An aortic aneurysm is a localized dilation or bulging of the aorta, the largest artery in the body, due to weakening of the vessel wall. Aneurysms can occur anywhere along the aorta but are most commonly classified as thoracic aortic aneurysms (TAA) or abdominal aortic aneurysms (AAA). If untreated, they can rupture, leading to life-threatening internal bleeding.
Types of Aortic Aneurysm 🩺
- Abdominal Aortic Aneurysm (AAA)
- Occurs in the abdominal portion of the aorta, usually below the kidneys.
- Accounts for ~80% of aortic aneurysms.
- Often asymptomatic until rupture.
- Thoracic Aortic Aneurysm (TAA)
- Occurs in the chest portion of the aorta.
- Can involve the ascending aorta, aortic arch, or descending thoracic aorta.
- More likely associated with genetic disorders (e.g., Marfan syndrome, Ehlers-Danlos).
- Thoracoabdominal Aortic Aneurysm
- Involves both thoracic and abdominal segments, rare and complex to treat.
Causes and Risk Factors ⚠️
- Atherosclerosis – buildup of fatty plaques weakening the aortic wall.
- Genetic Conditions – Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome.
- Hypertension – high blood pressure accelerates wall stress.
- Smoking – major modifiable risk factor.
- Age and Sex – more common in men over 65.
- Infections or Trauma – rare but can cause aortic wall damage.
Symptoms and Clinical Presentation 🔎
Aortic aneurysms are often asymptomatic until they enlarge or rupture. Symptoms can include:
- AAA:
- Pulsating abdominal mass
- Abdominal, back, or flank pain
- Nausea or hypotension if rupture occurs
- TAA:
- Chest or upper back pain
- Shortness of breath or difficulty swallowing (if compressing surrounding structures)
- Hoarseness (vocal cord nerve compression)
- Ruptured aneurysm: Sudden severe pain, hypotension, shock, and often fatal without immediate treatment.
Diagnosis 🧪
- Imaging Techniques:
- Ultrasound: Primary screening tool for AAA.
- CT Angiography: Detailed imaging, especially for TAA.
- MRI Angiography: Alternative for high-resolution imaging without radiation.
- Chest X-ray: Sometimes reveals TAA incidentally.
- Monitoring: Small aneurysms may be observed periodically with imaging to track growth.
Treatment Options 🏥
- Medical Management:
- Control blood pressure and cholesterol.
- Smoking cessation.
- Regular imaging surveillance for small aneurysms.
- Surgical Intervention:
- Open Surgical Repair: Replace weakened segment with synthetic graft.
- Endovascular Aneurysm Repair (EVAR/TEVAR): Minimally invasive stent graft inserted via arteries.
- Indicated when aneurysm exceeds 5–5.5 cm in diameter or shows rapid growth.
Complications ⚠️
- Rupture: High mortality (~80%).
- Dissection: Tearing of the aortic wall, causing severe pain and potential organ ischemia.
- Thromboembolism: Clots forming within aneurysm can travel to other organs.
Prevention and Screening 🛡️
Genetic counseling for families with hereditary aortic disorders.
Regular screening with ultrasound for men over 65 or high-risk individuals.
Lifestyle modification: Healthy diet, blood pressure control, and smoking cessation.
Last Updated on 2 weeks by pinc