Aortic aneurysm awareness

Overview

An aortic aneurysm is a bulge or ballooning in the wall of the aorta, the body's main artery that carries blood from the heart to the rest of the body. If it gets too large, it can be dangerous because it may burst (rupture) and cause life-threatening bleeding.

Aortic aneurysms are not extremely common, but they affect a significant number of people, particularly men over 65 and those with certain risk factors. The risk increases with age.

Aortic aneurysms most often affect older adults, especially men aged 65 and older. People with high blood pressure, a history of smoking, or a family history of aneurysms are also at higher risk. Some rare genetic conditions, such as Marfan syndrome, can also lead to aneurysms at a younger age.

Symptoms

Common symptoms

• Most aortic aneurysms cause no symptoms and are found during tests for other health issues.
• Some people may feel a deep, constant pain in the belly area (abdomen) or lower back.
• You might notice a pulsating feeling in your abdomen, like a heartbeat.

Symptoms in children

• Aortic aneurysms in children are very rare and usually linked to genetic conditions such as Marfan syndrome or Ehlers-Danlos syndrome. Symptoms are similar to adults but may include chest pain, tiredness, or a hoarse voice.

Symptoms in older adults

• Older adults may experience vague abdominal or back discomfort, but often have no symptoms at all. The aneurysm is sometimes found when they have an ultrasound for other reasons.

Causes

Main causes

• Weakening of the aortic wall over time, often due to atherosclerosis (hardening of the arteries)
• High blood pressure putting extra strain on the artery wall
• Genetic conditions that affect connective tissue, such as Marfan syndrome or Ehlers-Danlos syndrome

Risk factors

• Smoking or using tobacco products
• High blood pressure (hypertension)
• Being male and over 65 years old
• Having a close family member (parent, sibling) who had an aortic aneurysm
• Certain genetic disorders like Marfan syndrome or bicuspid aortic valve

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe pain in your chest, back, or abdomen, call emergency services immediately.
• If you lose consciousness or feel faint with these symptoms, seek emergency care.

Book a routine appointment if:

• If you are over 65 and smoke or used to smoke, talk to your doctor about screening for abdominal aortic aneurysm.
• If you have a family history of aortic aneurysm, even without symptoms, ask your doctor if monitoring is right for you.
• If you notice a pulsating sensation in your abdomen or have ongoing back pain, make an appointment.

Diagnosis

Aortic aneurysms are often found during imaging tests done for other reasons, such as an ultrasound, CT scan, or MRI. Sometimes a physical exam may reveal a pulsating mass in the abdomen.

Tests that may be done

• Abdominal ultrasound – uses sound waves to make a picture of the aorta
• CT (computed tomography) scan – provides detailed cross-section images
• MRI (magnetic resonance imaging) – uses magnets and radio waves to create images
• Chest X-ray – may show a widened aorta (for thoracic aneurysms)

What to expect at your appointment

If your doctor suspects an aortic aneurysm, they will likely order an imaging test. These tests are painless and non-invasive. You may be asked to lie still on a table while a technician takes images. Most scans take less than an hour. Your doctor will then review the results and discuss them with you.

Treatment

Treatment depends on the size, location, and growth rate of the aneurysm. Small aneurysms (usually less than 5 cm in the abdomen) are often monitored with regular ultrasounds. Larger or fast-growing aneurysms may need surgery to prevent rupture.

Self-care at home

• Quit smoking – this is the most important step you can take to slow aneurysm growth.
• Keep blood pressure under control – take any medications as prescribed and monitor your readings.
• Eat a heart-healthy diet low in salt and saturated fat.
• Get regular check-ups to monitor the aneurysm.

Medical treatments

Doctors may prescribe blood pressure medications, such as beta-blockers or ACE inhibitors, to reduce stress on the aortic wall. They may also recommend cholesterol-lowering medications. The goal is to slow aneurysm growth and lower the risk of rupture. Always take medications exactly as prescribed and discuss any side effects with your doctor.

When is surgery considered?

Surgery is usually recommended when an abdominal aortic aneurysm is larger than 5.5 cm (about 2.2 inches) in diameter, or if it is growing quickly (more than 0.5 cm over 6 months). For thoracic aneurysms, the threshold may be slightly larger. Surgery may also be done if the aneurysm is causing symptoms or if there is a leak. The two main types of surgery are open repair (cutting into the aorta and placing a graft) and endovascular repair (inserting a stent graft through a small incision in the groin). Your surgeon will discuss which option is best for you.

Living with this condition

If you have a small aneurysm that is being monitored, you can live a normal life with some adjustments. You will need to attend regular imaging appointments (usually every 6 to 12 months) to check the aneurysm size. Avoid heavy lifting or intense activities that could spike your blood pressure.

Lifestyle tips

• Stop smoking completely – ask your doctor for help if needed.
• Manage stress with relaxation techniques like deep breathing or gentle exercise.
• Avoid straining during bowel movements – eat plenty of fiber and stay hydrated.
• Keep your blood pressure under control with diet and medication if prescribed.

Diet and exercise

A heart-healthy diet is important: focus on fruits, vegetables, whole grains, lean proteins, and low-fat dairy. Limit salt to help control blood pressure. Regular moderate exercise, such as walking or swimming, is generally safe and beneficial. But avoid heavy weight lifting or sudden high-intensity activities. Always check with your doctor before starting a new exercise program.

Mental health and emotional wellbeing

It is normal to feel anxious or worried about having an aneurysm. The fear of rupture can be stressful. Talk to your healthcare team about your concerns. Some people find comfort in support groups or speaking with a counselor. Remember, small aneurysms are often stable and can be managed successfully.

Prevention

You cannot always prevent an aortic aneurysm, but you can reduce your risk. The best steps are to avoid smoking, keep your blood pressure in a healthy range, and maintain a healthy weight. If you have a family history, talk to your doctor about whether screening is appropriate.

Screening programmes

In many countries, including the UK, men aged 65 and over are offered a one-time ultrasound screening for abdominal aortic aneurysm. People with a family history of aortic aneurysms or certain genetic conditions may also be screened earlier. Ask your doctor if screening is right for you.

Complications

If left untreated

• Rupture of the aneurysm, causing severe internal bleeding, which is life-threatening
• Aortic dissection (a tear in the inner layer of the artery wall) that can block blood flow
• Blood clots that can form in the aneurysm and travel to other parts of the body, causing a stroke or other problems

Long-term outlook

The outlook for aortic aneurysm is generally good when it is found early and monitored or treated appropriately. Many aneurysms grow slowly and never rupture. With proper medical care and healthy lifestyle changes, most people with an aneurysm can live a full and active life. If surgery is needed, success rates are high, especially with planned repair. Always work closely with your healthcare team to manage your condition.

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