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| Aortic Aneurysm, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
Aortic aneurysm is a disease characterized by distension of the aortic blood vessel. Distension can occur in the aorta in the abdomen, chest, or both. The aorta is the main and largest blood vessel in the human body. These blood vessels function to drain oxygen-rich blood from the heart to the rest of the body. The aorta has thick walls, so it can maintain its shape even though the blood pressure inside is quite high.
In the case of an aortic aneurysm, the wall of the aorta weakens so that it cannot hold the blood pressure in it. This causes the aorta to distend. This swelling can occur slowly and cause no symptoms.
Symptoms of Aortic Aneurysm
Symptoms of an aortic aneurysm vary and depend on its location. Aortic aneurysms can occur in the aortic vessels of the abdomen (abdominal), chest (thoracic) or both (thoraco-abdominal). Aortic aneurysms in the abdomen are more common than aneurysms in the chest or in the abdomen and chest.
Some cases of aneurysms with distension that are small and do not enlarge often do not cause any symptoms. However, along with the enlargement of the aneurysm will appear complaints and symptoms according to its location.
In abdominal aortic aneurysm (abdominal), some of the symptoms that can be felt by sufferers are:
- Persistent pain from inside the abdomen or on the side of the abdomen
- Back pain
- A throbbing sensation around the navel
In a thoracic aortic aneurysm (thoracic), some of the symptoms that can appear are:
- Cough
- Voice becomes hoarse
- Short breath
- Chest pain or pressure in the chest
- Back pain
A distended aortic vessel can rupture or tear. Signs that an aneurysm ruptures or tears (dissection) are:
- Sudden, severe pain in the abdomen, chest, jaw, arms, or back
- Head dizzy
- Difficulty breathing
- Very fast heart rate
This condition is an emergency condition that must be treated immediately. Otherwise, a ruptured aneurysm can be fatal.
When to go to the doctor
Check with your doctor if you experience the complaints and symptoms as mentioned above.
Consult a doctor if you have risk factors for an aortic aneurysm, such as having hypertension, old age, have a family history of aortic aneurysm, or have a smoking habit. If you have any of these risk factors, an aortic aneurysm can appear without you knowing it.
Rupture of an aortic aneurysm is a dangerous condition. Immediately visit a doctor or ask people around you, both family and friends, to take you to the doctor if you experience symptoms of a ruptured aortic aneurysm.
Causes of Aortic Aneurysm
Aortic aneurysms are caused by weakening of the walls of the aortic vessels. Under normal circumstances, the aorta has a thick wall. The thickness of the aortic wall is useful to withstand the pressure of blood coming out of the heart. However, in some circumstances the aortic wall can weaken and eventually swell.
Until now, the cause of the weakening of the aortic wall is not known with certainty. However, there are several factors that are thought to have triggered the weakening, namely:
- Hardening of the arteries (atherosclerosis)
- Inflammatory diseases of the blood vessels (vasculitis), such as giant cell arteritis and Takayasu arteritis
- Infectious diseases, such as untreated syphilis
- Injury to the aorta
In addition to triggering factors, there are also risk factors for causing a person to develop an aortic aneurysm, namely:
- Have a smoking habit
- Over 65 years old
- Suffering from hypertension
- Having a family member with an aortic aneurysm
- Male gender
- Suffering from aneurysms in other blood vessels
- Suffering from genetic disorders, such as Marfan's syndrome
Diagnosis of Aortic Aneurysm
To diagnose an aortic aneurysm, the doctor will ask the patient's medical history and symptoms. After that, the doctor will perform a physical examination.
If a patient suspects an aortic aneurysm, the doctor will perform a scan to determine the location, size, and severity of the aortic aneurysm. Scan methods that can be performed include CT scans, chest or abdominal X-rays, MRI, and ultrasound.
If needed, the doctor can advise the patient to undergo genetic testing. This test is done to determine whether there is a genetic disorder that increases the risk of an aneurysm.
Aortic Aneurysm Treatment
The goals of treatment for an aortic aneurysm are to prevent the aneurysm from getting bigger and prevent the aneurysm from bursting. If the size of the aneurysm is still small and the patient does not feel any symptoms, the doctor asks the patient to do regular check-ups to monitor the development of the aneurysm.
In addition to routine check-ups, doctors can also prescribe medications to prevent or minimize the risk of aortic rupture.
Some of the drugs that will be given are:
- Statin drugs, to lower cholesterol and reduce the risk of aortic blockage due to atherosclerosis.
- Beta blockers or beta blockers, to lower blood pressure by slowing the heart rate.
- Angiotensin 2 receptor blocking drugs (ARBs), to lower blood pressure if beta-blocking drugs are not working effectively. This drug is often recommended in people with Marfan syndrome.
If the size of the aneurysm has reached more than 5.5 cm, the doctor will perform surgery. Surgery will also be recommended for patients who have a history of aortic dissection or Marfan syndrome in the family, even though the size of the aneurysm is still small. Surgery needs to be done as an emergency treatment if the aneurysm has ruptured or torn.
Some types of surgery to treat aortic aneurysms are:
• Open surgery
This operation is performed by removing the distended part of the aorta and replacing it with a new blood vessel (graft).
• Endovascular surgery
This procedure is less invasive. Endovascular surgery is performed by placing a stent or ring on the aneurysm using a catheter. Stent serves to strengthen the walls of the aortic vessels are weak and prevent rupture of these vessels.
After undergoing surgery, you will be asked to lead a healthy lifestyle. This healthy lifestyle is also beneficial for reducing the risk of aneurysm bursting. What you can do is:
- Quit smoking
- Avoid heavy thoughts that cause stress
- Avoid strenuous physical activity, such as lifting weights
- Reduce fat intake to lower cholesterol levels
These steps can also reduce the risk of aortic aneurysm while preventing the distension of the aortic blood vessels.
Complications of Aortic Aneurysm
The main complication that can be suffered by patients with an aortic aneurysm is tearing or rupture of the aortic wall. Symptoms of a ruptured aortic wall include:
- Sudden severe pain in the abdomen, chest, or back
- Difficulty breathing
- Low blood pressure (hypotension), even to shock
- Pain radiates to the back or to the legs
- Excessive sweating
- Short breath
- Difficulty swallowing
- Nausea and vomiting
- Heart beating fast
- Dizziness and loss of consciousness
In addition, aortic aneurysms can also cause complications such as:
- Aortic regurgitation, which is a condition when the aortic valve does not close completely so that blood flows back into the heart
- The appearance of blood clots that can block blood flow
- Kidney failure due to lack of blood flow to the kidneys
- Inflammation and damage to intestinal tissue due to lack of blood flow to the intestine
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