affect connective tissue (such as Marfan syndrome and Ehlers-Danlos syndrome) can also cause aortic aneurysms, specifically thoracic aortic aneurysms, to develop.
The narrowing or hardening of the arteries, known as atherosclerosis, is also a possible cause of aortic aneurysms. They can also be caused by high blood pressure, high cholesterol, and sudden traumatic injuries.
Since many aortic aneurysms develop without causing symptoms, they are often discovered during routine checkups or screenings. If you have a high risk of developing these aneurysms, your doctor will choose to run imaging tests such as CT scans, CT or MRI angiography, or ultrasounds.
If you have an aortic aneurysm that has yet to rupture, your doctor will monitor your condition closely. Treatment at this stage aims to prevent the aneurysm from growing any larger so that it does not burst or tear the artery. For smaller aneurysms, your doctor may prescribe medications that improve blood flow, lower your blood pressure, or manage your cholesterol levels. Larger aneurysms that are at high risk of rupturing may require surgery to treat it before it ruptures, and there are two main surgeries used.
An open aneurysm repair is where your doctor removes the aneurysm and sews a graft in place to repair the artery. An endovascular aneurysm repair is a minimally invasive procedure to fix aortic aneurysms. During endovascular surgery, your doctor uses a catheter to insert a graft to reinforce or repair the artery. Treating a ruptured aortic aneurysm is considered a medical emergency that requires either open or endovascular surgery as well.
Many people do not feel symptoms of aortic aneurysms until it ruptures or leaks, although there are certain symptoms you may experience before this occurs. These include difficulty breathing or shortness of breath, decreased appetite, pain where the aneurysm is growing, pain while swallowing, and swelling of your arms, neck, or face.
If the aneurysm ruptures, a different set of symptoms may occur which includes dizziness or lightheadedness, rapid heart rate, nausea or vomiting, blood clots, and sudden, severe pain in the chest, abdomen, or back. If an aneurysm ruptures, it is a medical emergency that requires immediate treatment, so call 911 right away.
If an aortic aneurysm does rupture, it will cause internal bleeding. The symptoms from a ruptured aneurysm are much more severe and can even cause life threatening complications. The aneurysm can also block the flow of blood from your heart to other organs, which may cause stroke or heart attack due to insufficient blood flow.
You can reduce the risk of developing aortic aneurysms by maintaining a healthy lifestyle. This includes eating a healthy diet and maintaining a healthy weight, as well getting regular physical activity. It is also important to quit using tobacco products and keep your cholesterol and blood pressure levels in check.
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Invasive therapies may also be used to treat an abnormal heart rhythm, such as electrical cardioversion which sends electrical impulses through your chest wall and allows normal heart rhythm to restart, or catheter ablation which disconnects the pathway of the abnormal rhythm. If your doctor determines that electrical devices are the best course of action, you may be given a permanent pacemaker, an implantable cardioverter-defibrillator (ICD), or biventricular (B-V) pacemakers and defibrillators.