Aortic Aneurysm

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KEY POINTS

• An aortic aneurysm is a weak spot in the wall of the aorta. The aorta is the large artery that carries blood from your heart to the rest of your body.
• You may need surgery to repair an aneurysm that causes symptoms or is bigger than 2 and 1/4 inches. Smaller aneurysms need to be checked regularly.
• Follow your healthcare provider’s advice about exercising, eating a healthy diet, watching your weight, not smoking, and checking your blood pressure.

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What is an aortic aneurysm?

An aortic aneurysm is a weak spot in the wall of the aorta. The aorta is the large artery that carries blood from your heart to the rest of your body. A normal aorta is about as wide as a garden hose. The aorta leads from the heart to the lower abdomen. Aneurysms cause the wall of the aorta to push out or bulge and can happen in your belly or in your chest.

Most aortic aneurysms grow slowly. Over many years, an area of the artery wall may slowly stretch and enlarge like a balloon. If the aneurysm does not grow much, you may live with a small aneurysm for years. However, if the aneurysm keeps getting bigger, the wall of the aorta may tear, causing internal bleeding. Because the aorta carries so much blood, a sudden tear is a medical emergency and is life threatening.

What is the cause?

Atherosclerosis, or hardening of the arteries, is the most common cause. Fatty deposits called plaque may build up in blood vessels and make them narrower. Plaque also weakens the wall of the aorta. Pressure from the flow of blood can make the weakened part of the wall start to bulge.

Aneurysms can run in families. You may be born with a weakness in your artery wall. Aneurysms may also be caused by some infections, inflammation, or diseases such as Marfan syndrome, which causes tissue in the body to become weak.

Aneurysms get worse faster in smokers and in people with high blood pressure.

What are the symptoms?

An aneurysm may not cause symptoms for a long time. When you have symptoms, they depend on where the aneurysm is and how bad it is. For example:

• An abdominal aortic aneurysm might cause pain in your stomach, back, or groin. You may be able to feel a bulge in your belly that has a pulse.
• An aneurysm in your chest may make it harder to swallow or might cause chest or back pain.

Sudden, very severe stomach, back, or chest pain may mean that the aorta has started to tear. Call 911 for emergency help right away if you have these symptoms.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Most aortic aneurysms are diagnosed by a healthcare provider during a routine exam. If your provider thinks that the aorta may be leaking or may have ruptured, you may have tests such as:

• CT scan, which uses X-rays and a computer to show detailed pictures of the blood vessel wall and possible tears
• Angiogram, which uses contrast dye injected into a vein and X-rays to look inside the heart and blood vessels
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the blood vessel wall and possible tears
• An echocardiogram, which uses sound waves (ultrasound) to see how well your heart is pumping

How is it treated?

Surgery usually is needed for aneurysms that cause symptoms or are bigger than 2 and 1/4 inches. The risk of rupture increases with the size of the aneurysm. Surgery replaces the weakened part of the aorta with a graft of manmade material. The graft sticks to the inside of the artery wall and protects the aorta from tearing.

Smaller aneurysms need to be checked regularly. If you are in good health except for having the aneurysm, and if you have no symptoms, you may not need surgery. Your healthcare provider will help you know what treatment is right for you.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Your provider will talk with you about lifestyle changes such as quitting smoking.
• You may need to take medicines for high blood pressure or high cholesterol.

Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and try to keep a healthy weight. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress.

Exercise according to your healthcare provider's instructions. Your provider may want you to avoid certain sports or activities and may ask you not to lift things over a certain weight.

Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent an aneurysm?

• Have your blood pressure and blood cholesterol checked regularly.
• Switch to a low-fat, low-cholesterol, high-fiber diet. Your provider or a dietitian can tell you which foods you should avoid.