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Abdominal Aortic Aneurysm: Causes, Symptoms, Treatment and Prevention

An abdominal aortic aneurysm is the enlargement of the lower section of the vessel caused due to weakening of its walls due to buildup of atherosclerotic plaques.  Aorta, the largest artery of the body, originates from the heart and travels through the abdomen to the lower extremities after dividing into its branches. Usually the aorta is 2 cm wide, but if an individual develops an abdominal aneurysm, then the diameter may increase up to 3 cm or more.

 

Abdominal Aortic Aneurysm

Symptoms

In most cases, an aneurysm in the abdominal aorta grows slowly over time, without presenting any symptoms. However, if the aneurysm ruptures, the individual might experience the following symptoms:

  • Abdominal and back pain
  • Sweaty skin
  • Vomiting
  • Dizziness
  • Increased heart rate
  • Loss of consciousness
  • A pulsing sensation near the navel

Causes

Although the exact reason for an abdominal aortic aneurysm is unknown, but below mentioned conditions can lead to AAA.

  • Atherosclerosis: It is accumulation of cholesterol, fat and other substances on the wall of a blood vessel.
  • High blood pressure: Can damage and weaken the aorta’s walls.
  • Blood vessel diseases: These diseases can 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 involved in a car accident can cause an abdominal aortic aneurysm.

Risk factors

The following are the factors that increases the risk of developing an abdominal aortic aneurysm:

  • Age 65 years or more
  • Caucasian race
  • Presence of aneurysm in another blood vessel
  • Smoking or other forms of tobacco consumption
  • Men are more prone to AAA.

Complications

Rupture of the aneurysm is a major complication. A ruptured aneurysm may cause internal bleeding and can be life-threatening condition. The risk of rupture increases with the size and the speed of growth of the aneurysm.

Blood clots are another complication. Small blood clots develop near the region of an aortic aneurysm, which may move elsewhere in the body and block a blood vessel. This blockage of the blood flow may lead to pain in the legs, toes, kidney, or abdominal organs.

Diagnosis and Treatment

The diagnosis may include reviewing of medical and family history. A physical examination may help to feel the bulge in the abdomen, through palpation.

Interventions

  • Abdominal ultrasound: This is a painless and the most common diagnostic test to detect abdominal aortic aneurysm. This procedure uses high-frequency sound waves to view and capture images of the organs inside the abdomen.
  • CT (computerized tomography) scans of the abdomen: CT scan is a specialized scan which uses X-rays to view the organs and blood vessels inside the abdominal cavity. This scan provides a detailed image of the aorta and helps in detecting the shape and size of the aneurysm.
  • Abdominal MRI: An abdominal MRI (magnetic resonance imaging) is a painless imaging test that helps to detect any abnormalities by using magnetic and radio waves. A dye can be injected into the blood vessels to make the aneurysms more visible.

Treatment

The treatment for an abdominal aortic aneurysm is decided based on the size and the rate at which the aneurysm is growing. The main goal of treatment is to prevent its rupture. The treatment options include:

Medical monitoring:

Medical monitoring may be a feasible treatment option, when the aneurysm is small, and the patient does not experience any symptoms. Medical monitoring includes:

  • Regular appointments to determine the size and supervise the growth of the aneurysm through imaging tests.  The frequency of imaging test may vary based on the size and growth of the aneurysm.
  • Management of other medical conditions, like high blood pressure or high cholesterol levels, to prevent the aneurysm from enlarging further

Surgery:

Surgery is recommended if an aneurysm is larger and is growing too quickly. Surgical options for abdominal aortic aneurysm include:

  • Open abdominal surgery: This procedure involves removing and replacing the damaged part of the aorta with a synthetic tube (graft). It is an invasive surgical procedure, and the recovery time is long. This surgery is preferred, if the aneurysm is very large or has ruptured.
  • Endovascular surgery: The procedure involves inserting a synthetic graft inside the aorta to support the weakened walls of the aorta. It is a less invasive procedure and is associated with less discomfort and a shorter recovery period.

 Prevention

  • An abdominal aortic aneurysm can be prevented by:
  • Exercising regularly
  • Maintaining a proper diet
  • Smoking cessation
  • Managing weight
  • Controlling blood pressure and cholesterol levels
  • Reducing alcohol intake

Diet

Certain dietary changes may help to delay the progression of the aneurysm.

  • Low-fat diet: Having food that is low in fat content and high in fiber content, such as fruits and vegetables, can help to lower blood pressure, and can reduce the chances of aneurysm rupture.
  • Low salt intake: Eating more amount of salt can raise the blood pressure. Hence, reducing salt intake can lower the risk of developing complications of abdominal aortic aneurysm.
  • Low saturated fats: Consuming a diet high in saturated fats can increase cholesterol levels in the body, which might raise the risk of rupture of aneurysms, therefore, a diet low in saturated fat is advised.
  • Avoid alcohol: Consumption of alcohol on a regular basis in large amounts can raise the blood pressure over time. Thus, alcohol must be avoided in individuals with abdominal aortic aneurysm.

FAQs

1. I have been diagnosed with hypertension. Will I be prone to the risk of abdominal aortic aneurysms?

Yes. Individuals with high blood pressure are at an increased risk of developing abdominal aortic aneurysms.

2. Can an infection in aorta cause abdominal aortic aneurysms (AAA)?

Yes. In some cases, either bacterial or fungal infection can cause abdominal aortic aneurysm (AAA).

3. Are men and women equally at risk of developing abdominal aortic aneurysms (AAA)?

No. Men are at a greater risk of developing abdominal aortic aneurysms (AAA) when compared to women.

4. Is obesity a risk factor of abdominal aortic aneurysm (AAA)?

Yes. Obese individuals have high cholesterol levels, which can increase the risk of developing an AAA.

5. My father was diagnosed and treated for abdominal aortic aneurysm (AAA) in the past. Would I be at a risk of developing the condition?

Yes. Individuals with a family history of abdominal aortic aneurysm (AAA) are at high risk of developing the condition when compared to people without a family history.

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