Not all Aneurysms are life threatening. But if the bulging stretches the artery beyond its capacity, the vessel may burst, causing a person to bleed to death. An Aneurysm that hemorrhages into the brain can lead to stroke or death.
Aneurysms usually develops in the arteries that supply blood to the brain (Cerebral Aneurysm) or in the abdominal or chest (Thoracic Aneurysm), portions of the Aorta (Aortic Aneurysms). An Abdominal Aortic Aneurysm (AAA) is usually located below the kidneys.
Left Ventricular Aneurysms
Sometimes an Aneurysm occurs after a heart attack and primarily involves the left Ventricle, the heart’s main pumping chamber. A section of damaged heart wall becomes scarred and grows thinner and weaker, significantly reducing the heart’s pumping ability. Ventricular aneurysms may cause shortness of breath, chest pain, or arrhythmia. Ventricular aneurysms are surgically repaired if they result in congestive heart failure, left ventricular heart failure, or arrhythmia. Aneurysms can be life threatening, the location and size usually determine the risk.
Any condition that causes the arterial walls to deteriorate can lead to an Aneurysm. Atherosclerosis (a build–up of plaque in the arteries that weakens the walls of blood vessels), high blood pressure, and smoking are risk factors. Penetrating wounds, injuries, or infections also can cause blood vessels to bulge. In some cases, the condition may be a congenital (inherited) abnormality. High–risk candidates include people who have an inherited disease such as Marfan Syndrome, a degenerative connective tissue condition characterized by long bones and hyperflexible joints. White men over the age of 55 have an increased risk of developing an Aneurysm. It is one of the top 10 leading causes of death among this population.
Diagnosis of Aneurysms
Aneurysms can be detected by a physical examination, on a basic chest or abdominal X–ray, or by using Ultrasound. The size and location can be estimated through Echocardiography or Radiological Imaging, such as Arteriography, Magnetic Resonance Imaging (MRI), and Computed Tomography (CT) Scanning.
Symptoms of Aneurysms
Symptoms may vary depending on the type and location of an aneurysm. Symptoms result from the pressure caused by an Aneurysm pressing against organs, nerves, and other blood vessels. For example:
- A dissecting Aneurysm (layers of the aortic wall separate or are torn, causing blood to flow between the layers) may cause sudden and severe pain, often described as “Ripping or tearing”.
- Aortic Aneurysms may cause shortness of breath, hoarseness, backache, or pain in the left shoulder or between the shoulder blades.
- Abdominal Aortic Aneurysms may cause abdominal pain or tenderness, loss of appetite, and nausea.
- Cerebral (brain) Aneurysms may have no symptoms, although some patients have headaches, radiating neck pain, facial pain, vision changes, and speech impairment.
Treatment depends on the size and location of the Aneurysm and the patient’s overall health. Aneurysms in the ascending aorta (in the upper chest) are usually operated on immediately. Aneurysms in the descending (lower chest) and abdominal portions of the aorta may not be life threatening. Aneurysms in these locations are monitored regularly. If they reach about 5 cm (almost 2”) in diameter, continue to enlarge, or become symptomatic, surgery is generally indicated. For Aortic Aneurysms or Aneurysms that occur in the peripheral vessels, surgery involves either removing the aneurysm or relining or replacing the weakened section of the aorta with an artificial tube (Grafting).
For patients with less severe Aneurysms in the descending aorta or abdominal parts of the aorta – those farthest from the heart, physicians usually monitor patients to follow the growth of the aneurysm. If growth is minimal, patients may live with the aneurysm for years. Physicians also may prescribe medications, especially hypertension–reducing drugs and beta blocker therapy to lower blood pressure and relieve stress on the aortic walls. In patients where the risk of surgery may be greater than the risk of the aneurysm itself, medication may improve the function of the heart and relieve the pressure on the aortic artery’s walls.