Overview
What Is Abdominal Aortic Aneurysm (AAA)?
An abdominal aortic aneurysm is an enlargement of the lower part of the aorta that extends through the abdominal area (at times, the upper portion of the aorta in the chest can be enlarged). The aorta is the main blood vessel that carries blood from the heart to the rest of the body. Since arteries are elastic and are filled with blood under high pressure, the wall of the artery may become weakened and distended like a balloon.
Aortic aneurysms can develop anywhere along the length of the aorta. The majority, however, are located along the abdominal aorta. Most (about 90%) of abdominal aneurysms are located below the level of the renal arteries, the vessels that leave the aorta to go to the kidneys. About two-thirds of abdominal aneurysms are not limited to just the aorta but extend from the aorta into one or both of the iliac arteries.
Types Of Aneurysms : -
- Abdominal Aneurysm -- in an artery in the abdomen (mid-section)
- Thoracic Aneurysm -- in an artery in the chest area
- Cerebral Aneurysm -- in an artery in the brain (usually treated by neurosurgeons)
- Peripheral Aneurysm -- in the large arteries that run down the legs and behind the knees, and occasionally arms
Most aneurysms occur in the abdomen. Abdominal aortic aneurysms occur most frequently in people over age 60 and most commonly at a point in the aorta just below the level of the kidneys. Men are more commonly affected by aneurysms than women.
AAA Causes
Physicians and researchers are not quite sure what actually causes an AAA to form in some people. The leading thought is that the aneurysm may be caused by inflammation in the aorta, which may cause its wall to weaken or break down. Some researchers believe that this inflammation can be associated with atherosclerosis (also called hardening of the arteries) or risk factors that contribute to atherosclerosis, such as high blood pressure (hypertension) and smoking.
other factors that can increase your risk of AAA include : -
- Being a man older than 60 years
- Having an immediate relative, such as a mother or brother, who has had AAA
- Having high blood pressure
- Smoking
- Your risk of developing AAA increases as you age. AAA is more common in men than in women.
AAA Symptoms
Aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. Some aortic aneurysms enlarge slowly, increasing less than half an inch (1.2 centimeters) a year. Others expand at a faster rate, which increases the risk of rupture. How quickly an aortic aneurysm may grow is difficult to predict.
As an aortic aneurysm grows, some people may notice : -
- A pulsating feeling near the navel, if the aneurysm occurs in the abdomen
- Tenderness or pain in the abdomen or chest
- Back pain
Complications
Rupture is a feared problem. Rupture of an abdominal aneurysm is a catastrophe. It is highly lethal and is usually preceded by excruciating pain in the lower abdomen and back, with tenderness of the aneurysm. Rupture of an abdominal aneurysm causes profuse bleeding and leads to shock. Death may rapidly follow. Half of all persons with untreated abdominal aortic aneurysms die of rupture within five years. Abdominal aortic aneurysms are the 13th leading cause of death in the U.S.
Peripheral embolization of clot within the aneurysm can occur when a piece of clot comes loose and travels further out in the arterial system. This clot fragment can lodge in a smaller artery and block the flow of blood. Infection of aneurysms can occur from turbulent blood flow from the rough inner surface of the affected aorta.
AAA Diagnosis
Abdominal AAs can be diagnosed from your symptoms when they occur but this may be too late. They are usually found when you have a routine physical examination and chest and abdominal X-rays.
When your doctor examines you, he or she may feel a pulsating mass in your abdomen which may be tender if your AAA is large. If your doctor suspects an AAA, he or she will request tests including those below. An ultrasound scan is the most common test to detect an aneurysm. It can also measure its size.
Other scans may also be performed before you have surgery. For example a CT scan uses X-rays to make three-dimensional images of the body. This is very useful for determining the exact position of your AAA.
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