Aneurysms :Symptoms and Treatements

An aneurysm is a bulge or "ballooning" in the wall of an artery. Arteries are blood vessels that carry oxygen-rich blood from the heart to other parts of the body. If an aneurysm grows large, it can burst and cause dangerous bleeding or even death.

Most aneurysms occur in the aorta, the main artery traveling from the heart through the chest and abdomen. Aneurysms also can happen in arteries in the brain, heart and other parts of the body. If an aneurysm in the brain bursts, it causes a stroke.

Aneurysms can develop and become large before causing any symptoms. Often doctors can stop aneurysms from bursting if they find and treat them early. Medicines and surgery are the two main treatments for aneurysms.

Aortic dissection occurs when the layers of the wall of the aorta separate or are torn, allowing blood to flow between those layers and causing them to separate further. When the aortic wall separates, blood cannot flow freely, and the aortic wall may burst.

Any condition that causes the walls of the arteries to weaken can lead to an aneurysm. The following increase the risk of an aneurysm or an aortic dissection:

• Atherosclerosis (a build-up of fatty plaque in the arteries).
• High blood pressure

• Smoking.
• Deep wounds, injuries, or infections of the blood vessels.
• A congenital abnormality (a condition that you are born with).
• Inherited diseases. An inherited disease such as Marfan syndrome, which affects the body's connective tissue, causes people to have long bones and very flexible joints. People with this syndrome often have aneurysms.

How are aneurysms detected?

Aneurysms can be detected by physical exam, on a basic chest or stomach x-ray, or by using ultrasound. The size and location can be found through echocardiography or radiological imaging, such as arteriography, magnetic resonance imaging (MRI), and computed tomography (CT) scanning.

Aneurysms Symptoms

• Aortic aneurysms may cause shortness of breath, a croaky or raspy voice, backache, or pain in your left shoulder or between your shoulder blades.

• Aortic dissection may cause sudden and severe pain, and patients often feel like something is ripping or tearing inside of them. The pain is mainly felt in the chest, but it can spread to the back or between the shoulder blades. Aortic dissection may also cause sudden stomach pain, lower back pain, or flu-like symptoms. If blood leaks from the dissection and builds up in the chest, the blood may enter the pericardial space (the sac that surrounds the heart) and prevent the heart from filling properly. This can lead to a life-threatening condition called cardiac tamponade.

• Abdominal aortic aneurysms may cause pain or tenderness below your stomach, make you less hungry, or give you an upset stomach.

Treating Aneurysms

Treatment depends on the size and location of the aneurysm and your overall health.

Aneurysms in the upper chest (the ascending aorta) are usually operated on right away.

Aneurysms in the lower chest and the area below your stomach (the descending thoracic and abdominal parts of the aorta) may not be as life-threatening. Aneurysms in these locations are watched regularly. If they become about 5 centimeters (almost 2 inches) in diameter, continue to grow, or begin to cause symptoms, your doctor may want you to have surgery to stop the aneurysm from bursting.

For aortic aneurysms or aneurysms that happen in the vessels that supply blood to your arms, legs, and head (the peripheral vessels), surgery involves replacing the weakened section of the vessel with an artificial tube, called a graft.

For patients with smaller or stable aneurysms in the descending aorta or abdominal parts of the aorta—those farthest from the heart, doctors usually ask patients to come in for regular check-ups so they can follow the growth of the aneurysm. If the aneurysm does not grow much, patients may live with the aneurysm for years. Doctors may also prescribe medicine, especially medicine like a beta blocker that lowers blood pressure, to relieve the stress on the aortic walls. Medicine to lower blood pressure is especially useful for patients where the risk of surgery may be greater than the risk of the aneurysm itself.

For patients with aortic dissection, surgery is usually recommended right away, especially if the dissection is in the part of the aorta closest to the heart. For dissections farther from the heart, patients will be given medicines (such as beta-blockers to lower blood pressure), and the dissection will be watched closely. But, if the dissection begins to leak blood, cause a blockage, or get bigger, surgery is needed.

About the Author

Dr. PN Rao , MS, MCh,Consultant Cardio thoracic Surgeon,Wockhardt Hospitals, Hyderabad
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