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What is Abdominal Aortic Aneurysm

An abdominal aortic aneurysm is a condition in which the aorta swells abnormally. Smaller aneurysms are rarely a source of concern. However, they can enlarge over time, increasing the risk of rupture. This is potentially fatal.

The aorta is the largest artery in the body. It transports oxygen-rich blood from the heart to the body's smaller arteries.

An abdominal aneurysm occurs when a section of the abdominal aorta ruptures. The section of the aorta between the bottom of the chest and the pelvis is referred to as the ascending aorta.



The aorta is typically about an inch (2.5 centimeters) in diameter.  The  size gradually increases as people age. When the abdominal aorta balloons swelling is greater than 3 centimeters in diameter, this is referred to as an abdominal aortic aneurysm. The most common symptom of an abdominal aortic aneurysm is a balloon-like swelling. The aorta's wall bulges out.

The majority of aortic aneurysms are caused by atherosclerosis. Atherosclerosis is a condition in which fatty deposits accumulate on the inside walls of blood vessels.

Symptoms

The majority of aortic aneurysms are asymptomatic. They are frequently detected during routine physical examinations. Alternatively, they are discovered during routine X-rays for unrelated illnesses.

When symptoms manifest, they may include the following:

Individuals in pain:
Abdomen 
Pain
Between the bottom of the ribs and the hips, the fleshy part of the sides
A sensation of fullness following a small meal
Vomiting and nausea
A pulsating mass in the abdomen


Floating blood clots form infrequently near the aneurysm. These clots may disintegrate. They can also obstruct blood vessels in other parts of the body.

Occasionally, an abdominal aneurysm that has not been discovered ruptures without warning. The patient collapses and dies as a result of massive abdominal bleeding.

Diagnosis

Your doctor will inquire about any family history of heart disease in your family. He or she will be interested in learning about any unexpected and possibly unexplained deaths in the family.

Your doctor will ask a few questions about whether you smoke. The doctor will perform tests to determine if you have high cholesterol, high blood pressure, or diabetes.

Based on the physical examination, your doctor may suspect an aortic aneurysm. Your physician may detect abnormal blood flow in your abdomen. Alternatively, your physician may notice and feel a pulsating mass in your abdomen.

In the majority of cases, an abdominal aortic aneurysm is discovered during an imaging study for another illness. Numerous imaging studies can detect aortic aneurysms. X-rays and ultrasound are examples of these.

Ultrasound is an extremely accurate method of detecting abdominal aortic aneurysms. Additionally, the patient is not exposed to radiation.

Once an abdominal aortic aneurysm forms, it is permanent. Most increase in size over time.

Prevention

You may be able to significantly reduce your risk of developing an aortic aneurysm. This can be accomplished by modifying your risk factors for atherosclerosis.

If you smoke, stop immediately.

If you have an elevated cholesterol level start consuming a low-fat and cholesterol-containing diet. Take cholesterol-lowering medication if necessary.

If you have hypertension:
Maintain a healthy weight or, if you are overweight, reduce your caloric intake.
Reduce salt consumption.
As needed, take medication to control your blood pressure.

If you suffer from diabetes:
Regularly monitor your blood sugar level.
Maintain a healthy diet
Maintain a normal blood pressure range.
Aim for an LDL cholesterol level of less than 100 mg/dL, if necessary with medication.
Additionally, exercise on a consistent basis and maintain an ideal weight.

Men aged 65 to 75 who have smoked at any point in their lives should undergo a one-time screening ultrasound.


Treatment

Treatment is largely determined by the size of the aneurysm. The larger the aneurysm, the greater the likelihood that it will burst (rupture). A ruptured aneurysm requiring emergency surgery carries a higher risk of death than an aneurysm repair scheduled in advance.

Surgery is almost always recommended for anyone who has a leaking aneurysm. Even if there are no symptoms, a person who has an aneurysm larger than 6.5 centimeters will almost always require emergency surgery to repair it. Surgery is generally recommended for individuals who have aneurysms larger than 5.5 centimeters in diameter, unless another illness makes surgery unusually dangerous.

Individuals with smaller aneurysms should undergo periodic imaging tests, most commonly using ultrasound. According to the Society for Vascular Surgery, the following imaging schedule is recommended depending on the size of the aortic aneurysm: Treatment

3.0 to 3.9 centimeters, imaging every three years
4.0 to 4.9 centimeters, imaging every 12 months
5.0 to 5.4 centimeters, imaging every 6 months

Some experts recommend imaging more frequently — once a year for abdominal aortic aneurysms less than 4.5 centimeters in diameter and once every six months once they reach that size.

Surgeons can repair abdominal aortic aneurysms in two ways. Abdominal surgery is the traditional method. This procedure entails temporarily clamping the aorta, repairing the blood vessel by removing the damaged section, and patching the aneurysm with a plastic patch.

The other technique is referred to as endovascular surgery. In the groin, small cuts are made over a branch of the artery that leads to the leg. Through the artery, a special tube called a stent is threaded to the location of the aneurysm. The stent protects the abdominal aorta's wall from internal pressure and can prevent the artery wall from expanding and weakening.

Duration
The majority of aortic aneurysms are asymptomatic. They are frequently detected during routine physical examinations. Alternatively, they are discovered during routine X-rays for unrelated illnesses.


When symptoms develop, they can include:
Pain in the:
Abdomen.
Back.
Nausea and vomiting.
A pulsating mass in the abdomen.
Fleshy part of the sides, between the bottom of the ribs and hips.
A feeling of fullness after eating a small meal.

Floating blood clots form rarely near the aneurysm. These clots may disintegrate. They can also obstruct blood vessels in other parts of the body.

Occasionally, an abdominal aneurysm that has not been discovered ruptures without warning. The patient collapses and dies as a result of massive abdominal bleeding.

Diagnosis

Your doctor will inquire about any family history of heart disease in your family. He or she will be interested in learning about any unexpected and possibly unexplained deaths in the family.

Your doctor will inquire as to whether you smoke. The doctor will perform tests to determine if you have high cholesterol, high blood pressure, or diabetes.

Based on the physical examination, your doctor may suspect an aortic aneurysm. Your physician may detect irregular blood flow in your abdomen. Alternatively, your physician may notice and feel a pulsating mass in your abdomen.

In the majority of cases, an abdominal aortic aneurysm is discovered during an imaging study for another illness. Numerous imaging studies can detect aortic aneurysms. X-rays and ultrasound are examples of these.

Ultrasound is an extremely accurate method of detecting abdominal aortic aneurysms. Additionally, the patient is not exposed to radiation.

Duration
Once an abdominal aortic aneurysm forms, it is permanent. Most increase in size over time.

Prevention

You may be able to significantly reduce your risk of developing an aortic aneurysm. This can be accomplished by modifying your risk factors for atherosclerosis.

If you smoke, stop immediately.

If you have an elevated cholesterol level:

Consume a low-fat and cholesterol-containing diet.
Take cholesterol-lowering medication if necessary.
If you have hypertension:

Maintain a healthy weight or, if you are overweight, reduce your caloric intake.
Reduce salt consumption
Consume a diet abundant in fruits and vegetables.
As needed, take medication to control your blood pressure. 

If you suffer from diabetes:

Regularly monitor your blood sugar level.
Maintain a healthy diet
Maintain a normal blood pressure range.
Aim for an LDL cholesterol level of less than 100 mg/dL, if necessary with medication.
Additionally, exercise on a regular basis and maintain an ideal weight.

Men aged 65 to 75 who have smoked at any point in their lives should undergo a one-time screening ultrasound.

Treatment

Treatment is largely determined by the size of the aneurysm. The larger the aneurysm, the greater the likelihood that it will burst (rupture). A ruptured aneurysm requiring emergency surgery carries a higher risk of death than an aneurysm repair scheduled in advance.

Surgery is almost always recommended for anyone who has a leaking aneurysm. Even if there are no symptoms, a person who has an aneurysm larger than 6.5 centimeters will almost always require emergency surgery to repair it. Surgery is generally recommended for individuals who have aneurysms larger than 5.5 centimeters in diameter, unless another illness makes surgery unusually dangerous.

Individuals with smaller aneurysms should undergo periodic imaging tests, most commonly using ultrasound. According to the Society for Vascular Surgery, the following imaging schedule is recommended depending on the size of the aortic aneurysm:

3.0 to 3.9 centimeters, imaging every three years
4.0 to 4.9 centimeters, imaging every 12 months
5.0 to 5.4 centimeters, imaging every 6 months

Some experts recommend imaging more frequently — once a year for abdominal aortic aneurysms less than 4.5 centimeters in diameter and once every six months once they reach that size.

Surgeons can repair abdominal aortic aneurysms in two ways. Abdominal surgery is the traditional method. This procedure entails temporarily clamping the aorta, repairing the blood vessel by removing the damaged section, and patching the aneurysm with a plastic patch.

The other technique is referred to as endovascular surgery. In the groin, small cuts are made over a branch of the artery that leads to the leg. Through the artery, a special tube called a stent is threaded to the location of the aneurysm. The stent protects the abdominal aorta's wall from internal pressure and can prevent the artery wall from expanding and weakening.


If you notice a pulsating mass in your abdomen but are otherwise healthy, contact your doctor.

If you are experiencing abdominal, back, or flank pain in addition to a pulsating mass, this is a medical emergency. It is an emergency that requires immediate attention.

Prognosis

The prognosis for an untreated abdominal aortic aneurysm is size dependent. Aneurysms that are larger have a greater chance of rupturing. In general, when an abdominal aneurysm is wider than 5-5.5 centimeters (a little more than 2 inches) or expands by more than 1 centimeter (a little less than half an inch) in one year, the risk of rupture outweighs the risk of surgery.

The prognosis is excellent following successful surgical repair.


Disclaimer:

No content on this site, regardless of date, should be used to replace direct medical advice from your doctor or another trained practitioner.

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