An aortic aneurysm is the swelling of the aorta's wall. Aorta is a major blood vessel that is responsible for the blood circulation from your heart to the rest of your body. In the case of aortic aneurysm, there is no specific location where the swelling may occur, it may occur anywhere in the aorta. The bulge can be round or the shape of a tube. Aneurysm usually happens when the blood vessel becomes weak. The weak spot in the vessel expands due to the constant blood flow. In the beginning, the swelling is small but eventually, it may become bigger with the increase in pressure. An aortic aneurysm is considered dangerous.
There are two types of aneurysm; abdominal aortic aneurysm and thoracic aortic aneurysm. The symptoms and causes of each are discussed below.
Abdominal aortic aneurysm symptoms might not be observed immediately and sometimes there are no symptoms at all. Some types of abdominal aortic aneurysm are hard to identify and some stay small always while others become bigger with time. Some abdominal aortic aneurysms become large pretty quickly. When an abdominal aortic aneurysm is increasing in size, there are certain symptoms. You may have back pain, abdominal pain, especially on the sides. You may feel a pulse around your belly button area.
Unlike abdominal aortic aneurysm, symptoms of Thoracic aortic aneurysm are hard to recognize. However, there are some signs and symptoms that indicate a thoracic aortic aneurysm. You might be constantly coughing all the time. You might feel like your voice becomes hoarse. You might feel like you are out of breath more often even when you are not doing anything. Pain in the back and chest are some of the other common symptoms of thoracic aortic aneurysm.
An abdominal aortic aneurysm occurs in the part of the aorta that is near the abdomen. Certain factors make you more prone to having an abdominal aortic aneurysm. If you are 65 years old or more, then you are more likely to have an abdominal aortic aneurysm. If you smoke regularly then there is a higher chance of abdominal aortic aneurysm. Males are more likely to have an abdominal aortic aneurysm and so are people of fair complexion. If you have a family history of abdominal aortic aneurysm, then your chances of having an abdominal aortic aneurysm are high.
A thoracic aortic aneurysm occurs in the section of the aorta that is near the chest. There are various risk factors of thoracic aortic aneurysm. The chances are high if you have a family history of someone with a thoracic aortic aneurysm. If you have high blood pressure, then you are more likely to have the problem. If you have certain disorders, then you are at a higher risk. If you consume tobacco and you are 65 years old or more, then you are highly likely to have a thoracic aortic aneurysm. If you have atherosclerosis, then you are more likely to have a thoracic aortic aneurysm. People with a bicuspid aortic valve are at a higher risk too.
At present, there are no medications that help to prevent aortic aneurysms. However, there are some ways in which you can prevent them. The following are some of the prevention strategies.
An abdominal aortic aneurysm can be diagnosed when you have your routine medical tests. Else, if you are having your abdomen or your heart examined, then your doctor can find out if you have an abdominal aortic aneurysm or not. Your doctor will first take a look at your medical history to see whether you are at risk. Your family history will be analyzed to see how likely you are to have an abdominal aortic aneurysm. Then, your doctor will conduct a physical exam. By this point, your doctor will get an idea about whether you have an abdominal aortic aneurysm or not. If s/he thinks that you might have it, s/he will perform other tests such as MRI, abdominal ultrasound and CT scan.
The treatment that your doctor provides you depends on two factors. It depends on how prominent the aortic aneurysm is and the rate at which it is growing. The aim of treating aortic aneurysm is to ensure that the aortic aneurysm does not rupture. Two treatment options are available; medical monitoring and surgery.
Medical monitoring is the treatment option that is best for you when your abdominal aortic aneurysm is not that prominent. Moreover, it might be chosen when there are no symptoms of an abdominal aortic aneurysm. You will have to visit your doctor regularly to ensure that the abdominal aortic aneurysm is not growing as there are chances that it can. Your doctor might choose to treat your other conditions that increase the risk factor of abdominal aortic aneurysm. For instance, if you have high blood pressure, then your doctor might give you medications and other treatment options to ensure the risk is kept low.
One of the treatment options is abdominal aortic aneurysm repair. This is used when the aortic aneurysm is anywhere between 4.8 centimeters to 5.6 centimeters. But, this method can be used when the aortic aneurysm is larger. If the abdominal aortic aneurysm is growing fast, then repair may be necessary. In addition to this, if you are showing certain symptoms, then your doctor might advise you to go for surgery. For instance, symptoms such as stomach ache might require you to consider surgery. If you have an aneurysm that is tender or if you have a leaking aneurysm, then you might require surgery too.
There are two types of repair options. The option that is best for you depends on what conditions you are currently suffering from, your overall health, your age, and the specifics of the aneurysm. Open abdominal surgery is the first option. In this surgery type, the aorta part that has been damaged is first removed. Then a synthetic tube is used to replace the damaged aorta part with the graft. It can take a few months for you to recover completely when you have open abdominal surgery. Another repair option is endovascular repair.
Endovascular repair is another abdominal aortic aneurysm surgery option that your doctor might suggest. In this type of repair, a synthetic graft is used. It is placed where the aneurysm is. It is first expanded and then placed on the site of the aneurysm. A catheter is used and a graft is attached at one end. Your doctor then threads it through an artery in your leg. The endovascular repair prevents the aneurysm from rupturing. This type of repair is a less invasive procedure. Once the procedure is complete, you will be required to go for imaging tests. These tests are to see that the repair is not leaking and is as it should be.
Just like an abdominal aortic aneurysm, thoracic aortic aneurysm can be found during your routine medical tests. If your doctor thinks that you might have developed a thoracic aortic aneurysm, then he might recommend you to get some tests done, such as echocardiogram, CT scan, chest X-ray, and an MRI scan.
There are three treatment options available for thoracic aortic aneurysm; medical monitoring, medications, and surgery.
In medical monitoring, your thoracic aortic aneurysm is going to be monitored. This option is used when the thoracic aortic aneurysm is small. Your doctor might prescribe certain medications for you. Besides, if you are suffering from other conditions that can potentially cause more damage, then your doctor might recommend treatment options accordingly. Your doctor will ask you for your medical history, family history, and will perform imaging tests. The imaging tests include magnetic resonance angiography (MRA), echocardiogram, and CT scan. These can be done after a few months following diagnosis.
There are various medications that your doctor might prescribe depending on your current health issues and what might increase the complications. For instance, artery blockages and high blood pressure can increase the risk of complications arising from a thoracic aortic aneurysm. Hence, your doctor might prescribe medicines accordingly. Statins might be prescribed by your doctor if you have a high cholesterol level. Statins are medications that help decrease artery blockages and hence reduces the risk of complications. Some examples of statins include simvastatin and atorvastatin.
Beta-blockers are often prescribed to people who have high blood pressure. Beta-blockers work by decreasing your heart rate. Some examples of beta-blockers are bisoprolol and metoprolol. Another medication option is angiotensin II receptor blockers. These are used if beta-blockers are unable to keep your blood pressure under control. If for some reason you cannot take beta-blockers, then these can be prescribed. Examples of angiotensin II receptor blockers include olmesartan and losartan. These can be recommended to people who have certain conditions such as Marfan syndrome.
Your doctor may advise you to go for a surgery for a thoracic aortic aneurysm if it is up 5 centimeters or bigger. If you have a connective tissue disease or if you have a family history of aortic dissection, then your doctor is likely to recommend surgery. Moreover, if you have a bicuspid aortic valve, then your doctor will most probably recommend surgery. If your doctor thinks that you have a higher chance of having an aortic dissection, then s/he will recommend surgery. Various types of surgeries can be recommended to you depending on the specific details of the thoracic aortic aneurysm.
Open chest surgery is the most common type of thoracic aortic aneurysm surgery and it is somewhat like the open abdomen surgery discussed previously. In this, the damaged aorta part is removed and then a graft is sewn in its place. You might require an aortic root replacement surgery if you have conditions such as Marfan syndrome. An aortic root replacement surgery is performed when an aorta’s part needs treatment that is near the place where the aorta and heart connect. Your doctor will remove a part of the aorta along with the aortic valve. A graft is used to replace the aorta part that has been removed. Instead of an aortic valve, a biological valve will be placed.
Another surgery option is endovascular surgery and it is similar to the one discussed in the abdominal aortic aneurysm section. Other surgical options are available too. The surgeries that your doctor will recommend depend on the problem that is causing your aneurysm to develop. For example, if the heart valves are causing the thoracic aortic aneurysm to develop, then he will perform surgery that will help to repair the valves. This can be done by repairing the valves or replacing the valves to ensure that your thoracic aortic aneurysm is treated.
People tend to think that since an aortic aneurysm is a serious condition, it isn’t possible to completely heal from it. However, that is not true at all. It is highly possible that you can recover completely after immediate diagnosis and appropriate treatment. Most people have a favorable outlook after proper treatment is given promptly to them. As long as you get the treatment that you require before further complications occur, you are safe and may heal completely from any type of aortic aneurysm. Hence, it all depends on the medical care that you get once you know you have an aortic aneurysm.
Recovery can take time but it is possible to completely heal after an aortic aneurysm. However, since it usually occurs in elderly people, the recovery may seem slow. But with proper aftercare and precautions, it is possible to lead a happy and healthy life. Recovery depends on the type of treatment you have received and how well you cope after the treatment. You should make a note of what your doctor tells you about aftercare because it can vary from patient to patient. You will most likely be required to have specialized tests done to ensure that you are healthy and fine. Your doctor will give you the specifics of how to best take care of yourself after treatment.
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