16742 Aorta Aortic Aneurysm

Overview

An aortic aneurysm is a bulging or ballooning in the wall of the aorta, the main artery that carries blood from your heart to the rest of your body. If it grows too large, it can become dangerous, so it is important to detect and monitor it early.

Aortic aneurysms are not extremely common, but they become more likely as people age. They are found more often in men and in people over 65.

Aortic aneurysms mostly affect older adults, especially men over 65, smokers, and people with high blood pressure or a family history of aortic aneurysm.

Symptoms

Common symptoms

• Often there are no symptoms at all.
• For abdominal aortic aneurysm: a pulsing feeling in the belly, or deep pain in the back or side.
• For chest (thoracic) aneurysm: chest or back pain, hoarseness, cough, or trouble breathing.

Symptoms in children

• Aortic aneurysms are very rare in children. If present, they may be linked to a genetic condition. Many are found during imaging tests for other reasons.

Symptoms in older adults

• Older adults may have no symptoms, or they may notice a pulsing mass in the belly, back pain, or tiredness.
• Some may have a cough or hoarseness from pressure on the airways.

Causes

Main causes

• The exact cause is not always known, but the main process is weakening of the aortic wall.
• Common causes include hardening of the arteries (atherosclerosis), high blood pressure, and inherited conditions that affect connective tissue.

Risk factors

• Being over 65
• Smoking
• High blood pressure
• High cholesterol
• A family history of aortic aneurysm
• Certain genetic conditions like Marfan syndrome

When to see a doctor

See a doctor urgently if:

• Pain in your belly or back that does not go away
• A strong pulsing feeling in your belly
• Dizziness or light-headedness

Book a routine appointment if:

• If you are over 65 and have risk factors, such as smoking or a family history, ask your doctor about screening.
• If you have high blood pressure or high cholesterol, keep your regular check-ups.

Diagnosis

Aortic aneurysms are often found by chance during an ultrasound, CT scan, or MRI for another reason. An ultrasound is the most common test to measure an abdominal aneurysm.

Tests that may be done

• Abdominal ultrasound
• CT scan
• Chest X-ray (for thoracic aneurysm)

What to expect at your appointment

Your doctor will ask about your medical and family history, then may order imaging tests to measure the size of the aneurysm. They will discuss how often you need follow-up scans, based on the size and growth rate.

Treatment

Treatment depends on the size, location, and growth of the aneurysm, as well as your overall health. The main goals are to prevent growth and reduce the risk of rupture.

Self-care at home

• Quit smoking, or ask your doctor for support with quitting.
• Keep your blood pressure within the range your doctor recommends.
• Attend all follow-up imaging appointments.

Medical treatments

Your healthcare provider may prescribe medicines to control blood pressure or lower cholesterol. Always take medicines as prescribed and talk to your doctor about any concerns.

When is surgery considered?

Surgery is considered when the aneurysm reaches a certain size or grows quickly. The two main types are open surgery (removing the weak section and replacing it with a graft) and minimally invasive surgery using a stent graft. Your doctor will explain which option is safest for you.

Living with this condition

Living with an aortic aneurysm means keeping a close relationship with your healthcare team. Most people can continue their normal activities, but you should avoid lifting heavy weights or intense straining that can increase blood pressure.

Lifestyle tips

• Do not smoke.
• Manage stress with relaxation techniques.
• Limit alcohol.
• Keep regular medical appointments.

Diet and exercise

Eat a heart-healthy diet rich in fruits, vegetables, whole grains, and lean protein. Aim for lighter regular exercise like walking, but avoid heavy lifting or very intense activity. Talk to your doctor before starting any exercise plan.

Mental health and emotional wellbeing

It is normal to feel anxious or worried after learning you have an aortic aneurysm. Talk to your doctor about your feelings and consider joining a support group or speaking to a counsellor.

Prevention

You cannot always prevent an aortic aneurysm, but you can lower your risk by not smoking, managing blood pressure, staying active, and eating well.

Vaccines

Keep your vaccinations up to date, including the flu and pneumonia vaccines, as infections can put extra strain on your heart and blood vessels.

Screening programmes

Screening for abdominal aortic aneurysm is offered in some countries (such as the UK) to men over 65. Ask your doctor if screening is recommended for you.

Complications

If left untreated

• Rupture of the aneurysm, which can cause life-threatening internal bleeding
• Dissection (a tear in the aortic wall)
• Blood clots that can block blood flow to other organs

Long-term outlook

With early detection and regular monitoring, most aortic aneurysms can be managed successfully. If surgery is needed, the outlook is often very good. Your healthcare team will help you understand your individual situation and what you can do to stay healthy.

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