Aneurysm

Overview

An aneurysm is a bulge or ballooning in the wall of a blood vessel. It happens when a part of the blood vessel wall becomes weak and stretches outward. An aneurysm can occur in different parts of the body, such as the brain (cerebral aneurysm), the chest, or the belly (abdominal aortic aneurysm). If an aneurysm grows too large or bursts, it can cause dangerous internal bleeding.

Aneurysms are not extremely common, but they are not rare either. Abdominal aortic aneurysms are the most common type, especially in men over 65. Brain aneurysms affect around 1 in 50 people at some point in their lives.

Aneurysms occur more often in older adults, especially men over 65. People with high blood pressure, high cholesterol, or who smoke are at higher risk. Some rare genetic conditions can cause aneurysms in younger people and sometimes in children.

Symptoms

Common symptoms

• Most small aneurysms cause no symptoms at all.
• If an aneurysm presses on nearby nerves or organs, you may feel pain or discomfort in that area.
• A brain aneurysm may cause eye pain, double vision, or a droopy eyelid if it presses on a nerve.
• A large belly aneurysm may feel like a pulsating lump in the stomach area.

Symptoms in children

• Aneurysms in children are very rare and usually linked to genetic conditions such as Marfan syndrome.
• Symptoms depend on the location, but may include headache, stomach pain, or feeling tired.
• Children with unexplained symptoms like these should be checked by a doctor as soon as possible.

Symptoms in older adults

• Older adults may notice a pulsing feeling in their belly or pain in the back, belly, or sides.
• A sudden onset of pain in the belly or back can be a warning sign of an enlarging or leaking aneurysm.
• Some older adults are diagnosed through a routine screening scan even without symptoms.

Causes

Main causes

• Weakening of the blood vessel wall, which can happen naturally with age.
• High blood pressure, which puts constant strain on the vessel wall.
• Atherosclerosis, a condition where fatty deposits build up inside arteries and damage them.
• Injury or trauma to a blood vessel.
• Some inherited conditions, such as Marfan syndrome or Ehlers–Danlos syndrome, that affect connective tissue.

Risk factors

• Smoking tobacco.
• High blood pressure that is not well controlled.
• High cholesterol levels.
• Being over the age of 60.
• Being male.
• Family history of aneurysm.
• Being white or of Scandinavian descent (for abdominal aortic aneurysm).

When to see a doctor

See a doctor urgently if:

• If you have any symptoms that suggest a leaking or bursting aneurysm, call your local emergency number immediately. Do not wait to see a doctor in clinic.

Book a routine appointment if:

• If you have a family history of an aneurysm, especially in a parent or sibling, talk to your doctor about whether you should have a screening scan.
• If you have symptoms like new belly, back, or chest pain that keeps coming back, make an appointment to get checked.
• If you feel a pulsing lump in your belly, seek medical advice within a few days.

Diagnosis

A doctor may suspect an aneurysm after asking about your symptoms and doing a physical exam. The main way to confirm an aneurysm is by using an imaging scan to see the blood vessels clearly. Many aneurysms are found by chance when you have a scan for something else.

Tests that may be done

• Ultrasound – often used to look at the belly artery.
• CT scan – gives detailed pictures of blood vessels.
• MRI or MR angiography – useful for brain aneurysms.
• Physical exam – a doctor may feel a pulsing mass in the belly or hear an unusual sound through a stethoscope.

What to expect at your appointment

If your doctor thinks you might have an aneurysm, they will usually refer you for a scan. The scan is painless and takes about 30 minutes to an hour. You may be asked not to eat for a few hours beforehand if it involves contrast dye. After the scan, a specialist will explain whether you have an aneurysm, how big it is, and what your options are. You will not usually need to stay in hospital just for the diagnosis.

Treatment

Treatment for an aneurysm depends on its size, location, and whether it is growing. Small aneurysms are often left alone and monitored with regular scans. Larger aneurysms or those that are causing symptoms may need a procedure to repair the blood vessel and prevent it from bursting. Your care team will talk through the risks and benefits with you.

Self-care at home

• If you smoke, ask your healthcare team about support to quit. This is the single most important step.
• Keep your blood pressure under control with regular checks and any medicines your doctor prescribes.
• Attend all monitoring appointments and scans, even if you feel well.
• Learn the warning signs of a ruptured aneurysm so you can get help fast.

Medical treatments

Medical treatment usually focuses on lowering blood pressure and cholesterol and reducing strain on the blood vessel wall. Your doctor may prescribe medicines to help with this, but you should never start or change any medicine without their advice. They may also recommend regular blood tests and scans to watch for any changes.

When is surgery considered?

Surgery may be recommended if an aneurysm is large, growing quickly, or causing symptoms. The two main types of repair are open surgery, where the weakened section is replaced with a synthetic tube, and endovascular repair, where a small tube (stent) is inserted through a blood vessel in the groin to reinforce the aneurysm. The choice depends on the aneurysm's position and your overall health. Emergency surgery is needed if an aneurysm bursts.

Living with this condition

Living with a small aneurysm means keeping a close eye on it, but it does not have to take over your life. Most people can work, travel, and do normal activities. You will have regular scans to check the size. It is also a good idea to let close family and friends know what to watch for and to keep a list of your medicines and emergency contacts.

Lifestyle tips

• Quit smoking – this is the most important lifestyle change.
• Keep your blood pressure within the range your doctor recommends.
• Avoid heavy lifting or intense straining, as this can temporarily raise blood pressure.
• Manage stress with deep breathing, gentle exercise, or hobbies you enjoy.
• Limit alcohol to the advised safe levels.

Diet and exercise

A heart-healthy diet and regular physical activity help keep your blood vessels strong. Eat plenty of fruits, vegetables, whole grains, and lean proteins, and cut back on salt, saturated fats, and processed foods. Aim for at least 30 minutes of moderate exercise on most days, such as brisk walking or cycling, before starting a new exercise plan. Always talk to your doctor first, and avoid heavy weightlifting or exercises that cause extreme straining.

Mental health and emotional wellbeing

Being told you have an aneurysm can feel worrying. The fear of something happening can sometimes be heavier than the condition itself. It is normal to feel anxious or stressed. Remember that most small aneurysms never burst, and you are taking active steps to stay safe. If anxiety is affecting your daily life, speak with your doctor about support.

Prevention

You cannot always prevent an aneurysm, especially if you have a family history or genetic condition. However, you can lower your risk by keeping your blood vessels healthy. The most powerful steps are not smoking, keeping your blood pressure and cholesterol in a healthy range, and getting regular check-ups.

Screening programmes

Some national health services, like the NHS in the UK, offer a one-time ultrasound screening for abdominal aortic aneurysm to men aged 65 and over. Other types of aneurysm are not routinely screened unless there is a strong family history or genetic condition. Talk to your doctor about whether a screening test is right for you.

Complications

If left untreated

• Bursting (rupture) of the aneurysm, which causes severe internal bleeding.
• Blood clots that can break off and block blood flow to other parts of the body, leading to stroke or damage to organs.
• Pressure on nearby nerves or organs, causing pain or problems with vision, swallowing, or movement.
• In a brain aneurysm, rupture can lead to bleeding around the brain, which is a life-threatening emergency.

Long-term outlook

The outlook for an aneurysm is better than many people think. Most small aneurysms are stable and never rupture. When treatment is needed, modern techniques such as endovascular repair are safe and effective for many people. With regular monitoring and a healthy lifestyle, you can live many active years after an aneurysm is found. Getting it discovered and looked after early is the best protection.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.