An aneurysm is an abnormal swelling of a weakened part of an artery or blood vessel. If left untreated, the aneurysm may enlarge and stretch the walls of the artery or blood vessel to the point of rupture. This, in turn can cause internal bleeding and sudden death.
Aneurysms can occur in any artery, but rupture of aneurysms in the aorta or brain are usually fatal.
Aneurysms are usually clinically silent and diagnosed incidentally or when they cause complications such as compression of adjacent structures, bleeding or rupture. Large aortic aneurysms can cause deep, diffuse chest pain, or rarely, difficulty in swallowing or hoarseness. Aneurysms in the brain may cause symptoms of headache.
Rupture of aneurysms of the aorta or brain are usually fatal, due to severe shock caused by massive leakage of blood into the chest or abdomen and major stroke caused by haemorrhage in the brain, respectively.
Detecting an aneurysm early may be difficult due to the initial lack of symptoms. Aneurysms are usually clinically silent and diagnosed incidentally or when they rupture. At a later stage, symptoms usually depend on the size and location of the aneurysm.
The best way to prevent or to slow the growth of aneurysms is to keep your blood pressure and cholesterol levels under control. Exercise regularly and quit smoking.
The most common causes are untreated, chronic high blood pressure (hypertension) and atherosclerosis (hardening of arteries due to accumulation of cholesterol plaques). They cause the artery walls to become so stretched and weakened that they bulge outward, creating a ballooned area called an aneurysm.
Congenital conditions such as
Marfan syndrome and
bicuspid aortic valves may also weaken aortic walls, diminishing their ability to withstand the sheer forces of blood flowing through them.
Aneurysms tend to affect more men than women. People over the age of 65 and those with a heart condition or high blood pressure (hypertension) should also watch out for pains in the chest, head or abdomen, as these could be signs of an aneurysm.
Doctors will conduct a thorough physical examination, checking for high blood pressure, heart murmurs, or any pulsating lumps in the abdomen, groin or legs.
A variety of tests including an ultrasound, computed tomography scan (CT scan), magnetic resonance imaging scan (MRI scan) and angiogram can help to confirm the diagnosis.
High blood pressure needs to be controlled to reduce the risk of expansion and rupture of an aneurysm. Although leaking or ruptured aneurysms are often fatal, immediate drainage of blood and surgical repair of the aneurysm may be life-saving for some patients.
The larger an aneurysm becomes, the more likely it will burst. Doctors will prescribe oral medications such as beta-blockers to reduce the force of blood pressure against the weakened artery wall. Generally, high blood pressure must will be treated aggressively.
Doctors may surgically remove or perform endovascular stenting for the aneurysm and replace the weakened portion of the aorta with a synthetic graft or endovascular stent graft, if the aneurysm is at risk of rupturing - usually when the aneurysm grows beyond a certain size. This threshold varies depending on the location of the aneurysm. Each treatment option is individualized, and may not be suitable for everyone.
Endovascular aneurysm repair is a less invasive surgery involving threading a stent through an artery in the groin. The stent can relieve excessive pressure on the vessel walls and reduce the risk of rupture.