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. An aneurysm is a bulge or dilatation in the wall of an artery, in this example, the aorta. This happens because there is a weakened spot in the artery wall causing that area to begin to deteriorate. This allows the artery to bulge or balloon out creating the aneurysm. It may remain stable and cause no problems, or it can expand and lengthen. If this happens, it can affect the blood flow to different organs. It may also leak or rupture (break open) and cause internal bleeding and even death.
A number of things can cause aortic aneurysms including:
- Marfan syndrome (An inherited condition that most commonly affects the heart, eyes, blood vessels, and skeleton.)
Risk factors that have been associated with aortic aneurysms include:
- Older age
- Family history
- Elevated cholesterol
- Tobacco use
- Men more than women
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). When there are symptoms, they may be vague, or they can include:
- Deep, steady pain in the abdomen and back
- Pulsating feeling in your abdomen
- Dizziness, fainting
- Low blood pressure
Once there are symptoms, it is important that it be taken care of. An expanding aneurysm causes symptoms of abdomen, back, flank or groin pain, which may come and go at first, or become constant. When an aneurysm ruptures, there can be 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 often be 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 or expanding aneurysms will require surgery. Surgical treatment involves removing the section of aorta where the aneurysm is 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 change 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.
- 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.
- You may return to your usual level of activity.
- 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 and don't add 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 containing 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. No matter how long you've smoked, quitting 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 care
Regular visits to your healthcare provider 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.
When to seek medical advice
Call your healthcare provider if any of the following occur:
- Sudden severe abdominal, back, flank or groin pain
- Blood in your stools
- Weakness or dizziness
- Weakness, numbness, pain or coolness of one leg
The symptoms of a heart attack or stroke can be life threatening. If you see or have any of the following symptoms, call 911 right away:
- Trouble breathing
- Confused or difficulty arousing
- Fainting or loss of consciousness
- Rapid heart rate
- New chest, arm, shoulder, neck or upper back pain
- Difficulty with speech or vision, weakness of an arm or leg
- Difficulty walking or talking, loss of balance, numbness or weakness in one side of you body, facial droop