The aortic aneurysm should be monitored and, if necessary, treated to avoid the risk of dissection and rupture.
The aorta – the main blood vessel that carries blood from the heart to the rest of the body – is the most common form of aneurysm, or the dilation of the wall of an artery.
It can be caused by trauma or damage to the aorta, such as those associated with smoking, high blood pressure and atherosclerosis, or conditions of genetic origin that cause this blood vessel to no longer be able to withstand the forces exerted on its wall.
Over time, dilation can increase to cause aortic dissection (i.e. tearing one of the layers of the artery wall) or even rupture.
Symptoms to recognize
Symptoms depend on the type of aneurysm and its localization, which can be abdominal or thoracic depending on the portion of the aorta affected.
Abdominal aortic aneurysms typically develop slowly, often without causing symptoms until they rupture; In some cases they can trigger a pulsating sensation in the abdomen, deep pain in the back or side or a constant abdominal discomfort that can last for hours or days.
In case of rupture there is a strong and sudden pain in the lower abdomen and back, nausea, vomiting, constipation, urination problems, sweating, dizziness and acceleration of the heartbeat in an upright position.
Thoracic aortic aneurysms can be associated with pain in the jaw, neck, back or chest, as well as symptoms (such as coughing or hoarseness, shortness of breath and difficulty breathing or swallowing) that can be caused by compression of surrounding structures.
However, even in this case, symptoms may be absent until the situation worsens with increased dilation or rupture of the aorta, which can trigger bleeding associated with a strong and sudden pain that can extend from the chest to the abdomen or arms.
The differences between the two situations are summarised in the following table:
| Abdominal aorta | Thoracic aorta | |
|---|---|---|
| Symptoms preceding rupture | Sensation of pulsation in the abdomen
Deep pain in the back or Constant abdominal discomfort that |
Pain in the jaw, neck, back or chest
Cough or hoarseness Shortness of breath Difficulty breathing or swallowing |
| Symptoms in case of rupture | Severe and sudden pain in the lower abdomen and back Nausea, vomiting Constipation Urination problems Sweating and dizziness Acceleration of the heartbeat in |
Strong, sudden pain from the chest to the abdomen or arms |
Therapies
In the event that you suspect the rupture of an aneurysm or dissection of the aorta it is good to immediately seek medical attention, because you risk a real shock, a condition in which blood pressure is lowered until it no longer guarantees an adequate blood supply to vital organs such as brain and kidneys.
In addition, ruptures and dissections can be avoided thanks to early diagnosis, careful monitoring of the situation and, if necessary, appropriate treatment.
Typically, if an aortic aneurysm of less than 5 cm is not associated with symptoms, doctors prescribe regular check-ups to make sure it is not increasing in size.
Aneurysms greater than 5 cm may require medication to lower blood pressure, relax blood vessels and reduce the risk of rupture, such as beta blockers and calcium channel blockers.
If the size of the aneurysm increases rapidly or if there is a real risk of dissection or rupture, surgery may be necessary.
Typically, an incision is made in the abdomen or chest and the aneurysm is removed, and then the damaged section of the aorta is replaced; However, in some cases it is sufficient to use a prosthesis to strengthen the aorta, positioned thanks to the use of catheters inserted in the groin (endovascular repair of the aneurysm).
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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