The Bulge usually occurs in a weak area of the artery's wall. The pressure of blood inside the artery forces the weak area to balloon outward. If untreated, an aneurysm may rupture, resulting in internal bleeding. Consequences depend on the size of the rupture. A large rupture may be rapidly fatal, and a small one (sometimes termed a “leak”) may produce warning symptoms that allow people to seek medical care.
People who have an abdominal aortic aneurysm often have no symptoms, but some people become aware of a pulsing sensation in their abdomen. The aneurysm may cause pain, typically a deep, penetrating pain mainly in the back. The pain can be severe and is usually unrelenting if the aneurysm is leaking .
The symptoms usually begin suddenly, and include severe chest pain. The pain may:
- Be described as sharp, stabbing, tearing, or ripping
- Be felt below the chest bone, then moves under the shoulder blades or to the back
- Move to shoulder, neck, arm, jaw, abdomen, or hips
- Change position -- pain typically moves to the arms and legs as the aortic dissection gets worse
Proper treatment and control of atherosclerosis (hardening of the arteries) and high blood pressure may reduce your risk of aortic dissection. Tight control of blood pressure in patients at risk of dissection is very important. Drugs such as angiotensin receptor blockers, ACE inhibitors, and beta-blockers may reduce the likelihood of dissection.
Take safety precautions to prevent injuries, which can cause dissections.
Many cases of aortic dissection cannot be prevented.
Exams and Tests
The health care provider will take your family history and listen to your heart, lungs, and abdomen with a stethoscope. A "blowing" murmur over the aorta, a heart murmur, or other abnormal sound may be heard.
There may be a difference in blood pressure between the right and left arms, or between the arms and the legs.
There may be low blood pressure, bulging neck veins, or signs resembling a heart attack. There may be signs of shock, but with normal blood pressure.
Aortic dissection or aortic aneurysm may be seen on:
- Aortic angiography
- Chest x-ray -- may show chest widening or fluid in the lining of the lung (pleural effusion)
- Chest MRI
- CT scan of chest with dye
- Doppler ultrasonography (occasionally performed)
- Transesophageal echocardiogram (TEE)
- Aortic rupture causing rapid blood loss, shock
- Bleeding from the aorta
- Blood clots
- Cardiac tamponade
- Heart attack
- Not enough blood flow past the dissection
- Permanent kidney failure
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