Abdominal Aortic Aneurysm – A Potential Life Threatening Medical Condition
The largest aorta of the body originates from the left ventricle of the heart and descends until the abdominal aorta that is the biggest artery in the abdominal cavity. The major blood vessel that carries oxygenated blood to various parts of the body. Abdominal aortic aneurysm (swelling) takes place when the aortic walls begin to weaken. Weakening of the walls leads to ballooning of the blood vessel which is called dilatation. If the aneurysm expands rapidly or out of proportion, it ruptures causing internal bleeding. This is a very serious condition and mortality rate is about 60% to 90%.
Abdominal aortic aneurysm occurs mostly in males and people who smoke a lot. People between 65 to 75 years of age are more prone to this illness. Aortic aneurysms are of various sizes. They may grow up to 50% more than its normal size. Aneurysm more than 3cm in diameter is risky and requires open surgery or endovascular abdominal aortic aneurysm surgery to restore it.
Abdominal aortic aneurysm symptoms
Usually ‘AAA’ symptoms are asymptomatic that is it does not show subjective evidence of the presence of the disease. However, due to abnormal expansion of the blood vessel it may cause
• Pain in the abdomen
• Pulsating feeling in the abdomen
• Pain in scrotum, lower back, scrotum, chest and hips
• Rapid heart rate
Most ‘AAA’ cases are detected during ‘X-ray’ or ‘CT scan’ ordered for examination of other diseases. However, if ‘AAA’ develops rapidly, symptoms appear like
• Vomiting
• Nausea
• Sweaty skin
• Shock
• Pain in lower back and groins occurs
It also poses risk of rupture that can create major complications like acute aortic occlusion, peripheral embolization, and aortoduodenal or aortocaval issues. Such situations require urgent medical attention and surgery.
What happens in abdominal aortic aneurysm?
The bloating of the artery leads to rupture that causes internal bleeding. Rapid bleeding from the blood vessel can lead to development of tachycardia, hypotension (low blood pressure), hypovolemic shock, disturbed mental condition or cyanosis. The ruptured abdominal aortic aneurysm is usually situated below the point of renal arteries. If ‘AAA’ develops below the kidney, it is called infrarenal abdominal aortic aneurysm. Nonetheless, it can also occur above the kidney (suprarenal AAA) or at the same level or place of the kidney (pararenal AAA).
Once the blood vessel burst open, it creates a fistula either between the aorta (aortacaval) or between the intestine (aortaintestinal). Bleeding occurs either in retroperitoneal area that is behind the peritoneum (serous membrane inside layer of the cavity of the abdomen) or in intraperitoneal area that is inside the cavity of peritoneum.
Causes of Abdominal Aortic Aneurysm – The actual development process is yet to be known however, following factors may influence the development:
Smoking
Chewing tobacco
High blood pressure
Obesity
Genetic aspects
High cholesterol
Emphysema
Infection in vasculitis (aorta)
Cystic medial necrosis
Trauma
Arteritis
Atherosclerosis (coagulation or solidification of the arteries)
The above factors cause breakdown of collagen and elastin proteins located in the wall of the aorta. They weaken the walls leading to development of ‘AAA’.
An abdominal aortic aneurysm screening can be done with help of ultrasound or CT scans and confirms presence of the disease. If the aneurysm is above three cms in diameter, it can be treated through open (invasive) or endovascular (non-invasive) surgery. The type of surgery is based on severity of the aneurysm and risk of the aneurysm rupturing. Although smaller ‘AAA’ may not require surgery but surely proper medical attention is needed as they can rupture. Hence, special medical advice or test done for abdominal aortic aneurysm post 50 years of age can help avert this potentially life-threatening illness.