An aneurysm is an abnormal ballooning or bulging of an artery. Aneurysms that occur in the aorta, the body’s main artery, are known as aortic aneurysms. This condition is the 10th leading cause of death amongst white men ages 65 to 74. However, aortic aneurysms affect many individuals outside of this demographic.
Aortic aneurysms may occur in the abdominal region; they can grow to a diameter of two inches or more if left untreated. Aortic aneurysms may also develop in the thoracic (chest) region; thoracic aortic aneurysms are typically caused by atherosclerosis and other associated symptoms, such as high cholesterol and hypertension. Aneurysms located between these two regions are called thoracoabdominal aortic aneurysms.
Aortic dissections are similar to aneurysms. An aortic dissection is a tear in the inner layer of the aorta. As blood moves through the aorta, it forces into the tear and separates the inner and middle layers of the aorta. Dissections are very dangerous – especially if they occur in the aortic area immediately outside the heart.
Symptoms of Aortic Aneurysm
Aortic aneurysms are usually slow growing – one reason why many affected individuals don’t notice any symptoms until the aorta has bulged significantly. Abdominal aortic aneurysms may cause the following symptoms:
- Abdominal pain
- A searing pain in chest or back
- Cold or numb extremities
Thoracic aortic aneurysms can be accompanied by these symptoms:
- Shortness of breath
- Coughing or feeling of hoarseness
- Pain or tenderness in the chest
- Back pain
If you experience any of these symptoms, you should let your physician know immediately.
Aortic Aneurysm Risk Factors
Because early symptoms are uncommon, it’s critical for patients to be aware of their risk factors. Aortic aneurysms are most common in men between the ages of 65 and 75 who have smoked at least 100 cigarettes in their lifetime. Aortic dissections are most common in men between the ages of 60 and 70, as well as individuals who have Turner’s syndrome, Marfan syndrome, Loeys-Dietz syndrome, or Ehlers-Danlos syndrome
Diagnosing Aortic Aneurysm
Your physician may first notice an abdominal aortic aneurysm during a routine physical exam. This type of aneurysm may be felt with the fingers as a pulsing mass in the abdomen. Thoracic aortic aneurysms cannot be detected by touch since the rib cage guards this area. If your physician suspects an abdominal aortic aneurysm, you may receive an abdominal ultrasound or x-ray. Thoracic aortic aneurysms may be detected with a chest x-ray or echocardiogram.
Preventing & Managing Aortic Aneurysm
Positive lifestyle changes are some of the best things a high-risk individual can do for himself to prevent aortic aneurysms. Quit smoking, and avoid secondhand smoke. Eat a healthy diet that’s low in all fats (especially trans and saturated fats), cholesterol, sugar, and sodium. Also, follow your doctor’s advice on lowering your blood pressure and blood cholesterol to healthy levels.
Individuals who are at a high risk may want to discuss preventative screening for aortic aneurysms with their physician. High-risk individuals are defined as:
- Males between 65 and 75 who have ever smoked.
- Males and females between 65 and 75 with a family history of aneurysms.
Endovascular Aortic Aneurysm Repair
Not all aortic aneurysms require treatment. Small aneurysms that don’t cause any symptoms, for example, are frequently left untreated. Instead, the patient comes in for regular monitoring to ensure the aneurysm isn’t growing or causing any harm. This is known as “watchful waiting.”
Once an aortic aneurysm is at least 5 centimeters (2 inches) in diameter, most physicians will suggest treatment. (Again, this depends on the size, location, and rate of growth of the particular aneurysm.) For decades, open abdominal or open chest repair has been the standard in aortic aneurysm treatment. At Phoenix Heart Center, cardiologists use an endovascular approach instead.
During endovascular aneurysm exclusion, the cardiologist inserts a stent graft (via catheter) into one of the patient’s arteries. The entire procedure is performed through this small, flexible tube threaded through the arteries. Using advanced imaging technology the catheter and surgical parts are guided to the aortic aneurysm. Next, the cardiologist permanently attaches the stent graft to the aortic wall. The catheter is then removed. Now the pressure on the aortic wall has been relieved. Over time, the bulging section of aorta may shrink around the graft. Healthy blood flow through the aorta has been restored.
For more information about diagnosing and treating aortic aneurysms, contact a Phoenix Heart Center practice location convenient to you. Now serving Central Phoenix, Mesa, and Tempe. You can also schedule an appointment online.