An aneurysm is an outward bulge, similar to a bubble or balloon, caused by an abnormal weak spot located in the wall of a blood vessel. Aneurysms can be the result of inherited or acquired diseases. Aneurysms can also act as a potential source for blood clots (thrombosis) and embolization. The chance of aneurysm rupture rises as it grows in size, resulting in uncontrollable bleeding. Although they may arise in any blood artery, a circle of Willis aneurysms in the brain, aortic aneurysms affecting the thoracic aorta, and abdominal aortic aneurysms are especially fatal instances. Aneurysms can arise in the heart itself after a heart attack, including aneurysms of the atrial and ventricular septum. There are congenital aneurysms of the atrial septum, a rare heart defect.
What is Aneurysm?
An aneurysm is a bulge or "swelling" in the wall of an artery. Blood vessels that transmit oxygen-rich blood from the heart to other regions of the body are known as arteries. If an aneurysm enlarges, it can burst and cause dangerous bleeding or even death.
The aorta, the main artery that goes from the heart to the chest and belly, is where the majority of aneurysms form. Aneurysms can also occur in the arteries of the brain, heart, and other parts of the body. If an aneurysm in the brain bursts, it causes a stroke.
Aneurysms can develop and enlarge before causing any symptoms. Doctors can often prevent aneurysms from bursting by finding and treating them early. They use imaging tests to find aneurysms. Oftentimes, aneurysms are found by chance during tests done for other reasons. Aneurysms are treated mostly with medications and surgery.
Types of Aneurysm
There are three types of aneurysms: abdominal aortic, thoracic aortic, and cerebral.
Abdominal aortic aneurysms
Abdominal aortic aneurysms sometimes referred to as "Triple-A" aneurysms, are the most common aneurysms of the aorta, the large blood vessel that carries blood from the heart and through the body.
Given the scope and size of the aorta (it is nearly an inch wide in places), substantial internal bleeding occurs when blood pressure rises against the walls of the aorta, causing it to rupture. Sometimes mistaken for a heart attack, a ruptured abdominal aorta can be characterized by chest and jaw pain, throbbing abdominal or back pain, fainting, shortness of breath, and weakness on one side of the body.
Thoracic aortic aneurysms
Thoracic aortic aneurysms develop in the part of the aorta that runs through the chest. Also like abdominal aortic aneurysms, thoracic aortic aneurysms are largely asymptomatic, so you are unlikely to know that it is lurking. However, some symptoms to look out for are back pain, hoarseness, shortness of breath, or chest pain or tenderness before a thoracic aneurysm ruptures.
Brain aneurysms are bulging, weakened vessels above the aorta in the brain. These are most common in people ages 30 to 60. While brain aneurysms can be small and cause no problems, larger ones can rupture and cause bleeding in the brain and potentially become fatal.
Most aneurysms are clinically silent. Symptoms generally do not occur unless an aneurysm ruptures.
However, an unruptured aneurysm can still obstruct circulation to other tissues. They can also form blood clots that can clog the smallest blood vessels. This is a condition known as a thromboembolism. It can lead to an ischemic stroke or other serious complications. Symptoms are often related to rapidly developing abdominal aneurysms. Stomach aneurysms can cause abdominal discomfort, low back pain, or a shooting feeling in the abdomen, according to some patients.
Thoracic aneurysms can also impact surrounding nerves and blood vessels, causing swallowing and breathing problems as well as discomfort in the jaw, chest, and upper back.
Symptoms may also be related to the cause of an aneurysm rather than the aneurysm itself. A person may have a fever, malaise, or weight loss if an aneurysm is caused by vasculitis or inflammation of the blood vessels.
What Causes an Aneurysm?
Although the exact cause of an aneurysm is unclear, certain factors contribute to the condition.
For example, damaged tissue in the arteries can play a role. Blockages, like fatty deposits, can damage your arteries. These deposits can cause the heart to pump harder than necessary to push the blood past the accumulation of fat. This added stress from increased pressure can damage your arteries.
An atherosclerotic disease can also cause an aneurysm. People with the atherosclerotic disease have a form of plaque build-up in the arteries. Plaque is a hard substance made up of cholesterol, fat, and other substances that damages arteries and prevents blood from flowing freely.
High Blood Pressure
High blood pressure can also cause an aneurysm. The force of the blood as it travels through the blood vessels is measured by the amount of pressure it exerts on the walls of the arteries. If the pressure rises above normal, it can enlarge or weaken the blood vessels.
An adult's blood pressure is considered normal at 120/80 mm Hg or less, or millimeters of mercury.
Significantly higher blood pressure can increase the risk of heart, blood vessel, and circulation problems. However, higher-than-normal blood pressure doesn't necessarily put you at risk for an aneurysm.
How Is An Aneurysm Diagnosed?
To diagnose an aneurysm, your doctor will ask you questions, even if another member of your family has had one. Then, they will give you a complete exam, during which:
- Listen to your heart
- Check your blood pressure
- Listen to the arteries in your neck.
- Feel your abdomen for a mass.
- Look behind the knee for popliteal aneurysms.
If your doctor thinks you have an aneurysm in your aorta, the main artery in your body, you may have an ultrasound. This is painless and can identify and measure an aneurysm. If they think you have one on your chest, you may have a CT scan.
If your doctor is concerned that you have one in your brain, you may have a CT scan or an invasive test called angiography. During this process, a dye is injected into an artery in an arm or leg and travels to the brain. A picture of your brain is then taken. The dye will make it easier for your doctor to detect any problems.
Your aorta, or blood vessels in your brain, can also be checked with an MRI.
How Is An Aneurysm Treated?
The only way to treat an aneurysm is to repair it with surgery or an endovascular procedure. Sometimes surgery is not possible or it can be more dangerous than an aneurysm. In that case, careful monitoring and medication may be best. The size, type, and location of the aneurysm will be identified by your doctor. What they discover will aid in determining the right plan of action for them. In the case of inoperable aneurysms, drugs to lower blood pressure or reduce the power of your pulse may be recommended. Your chance of it exploding will decrease.
Even for an operable aneurysm, your doctor may first try medication and a wait-and-see approach, monitoring its growth. You may need surgery if your doctor finds that the aneurysm has become large enough to be dangerous. A surgeon can treat it by inserting a clip that cuts off blood flow to the affected area. In some cases, the aneurysm can be removed. That section of the artery can be replaced with a synthetic graft.
The first signs of a previously undetected aneurysm could be complications after the rupture. Symptoms tend to be the result of a rupture rather than the aneurysm alone.
Most people who live with an aneurysm do not experience any complications. However, in addition to thromboembolism and aortic rupture, complications can include:
- Severe chest or back pain: Severe chest or back pain can arise after a ruptured aortic aneurysm in the chest.
- Angina: Certain types of aneurysms can cause angina, another type of chest pain. Myocardial ischemia and heart attack can occur as a result of angina.
- A sudden, extreme headache: If a brain aneurysm causes SAH, the main symptom is a sudden, severe headache.
- Any ruptured aneurysm can cause pain, low blood pressure, rapid heart rate, and dizziness. The majority of persons who have an aneurysm will not have any problems.
Is there a Way to Prevent an Aneurysm?
Eating a nutrient-dense diet that contains lots of fruits, whole grains, and vegetables can help prevent an aneurysm from forming. Meats and poultry low in saturated fat and cholesterol are also good protein options. Low-fat dairy products are also beneficial.
Incorporating regular exercise into your routine, especially cardio, can promote healthy blood circulation and blood flow through the heart, arteries, and other blood vessels.
If you smoke tobacco products, consider quitting. Eliminating tobacco can reduce the risk of developing an aneurysm. Quitting smoking can be challenging, but a healthcare professional can help you create a quitting plan that works for you and connect you with other support resources.
Scheduling annual checkups is another way to be proactive in helping to prevent an aneurysm. It is also a way to help promote overall health and wellness.
Consult Dr Sahaja Rao Aravelly, Best Vascular and Endovascular Surgeon for Painless Varicose Vein Treatment, Dialysis Fistula, Bypass Surgery, Peripheral Angioplasty and Stenting, Aortic Aneursym Stenting