Abdominal Aortic Aneurysm (Stable)

Abdominal Aortic Aneurysm (Stable)

The aorta is the body’s main artery that carries oxygen-rich blood from the heart. It travels from the heart down to the lower abdomen, where it divides into smaller blood vessels. Certain conditions such as hypertension (high blood pressure), atherosclerosis (hardening of the arteries) and obesity, and certain lifestyles such as smoking and using stimulant drugs (cocaine and amphetamines) can weaken the wall of the aorta. An aneurysm can form in the weakened aortic wall. This appears as a small bulge in the wall of the aorta, which can slowly expand. Because the bulging area is stretched thinner than the normal aortic wall, it can rupture. A rupture of the aorta causes massive internal bleeding and death.

Most aortic aneurysms do not cause any symptoms until they begin to expand rapidly or rupture. Therefore, most aneurysms are discovered on exams or tests done for other reasons (like an X-ray, ultrasound or CT scan).

An expanding aneurysm causes symptoms of abdomen, back, flank or groin pain, which may come and go at first, or become constant. In the case of a ruptured aneurysm, there is sudden abdominal, back or groin pain, followed by weakness, dizziness and loss of consciousness as blood pressure drops and a shock state occurs. This is a fatal condition unless immediate surgery is performed.

Small aneurysms rarely rupture and can be safely treated with medicines to lower blood pressure and reduce stress on the aortic wall. Routine ultrasound or CT scans can determine if the aneurysm is growing. Larger aneurysms will require surgery. Surgical treatment involves removing the section of aorta with the aneurysm and replacing it with an aortic graft (artificial blood vessel). A newer alternative to surgery, which can be used in certain cases, involves the placement of a stent (tubular wire mesh) inside the aorta to support the wall and reduce stress on the aneurysm.

Rarely, a blood clot can form inside of an aortic aneurysm with no symptoms. A piece of the clot can break off and pass to smaller blood vessels in the intestines or legs and cause pain and loss of blood flow to that part.

If a small aneurysm has been identified, which does not require surgery, you should still address any lifestyle factors that may improve your overall cardiovascular health. This includes such things as following a healthy diet, losing weight, stopping smoking, and lowering your cholesterol.

Home Care

  1. Your aneurysm is small and does not require surgery; you will be followed along as an outpatient with routine ultrasound screening exams to measure the size of the aneurysm every 6 months.

  2. You may return to your usual level of activity.

  3. Follow these guidelines to improve your cardiac health:

  • If you are overweight, begin a weight loss program.

  • If you have hypertension, reduce your salt intake.

-- Avoid high salt foods (olives, pickles, smoked meats, salted potato chips, etc.).

-- Do not add salt to your food at the table.

-- Use only small amounts of salt when cooking.

  • Begin an exercise program. Discuss with your doctor what type of exercise program would be best for you. It doesn't have to be difficult. Even brisk walking for 20 minutes three times a week is a good form of exercise.

  • Avoid medicines which contain heart stimulants. This includes many cold and sinus decongestant pills and sprays as well as diet pills. Check the warnings about hypertension on the label. Stimulants such as amphetamine or cocaine could be lethal for someone with hypertension. Never take these.

  • Limit your caffeine intake or switch to caffeine-free products.

  • Stop smoking. If you are a long-time smoker, this can be hard. Enroll in a stop-smoking program to improve your chance of success.

  • Learning how to handle stress better is an important part of any program to lower blood pressure. Learn about relaxation methods such as meditation, yoga or biofeedback.

  • If medicines were prescribed for hypertension, take them exactly as directed. Missing doses may cause your blood pressure get out of control.

  • Consider buying an automatic blood pressure machine (available at most pharmacies). Use this to monitor your blood pressure at home and report the results to your doctor.

Follow Up:

Regular visits to your own physician for blood pressure checks and periodic ultrasounds of the aorta are an important part of your care. Make a follow-up appointment with your doctor, or as directed by our staff.

Get Prompt Medical Attention

if any of the following occur:

-- Sudden severe abdominal, back, flank or groin pain

-- Blood in your stools

-- Chest pain or shortness of breath

-- Generalized weakness, dizziness or fainting

-- Local weakness, numbness, pain or coolness of one leg