Abdominal Aortic Aneurysm

An abdominal aortic aneurysm (AAA) is caused by dilation of the aorta secondary to weakening of all layers of the aortic wall. A leaking AAA generally causes intense pain that can be confused with the pain of a renal stone.

Causes

Main factors that can increase your risk of AAA include:

• Being a man older than 60 years
• Having an immediate relative, such as a mother or brother and any family member, who has had AAA
• High blood pressure
• Smoking
• If you do little physical activity
• overweight

Risk of developing AAA increases as you age. Aaneurysm are much more common in men than in women. If your any relatives had an aneurysm, tell your doctor arrange a screening exam.

Symptoms

• Severe abdominal pain ++++
• Flank or back pain with radiation to the groin or legs
• Syncope

Signs

• Pulsatile abdominal mass ++++
• Diffuse abdominal tenderness
• Abdominal bruit ++
• Hypotension(late finding) +++
• Hematuria ++
• Flank ecchymosis (late sign)
• Evidence of peripheral embolization +
• Ischemic lower extremities
• High output cardiac failure (rare)
• GI bleed (rare)

Treatment

Aneurysm larger than 5cm wide, surgery is usually advised. For larger aneurysms the risk of rupture is usually higher than the risks of surgery. However, this will depend on your personal state of health. For some people the risks of surgery will still outweigh the benefits. Doctor advise you if surgery is the best treatment for you.

The medical treatment of aortic dissection includes aggressive control of blood pressure and heart rate while the aorta heals. The risk of death with medical treatment of descending thoracic aortic dissection is about 10 percent. If surgery is required, however, the risk is higher at about 30 percent. Every effort is therefore made to treat these patients with medication.

Once the acute dissection has healed, adequate control of blood pressure may eliminate the need for surgery. Lifelong monitoring of diameter of the aorta is required because a previously dissected descending thoracic aorta may enlarge and rupture.