Understanding Aortic Aneurysm: Symptoms, Causes & Treatments
An aortic aneurysm is a potentially life-threatening condition. It affects the aorta, the largest artery responsible for carrying oxygenated blood. This condition is a balloon-like bulge in the aorta, which often lacks symptoms until it’s about to rupture. By identifying crucial risk factors and warning signs, patients may empower themselves to take proactive measures and protect their vascular health.
Who Is at Risk of Aortic Aneurysm
Aortic aneurysms are more prevalent in males over 60 with risk factors, including smoking, high blood pressure, high cholesterol levels, family history, and certain connective disorder conditions such as Marfan and Ehlers-Danlos syndrome.
The primary risk factor for aortic aneurysms is tobacco use due to its direct and indirect damage to the arteries. For instance, nicotine, one of the chemical ingredients of cigarettes, quickens aneurysm formation and contributes to increasing fatty build-up in the blood vessels.
What Are Aortic Aneurysm Symptoms and Causes
Referred to as a “silent killer”, aortic aneurysms may occur in the chest (Thoracic Aortic aneurysm) or in the abdomen (Abdominal Aortic Aneurysm) as this artery extends to the heart and the rest of the body.
Noticeable aortic aneurysm symptoms emerge when it reaches more than 5 cm, including
- Chest or back pain
- Pulsating sensation in the abdomen
- Shortness of breath
- Hoarseness
- Difficulty swallowing
The primary cause of aortic aneurysm is the weakening of the arterial wall, leading to the formation of a bulge. This weakening occurs due to various factors, such as the build-up of plaques in the arteries, genetic factors, and trauma.
Why Early Detection of Aortic Aneurysm is Important
Early detection allows patients to pursue preventive measures and treatment options while aortic aneurysms remain manageable. Regular checkups, especially for individuals at higher risk, prevent potential massive internal bleeding, a common complication of a ruptured aneurysm. As a result, screening is recommended for males over 65 with a smoking history. This test uses an ultrasound to detect an enlarged aorta at the abdomen or thoracic area.
Appropriate and timely management improves outcomes and prevents life-threatening complications.
How to Spot Warning Signs of Aortic Aneurysm
Awareness of the warning signs of aortic aneurysm is vital for timely intervention. Watch for symptoms such as sudden, intense, and persistent pain in the abdomen, back, or chest. Additionally, monitor for changes in your voice, difficulty swallowing, or shortness of breath. Other rare signs are a cold foot or a painful black toe from a blood clot that blocks blood flow and weight floss from an inflammatory aortic aneurysm.
Seek immediate medical attention if you notice these warning signs.
Aortic Aneurysm Treatment Options
When treating aortic aneurysms, various options are available depending on the aneurysm’s size, location, and overall health. For smaller aneurysms, close monitoring and lifestyle modifications may be sufficient. However, larger aneurysms or those at risk of rupture may require surgical intervention.
- Open Surgery involves a large incision in the affected area to visualise the aneurysm and replace the weakened segment with a graft. This is an emergency procedure to stop internal bleeding.
- Endovascular Treatment is a minimally invasive surgery to treat an aneurysm by threading a catheter and placing a stent graft.
- Endoleak Treatment uses techniques such as embolisation or sealing the leak with medical glue to stop the bleeding after the first endovascular surgery. This follow-up surgery ensures the effectiveness of the original repair and prevents rupture.
When To Seek Treatment for Aortic Aneurysm
Seeking treatment for an aortic aneurysm requires a thorough and regular assessment by a vascular specialist.
Here are some factors our vascular specialist, Dr Julian Wong, considers to determine the right time for surgical treatment:
- Size of the Aneurysm: Smaller aneurysms less than 5 cm are closely monitored. However, aneurysms reaching 5.5 cm or larger require immediate surgical intervention.
- Rate of Aneurysm Growth: If the aneurysm shows a rapid increase in size, even below 5 cm, earlier intervention may be necessary to mitigate the risk of rupture.
- Symptoms, Risk Factors, and Causes: While aortic aneurysms can be asymptomatic, the presence of symptoms such as severe pain, tenderness, or signs of impending rupture requires immediate medical attention. Additionally, aortic aneurysm causes and other risk factors, such as a family history or connective tissue disorders, may influence the decision to pursue treatment earlier, even if the aneurysm is smaller.
- Overall Health: Overall health and medical history play a crucial role in determining the appropriate timing for treatment. Before the intervention, assessing vascular health, other underlying medical conditions, and surgical risk factors ensures a safe and optimal treatment plan.
Patients should discuss concerns or questions they may have at every checkup. Dr Julian Wong provides personalised recommendations based on the situation and guides every patient through crucial health decision-making.
Key Takeaways: Take Action Before It’s Too Late
Aortic aneurysms require attention and vigilance. As a result, recognising the risk factors, symptoms, and importance of early detection helps patients take control of their vascular health. For example, individuals with inherited connective tissue disorders may need to take additional precautions when diagnosed with aortic aneurysms due to the higher risk of rupture for smaller aneurysms. Additionally, males over 65 with a smoking history should consider annual screening to detect an aneurysm. Be proactive in seeking regular checkups, especially if you are at higher risk.