Abdominal Aortic Aneurysm

An abdominal aortic aneurysm (AAA) is confined at the lower part of the body’s large artery (aorta). The abdominal aorta looks like an unusual enlargement or swells out like a balloon. The abdominal aorta becomes thin and stretched with time.

It has no significant symptoms of occurrence because aneurysm grows with age. The aortic wall becomes thinner and at risk of rupture at 65 or above usually in men. If an abdominal aortic aneurysm ruptures, then it urgently requires medical surgery. It can lead to serious internal bleeding and can cause death if not treated well and early.

Types of Abdominal Aortic Aneurysms

Abdominal Aortic Aneurysm is of different types based on location and their severity:

1- Fusiform aneurysm

It is uniformly ballooned out along with the entire circumference of the aortic wall. It occurs mostly in the internal carotid artery and middle cerebral artery.

2- Saccular aneurysm

It is balloon out on one side of the aortic wall and looks like a sac. It has a high risk of rupture and, hence should be treated at a smaller diameter.

3- Pseudoaneurysm

It is also known as a false aneurysm, is rare and occurs when a hematoma or blood clot forms (due to bleeding of arterial blood into nearby tissues) outside the aortic wall, often due to trauma, injury, or infection.

Symptoms of an Abdominal Aortic Aneurysm

Mostly, abdominal aortic aneurysms don’t show any predictable symptoms in their early formation. Because of this reason, AAA is often referred to as “Silent Killer“. However, as the aneurysm grows larger with time, the following signs and symptoms may appear:

• Abdominal pain or discomfort: A constant, burning pain or pulsing sensation(i.e. vibration) in the abdomen, back, or groin area may indicate an expanding aneurysm.
• Pulsating mass: When a pulsating mass or lump is felt in the abdomen, then it could be a sign of a bulging aneurysm.
• Back pain: Consistent back pain, especially in the lower back, can be a symptom of an AAA.
• Leg pain or numbness: If an aneurysm enlarges enough to compress the nearby tissues or blood vessels, one may experience leg pain, numbness, or weakness.
• Nausea or vomiting: Although uncommon, patients with aneurysms might experience nausea, vomiting, or general malaise.

When to See a Doctor

When you experience constant abdominal pain, severe back pain, leg pain, weakness or numbness, and a pulsating mass in your abdomen then you should consult a doctor as early as possible because it can be life-threatening if AAA ruptures. Regular screenings and checkups are necessary, particularly for men over 65, people with an AAA family history, and smokers. If you need consultation for your symptoms, Fitwell Hub offers expert medical consultations.

Causes of Abdominal Aortic Aneurysms

Some of the risk factors that cause abdominal aortic aneurysms are as follows:

1- Gender: A man runs a 4 to 5 times greater risk of developing an AAA than an ordinary woman of the same age.
2- Age: AAA risk increases with age and is particularly high among individuals who are over 65.
3- Smoking: Tobacco is a major risk factor for many diseases and can cause the thickness of the aortic wall and disrupt its function.
4- High blood pressure (Hypertension): Uncontrolled high blood pressure can result in added stretching in the aortic wall and more chances of aneurysm formation.
5- Family history: If a first-degree relative (father, brother) has had an AAA then you are at a higher risk of getting AAA.
6- High cholesterol: High cholesterol can deposit fats in the blood arteries that can swell the aortic wall.
7- Genetic disorders: Even certain genetic disorders such as Marfan and Ehlers-Danlos syndromes (connective tissue disorder) can also increase the risk of aortic aneurysm development.
8- Atherosclerosis: The buildup of plaque in the arteries ( atherosclerosis), can weaken the aortic wall and lead to the production of aneurysms.
9- Trauma or injury: Major trauma or injury to the abdomen can also cause AAA formation.

Risk Factors and Complications

Abdominal aortic aneurysms can be clueless for many years and no symptoms appear. It can cause a life-threatening medical emergency and severe complications if not treated well. Some of the main complications and potential dangers caused by AAA may include:

Rupture:

The most severe and life-threatening complication of an AAA is a rupture, which occurs when the weakened aortic wall tears. The consequences of a ruptured AAA are fatal when not immediately treated through surgery. It leads to extreme internal bleeding, shock, and potentially death.

Thrombosis:

It can occur blood clots develop within an aneurysm leading to blockage of blood flow, damage, & failure of other organs.

Compression of nearby structures:

When an aneurysm enlarges, it can compress other structures around it. These include nearby organs or blood vessels. Such compressions can result in severe pain and discomfort, besides compromising the functions of these compressed structures.

Dissection:

Layers of the aortic wall might split or part completely creating a tear, or separation, causing internal bleeding & other complications.

Infection:

Rarely, an AAA will develop into an infection, which promotes the chances of rupture which in turn causes other complications. Early diagnosis and effective treatment are necessary to decrease these potential dangers and prevent life-threatening complications caused by AAA.

Preventions of Abdominal Aortic Aneurysms

Major lifestyle changes can control abdominal aortic aneurysms. To decrease the risk factors for abdominal aortic aneurysms, consider the following preventive measures:

Prevention/Treatment Strategy	Description
Quit Smoking	Smoking is a major cause of AAA, and quitting smoking can decrease the risk of growth or severity of an aneurysm.
Manage Blood Pressure	Reducing blood pressure can lower the risk of aneurysm growth. This can be achieved through medication and lifestyle changes, such as diet adjustment, regular exercise, and managing workload.
Exercise Regularly	Regular exercise improves cardiovascular health, boosts metabolism, and reduces strain on the aortic wall, lowering the risk of AAA development.
Maintain a Healthy Diet	A well-balanced diet, including vegetables, fruits, and proper water intake, helps control weight, blood pressure, and cholesterol levels, reducing the risk of AAA.
Manage Other Medical Conditions	Proper management of conditions like high blood pressure, diabetes, atherosclerosis, and cholesterol levels can decrease aneurysm growth and formation.
Participate in Screening Programs	Early detection through recommended screening programs and timely treatment can reduce the high risk of AAA.

Diagnosis and essential tests of abdominal aortic aneurysms

Different diagnostic tests and medical procedures can diagnose and detect abdominal aortic aneurysms at an early stage, preventing a life-threatening emergency.

1- Physical examination

The doctor may perform a physical examination by placing a stethoscope on the abdomen of the affected person, listening for abnormal sounds, and feeling for any vibrating mass.

2- Abdominal ultrasound

The use of this non-invasive imaging method helps to determine the dimensions. Their severity level of an aneurysm by producing elaborated internal pictures of the abdominal aorta with sound waves of high frequency.

3- CT (computed tomography) scan

A CT scan on the other hand is a sophisticated imaging method that provides information about the size and position of the aneurysm by producing comprehensive cross-sectional pictures that display details inside the abdomen, and also give information about its severity.

4- MRI (magnetic resonance imaging)

MRI scan is a non-invasive medical imaging technique that employs strong magnetic fields and radio waves. It creates detailed pictures of the abdominal aorta without the use of harmful ionizing radiation. These images allow for precise measurements of an aneurysm’s size, location, and severity.

5- Angiography

Another diagnostic test called angiography involves injecting a contrast dye into blood vessels. This helps in visualizing the arteries on X-ray images.

We can study the path taken by blood flow along them to detect any deviation typically caused by blockages . What diagnostic test to select depends on several factors. These comprise the presumed size, location of the aneurysm, and even the individual’s general health and medical history.

Screening for abdominal aortic aneurysms

Regular screening can identify an AAA before it ruptures and becomes deadly. It helps in treating it on time to prevent any additional complications. The US Preventive Services Task Force (USPSTF) recommends men who smoke aged 65 to 75 one time screening for AAA with an abdominal ultrasound. This will help in decreasing the severity level of the disease. For people at high risk, early detection and screening are necessary for abdominal aortic aneurysms.

Healthcare providers may suggest more frequent or earlier screenings for those with particular risk factors. Such as family history or certain genetic conditions related to aneurysms occurring on arteries other than the heart. It is important to discuss your risk factors and screening recommendations with your doctor to determine the most effective approach for early detection and prevention of abdominal aortic aneurysms.

Treatment options for abdominal aortic aneurysms

Treatment options for abdominal aortic aneurysms highly depend upon the size and location of the aneurysm, its symptoms, and the patient’s health. Some are given below:

• Watchful waiting and monitoring:
  In the early stages no symptoms appear, so doctors may recommend regular monitoring by ultrasound tests to analyze the aneurysm’s severity and size growth.
• Open surgical repair:
  Open surgical repair is a traditional process involving making a large incision in the abdomen. Then approach the aortic wall and repair its thinner part with a synthetic graft.
• Endovascular aneurysm repair (EVAR):
  This is a minimally invasive procedure that involves looping a synthetic graft by a small incision in the groin and positioning it inside the aneurysm to strengthen the weakened aortic wall.
• Medical management:
  Doctors may sometimes recommend medications to control basic conditions or risk factors, such as cholesterol or high blood pressure levels. It can help to reduce the growth of this disease.

What diagnostic test to select depends on several factors?

These comprise the presumed size, location of the aneurysm, and even the individual’s general health and medical past information. Healthcare professionals prescribe medications to control risk factors for abdominal aortic aneurysm (AAA), as discussed below:

1. Beta-blockers: Beta-blockers are used to slow the development of an aneurysm by decreasing blood pressure and reducing the workload of the heart.
2. Antiplatelet agents: Aspirin is used to prevent blood clotting and is important for persons with atherosclerosis which is a common risk factor of AAA.
3. Anti-hypertensives: Anti-hypertensives are used to reduce strain on the aortic wall, control high blood pressure, and reduce the chances of aneurysm growth and rupture.
4. Cholesterol-lowering drugs (Statins): These drugs are used to lower the blood’s cholesterol levels, prevent the formation of plaques in blood arteries, and reduce the chances of aneurysm development and growth.
5. Angiotensin II receptor blockers (ARBs): ARBs are used for relaxing blood vessels, reducing blood pressure, and decreasing the chances of aneurysm rupture by decreasing the stress on the aorta.

Fitwell Hub pharmacy has a variety of drugs for patients suffering from adrenal cancer. Visit our pharmacy section.

Frequently Ask Questions (FAQ’s)