Institute Of Cardiac Sciences >> Specialties & Aortic aneurysm
What is called an aortic aneurysm?
Aortic aneurysm is bulging or increase in the size of aorta. Aorta the body’s main artery and is usually around 2cm wide. Aneurysm means bulging. The function of aorta is to carry oxygen rich blood from heart to the rest of the body. Aneurysm weakens the aorta which can burst. If aorta bursts, it may cause serious problems leading to death in certain situations. An aneurysm can form in any section of the aorta.
They are most commonly found in the belly area, and are called abdominal aortic aneurysms.
They can also occur in the Torso region and are termed as thoracic aortic aneurysm. Thoracic aneurysms are also known as ascending or descending aortic aneurysms.
Causes leading to aortic aneurysm:
Main causes of aortic aneurysm are uncontrolled high blood pressure and atherosclerosis. Atherosclerosis is hardening or thickening of arteries. The wall of artery is normally elastic it can stretch and then shrink back as needed to adapt to the blood flow. The artery’s elasticity is inhibited due to atherosclerosis.
Atherosclerosis causes changes to the lining of the artery wall that may affect oxygen and nutrient flow to the aortic wall tissues. The resulting tissue damage and breakdown may lead to the development of an aneurysm.
Genetics: some people may inherit such conditions; the walls of the major arteries, including the aorta are weakened. Aortic aneurysm may be a genetic defect in many cases.
Aging: the aorta naturally becomes less elastic and stiffer with age, increasing the risk for an abdominal aortic aneurysm due to lack of physical activity in aging individuals.
Infections: infections such as syphilis and endocarditic an infection of the lining of the heart, can cause aneurysm.
Injury:a sudden intense blow to the chest or abdomen such as hitting the steering wheel in a car accident, or sudden shock or too much stress or pressure on the artery can damage the aorta.
Signs and symptoms of the disease:
Most of the cases aortic aneurysm doesn’t depict any symptoms. Most of the time doctor finds them during exams or test done for other reasons. Patients who have symptoms complain of belly, chest, or back pain and discomfort. The symptoms may come and go or may remain constant. In the final stages, an aneurysm can burst, or rupture. This causes severe pain and bleeding and may often lead to death within minutes or hours.
The most common symptom of a ruptured aortic aneurysm is sudden and severe pain in the abdomen.
An aortic aneurysm can also lead to other problems. Blood flow slows in bulging area of an aortic aneurysm, causing clots to form. If this blood clot breaks off an aortic aneurysm in the chest area, it can travel to the brain and cause a stroke. Blood clots that break off from an aortic aneurysm in the belly area can block blood flow to the belly or legs.
What happens when aortic aneurysm increases?
If you have an aortic aneurysm you will have to see your doctor regularly to check on the following factors. The size of the aneurysm and how fast it is growing both help to determine how and when to treat it.
Rupture: it is a dangerous complication. As an aneurysm expands, the tension on the blood vessel wall increases causing the aneurysm to expand further, which puts even more tension on the wall. We at KIMS will repair an aneurysm before it has a risk of rupture.
Blood clots: When an aneurysm develops it can damage the wall of the aorta. The damage leads to clot formation. A blood clot can narrow the aorta and slow down blood flow to the rest of the body. Pieces of the blood clot can break off and get struck in the blood stream blocking blood flow and damaging the tissue beyond the blood clot.
How to diagnose aortic aneurysm:
Aneurysms are often diagnosed by chance during routine examinations or tests done for any other reasons. In some cases they are found during a screening test for aneurysms. Screening tests help look for a certain disease or underlying conditions before any symptoms appear.
Who are eligible for screening for aneurysm?
KIMS recommends screening tests for abdominal aneurysms for men who are ages 65 to 75 and they are habitual smokers or occasional smokers
If aneurysm is present in their family history, one can get screened between 60yrs to 70 yrs onward
Habitual smokers are more likely to have an aneurysm than women or non smoking men.
KIMS Doctors and experts recommend screening tests for a thoracic aneurysm for anyone who has a close relative who has had a thoracic aortic aneurysm.
If one has an aortic aneurysm, we recommend for ultrasound, a CT scan, and MRI. These tests will find out exactly where it is located and how big it is. Based on the results, our effective treatment will be aimed at curbing it completely once and for all.
Tests for aortic aneurysm:
When an aneurysm is suspected or diagnosed, it is important to
- Pinpoint or identify the exact location of the aneurysm
- Find out the size and how fast it is growing
- Find out whether the blood vessels are involved
- Check for blood clots or inflammation.
We will listen to your heart to check for blood flow problems. If a mass is present or found in the abdomen, further testing will be suggested to evaluate. Suggest further an abdominal aneurysm is typically more difficult to find in those who are overweight, and we at KIMS with our cutting edge technologies rule out such problems, and ensure that the aneurysm is detected and curbed.
Line of treatment:
The treatment of this condition depends on the patient’s overall health. Treatment of an aortic aneurysm is mainly based on two things, the size and its growth pattern. Treatment of aortic aneurysm is mostly surgery. If you have large or fast growing aneurysm you need surgery. Your doctor will repair the damaged part of the blood vessel during open surgery. The risks and benefits of surgery for abdominal aortic aneurysms are different than those for thoracic aortic aneurysm.
If you have small aneurysm it may take time to rupture and are usually treated with high blood pressure medicine, such as beta-blockers. This medicine lowers the blood pressure and stress on the aortic wall. If you don’t have a repair surgery or procedure you will have routine ultrasound tests to see if the aneurysm is getting bigger. Even if the aneurysm does not grow or rupture one may be at risk for heart related issues and need to be monitored closely. We suggest that you exercise more, eat a heart healthy food and stop smoking. Don’t forget to take prescribed medicines which will help to lower high blood pressure.
Abdominal aortic aneurysms are unlikely to rupture if they develop slowly, are less than 5.5cm about 2inches in diameter, and are causing no symptoms. As the aneurysm enlarges to greater than 5.5cm, surgical correction is the usual treatment opted for. Aneurysms that are enlarging rapidly causing symptoms, or showing signs of probably rupture such as leaking requires immediate surgery. Delaying this surgery puts the patient at even greater risk of a rupture.
Thoracic aortic aneurysms may originate in either ascending or descending aorta and because of their close proximity to the heart than abdominal aortic aneurysms they have greater potential to harm the heart or create other problems related to the heart.
Any thoracic aortic aneurysm 6cm or larger requires surgery, but if the patient has Marfan syndrome or a familial history of aneurysms, 5cm aneurysms are considered for surgery.
Although a ruptured aortic aneurysm can be repaired by surgery, these cases tend to be less successful than in those individuals who undergo surgery for unruptured aneurysms. Generally only about 50%of people who undergo urgent surgery for repair of a ruptured aneurysm survive surgery; kidney failure, dead bowel, and leg ischemia are common complications.
Open surgery has long been the accepted treatment for aortic aneurysms of the chest or abdomen. A large incision is made in the chest or the abdomen. Blood flow in the aorta is stopped by hooking the circulatory system to an outside pump. This machine circulates blood to the body and keeps the vital organs and other tissues oxygenated properly.
Hospitalisation and recovery:
Although this surgery is usually successful, it may pose risks to the heart, brain, lungs, and kidneys. It also involves considerable recovery time because of the size of the incision and complexity of the surgery. Usually a patient has to stay in the hospital for a week and recovery time is 6 to 8 weeks.
With our prompt diagnosis and proper surgical treatment most people recover completely to get back into their routine life style.
Life style pattern to be adhered to if aneurysm is present:
We conduct regular tests to check the size and growth of the aneurysm, at periodical intervals as and when required. Controlling blood pressure, healthy eating and keeping the vital parameters in line are the main considerations.
Control high cholesterol. To control this eat low fat diet.
Manage your weight. It may lower the risk of complications.
Eat heart healthy diet. It includes fruits, vegetables, high fibre foods, and foods low saturated fat, Trans fat, and cholesterol.
If a person is found to have an aortic aneurysm less than 5cm in size it should be watched and monitored.
Our experts recommend screening for all individuals older than 55years. Screening would detect many aortic aneurysms that may not be noticed as no symptoms are portrayed.
Ultra sound examination of the abdomen is 80%accurate in screening for the existence of abdominal aortic aneurysm.
At KIMS we weed out the aneurysms and prevent any further relapse, we constantly monitor and ensure a healthy heart and a “Healthy you”.