Aneurysms: The Silent Killers

Abdominal aortic aneurysms are silent killers that show little or no symptoms of the condition at all.

Most people with an abdominal aortic aneurysm do not show any symptoms; they don't know that the largest blood vessel in their body is slowly and silently dilating, creating a blood-filled bulge. If left untreated, the bulge or aneurysm could rupture, and the bleeding could be deadly.

Every year, 200,000 people in the U.S. are diagnosed with an abdominal aortic aneurysm. A ruptured abdominal aortic aneurysm is the 15th leading cause of death in the country, and the 10th leading cause of death in men older than 55.

Doctors recommend that you screen for an abdominal aortic aneurysm when you turn 60, particularly if you're at a higher risk due to smoking and other factors. The screening test uses an abdominal ultrasound to scan your aorta for bulges.

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If you get an aneurysm, it means you have a bulge in the wall of an artery. It happens when the pressure of blood passing through has forced a weakened part of the artery to balloon outward. Aneurysms can occur in any blood vessel, but they usually form in the belly or chest portions of your aorta -- the main blood vessel that carries blood from your heart -- or in arteries that nourish your brain.

Aneurysms are serious, while those in other areas, such as your leg, are often less hazardous.

The most serious threat of an aneurysm is that it will burst and cause a stroke or massive bleeding, which can be life-threatening. In addition, a large aneurysm can affect your circulation and lead to blood clots.

It's essential to get it diagnosed and treated early. Aneurysms often have mild symptoms or none at all, so routine exams can help your doctor check for warning signs.

Aortic aneurysm. As the name suggests, this type happens in your aorta. It can be linked with the hardening of the arteries, also known as atherosclerosis. It may be an inherited condition or a complication of high blood pressure or smoking.

Cerebral aneurysm. Also known as a berry aneurysm, you get this kind in the wall of a blood vessel in your brain. Smoking raises your risk of getting one.

Ventricular aneurysm. This is a bulge in the wall of your heart. A previous heart attack is the most common cause. In rare cases, a severe chest injury can also lead to it.

Any condition that causes your artery walls to weaken can bring one on. The most common culprits are atherosclerosis and high blood pressure.

Deep wounds and infections can also lead to an aneurysm. Or you may be born with a weakness in one of your artery walls.

An abdominal aortic aneurysm is an enlarged area in the lower part of the central vessel that supplies blood to the body (aorta). The aorta runs from your heart through the center of your chest and abdomen.

The aorta is the largest blood vessel in the body so that a ruptured abdominal aortic aneurysm can cause life-threatening bleeding.

Depending on the size of the aneurysm and how fast it's growing, treatment varies from watchful waiting to emergency surgery.

Abdominal aortic aneurysms often grow slowly without symptoms, making them difficult to detect. Some aneurysms never rupture. Many start small and stay small; others expand over time, some quickly.

If you have an enlarging abdominal aortic aneurysm, you might notice:

• Deep, constant pain in your abdomen or on the side of your abdomen.
• Back pain.
• A pulse near your belly button.

When to see a doctor
If you have pain, especially if the pain is sudden and severe, seek immediate medical help.

Aneurysms can develop anywhere along the aorta, but most aortic aneurysms occur in the part of your aorta that's in your abdomen. Several factors can play a role in developing an aortic aneurysm, including:

• Hardening of the arteries (atherosclerosis). Atherosclerosis occurs when fat and other substances build up on the lining of a blood vessel.
• High blood pressure. High blood pressure can damage and weaken the aorta's walls.
• Blood vessel diseases. These are diseases that cause blood vessels to become inflamed.
• Infection in the aorta. Rarely, a bacterial or fungal infection might cause an abdominal aortic aneurysm.
• Trauma. For example, being in a car accident can cause an abdominal aortic aneurysm.

Abdominal aortic aneurysm risk factors include:

• Tobacco use. Smoking is the most potent risk factor. It can weaken the aortic walls, increasing the risk of developing an aortic aneurysm and rupture. The longer and more you smoke or chew tobacco, the greater the chances of developing an aortic aneurysm.
• Age. These aneurysms occur most often in people age 65 and older.
• Being male. Men develop abdominal aortic aneurysms much more often than women do.
• Being white. People who are white are at higher risk of abdominal aortic aneurysms.
• Family history. Having a family history of abdominal aortic aneurysms increases your risk of having the condition.
• Other aneurysms. Having an aneurysm in another large blood vessel, such as the artery behind the knee or the aorta in the chest, might increase your risk of an abdominal aortic aneurysm.

Tears in one or more of the layers of the aorta wall (aortic dissection) or a ruptured aneurysm are the main complications. A rupture can cause life-threatening internal bleeding. In general, the larger the aneurysm and the faster it grows, the greater the risk of rupture.

Signs and symptoms that your aortic aneurysm has ruptured can include:

• Sudden, intense, and persistent abdominal or back pain, which can be described as a tearing sensation
• Low blood pressure
• Fast pulse

Aortic aneurysms also put you at risk of developing blood clots in the area. If a blood clot breaks loose from the inside wall of an aneurysm and blocks a blood vessel elsewhere in your body, it can cause pain or block the blood flow to the legs, toes, kidneys, or abdominal organs.

To prevent an aortic aneurysm or keep an aortic aneurysm from worsening, do the following:

• Don't use tobacco products. Quit smoking or chewing tobacco and avoid secondhand smoke.
• Eat a healthy diet. Focus on eating various fruits and vegetables, whole grains, poultry, fish, and low-fat dairy products. Avoid saturated fat, trans fats, and limit salt.
• Keep your blood pressure and cholesterol under control. If your doctor has prescribed medications, take them as instructed.
• Get regular exercise. Try to get at least 150 minutes a week of moderate aerobic activity. If you haven't been active, start slowly, and build up. Talk to your doctor about what kinds of activities are right for you.

If you're at risk of an aortic aneurysm, your doctor might recommend other measures, such as medications to lower your blood pressure and relieve stress on weakened arteries.

Patients seeking treatment for abdominal aortic aneurysms may undergo a repair procedure that does not require a surgical incision.

In Los Cabos, Dr. Guillermo Prado MD offers the non-invasive, incision-less procedure for abdominal aortic aneurysms. The surgeon utilizes a small puncture site in the skin to repair the artery, thus obviating the need for an incision. The patient typically goes home the day after surgery and has minimal, if any, discomfort.

An abdominal aortic aneurysm occurs when sections of the aortic wall weaken and cannot support the force of blood flow, causing a bubble on the wall. As these bubbles get larger, they are prone to bursting, often resulting in death. Traditional treatment of aortic aneurysms involved an extensive surgical procedure involving a long abdominal incision until the late 1990s, when the Food and Drug Administration approved endovascular repair of abdominal aortic aneurysms (EVAR). With EVAR, which is minimally invasive, surgeons access the aneurysm through an incision made in the femoral artery.

Several years ago, surgeons began performing EVAR through a small puncture site in the skin above the femoral artery in the groin rather than through a surgical groin incision. The graft is then inserted through the puncture site, under fluoroscopic guidance, and finally deployed in the aorta. The hole in the artery is closed using a series of percutaneously placed sutures. The skin puncture site is so small that it heals without any sutures.

Once the graft is released, blood flows through the new graft. As a result, the aneurysm slowly shrinks and is no longer a threat to the patient.

About 80 percent of the patients with an abdominal aortic aneurysm are eligible for the new technique. Physicians determine eligibility using factors such as the aneurysm's shape and location and the amount of calcium in the aorta wall.

Not everyone is a candidate for incision-less EVAR, however. Patients have to have large enough femoral arteries and minimal arterial calcification.

For more information about repairing abdominal aortic aneurysms, you should contact PRMEDICA at info@prmedica-inc.com | Telephone +52 624 688 8497.

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