What Is an Abdominal Aortic Aneurysm?
An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. The aorta runs from your heart through the center of your chest and abdomen. Because the aorta is the body's main supplier of blood, a ruptured abdominal aortic aneurysm can cause deadly bleeding. Depending on the size and the rate at which your abdominal aortic aneurysm is growing, treatment may vary from watchful waiting to emergency surgery. Once an abdominal aortic aneurysm is found, doctors will closely monitor it so that surgery can be planned. Emergency surgery for a ruptured abdominal aortic aneurysm can be risky.
Types
AAAs are usually classified by their size and the speed at which they’re growing. These two factors can help predict the health effects of the aneurysm.
- Small (less than 5.5 centimeters) or slow-growing AAAs generally have a much lower risk of rupture than larger aneurysms or those that grow faster. Doctors often consider it safer to monitor these with regular abdominal ultrasounds than to treat them.
- Large (greater than 5.5 centimeters) or fast-growing AAAs are much more likely to rupture than small or slow-growing aneurysms. A rupture can lead to internal bleeding and other serious complications. The larger the aneurysm is, the more likely that it will need to be treated with surgery.
Signs and symptoms
AAAs are usually asymptomatic until they expand or rupture. An expanding AAA causes sudden, severe, abdominal, or groin pain. Syncope may be the chief complaint, however, with pain less prominent. Most clinically significant AAAs are palpable upon routine physical examination. The presence of a pulsatile abdominal mass is virtually diagnostic but is found in fewer than half of all cases.
Patients with a ruptured AAA may be in frank shock, as evidenced by altered mental status, tachycardia, and hypotension. Whereas abrupt onset of pain may be somewhat dramatic, associated physical findings may be very subtle. Patients may have normal vital signs in the presence of a ruptured AAA as a consequence of retroperitoneal containment of hematoma. Unfortunately, at least 65% of patients with a ruptured AAA die of sudden cardiovascular collapse before arriving at a hospital.
Causes
Doctors don’t exactly know why abdominal aortic aneurysms happen, but here are several things that can play a part:
- Smoking and using other types of tobacco
- High blood pressure
- Blood vessel diseases
- Infections in the aorta
- Genetics
- Trauma from something
Treatment
Depending on the size and exact location of the aneurysm, your doctor may perform surgery to repair or remove the damaged tissue. This may be done either with open abdominal surgery or endovascular surgery. The surgery performed will depend on your overall health and the type of aneurysm. Open abdominal surgery is used to remove damaged areas of your aorta. It’s the more invasive form of surgery and has a longer recovery time. Open abdominal surgery may be necessary if your aneurysm is very large or has already ruptured. Surgery has risks, and small aneurysms generally don’t rupture.
It's never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and becoming more physically active. These are primary lines of defense to keep your blood vessels healthy and prevent an abdominal aortic aneurysm from developing or rapturing. If you're diagnosed with an abdominal aortic aneurysm, you should ask about the size of your aneurysm, whether your doctor has noticed any changes and how frequently you should visit your doctor for follow-up appointments.
