An aneurysm is a bulge or ballooning that occurs when part of an arterial wall weakens. This medical event can occur in any artery and may develop over many years without warning symptoms. Once detected, doctors may monitor an aneurysm; sometimes, they choose to perform surgery to place a stent to reinforce the arterial wall or coil or clip it to lessen the risk of rupture.
If an aneurysm bursts, it is a medical emergency and can have devastating effects.
Many things can contribute to a thoracic aortic aneurysm. The risk of having one increases as you age, and they are most common in adults over 65. There appears to be a genetic component, as people with a parent, sibling, or child with this condition have a one in five chance of developing it, too.
Some genetic disorders increase the risk of a thoracic aortic aneurysm, including Ehlers–Danlos syndrome and Marfan syndrome. Health conditions, including COPD, high cholesterol, heart disease, trauma, and some bacterial infections, can lead to this type of aneurysm, as can smoking and stimulant use.
Most thoracic aortic aneurysms are asymptomatic, though some patients experience chest pain, difficulty breathing, or hoarseness. In rare cases, there are signs of heart failure or coughing up blood.
Other possible symptoms include feeling full after not eating much, pulsating pain in the abdomen, and swelling in the face, neck, or arms.
Cerebeal aneurysms affect the blood vessels in the brain, typically at areas where the arteries branch off, as these points are the weakest.
Sometimes, cerebral aneurysms are present from birth. Risk factors include connective tissue disorders, arterial malformations, untreated high blood pressure, smoking, drug abuse, and being over 40.
Data from the American Association of Neurological Surgeons indicates that more than half of people with this type of aneurysm are asymptomatic, but symptoms of an unruptured cerebral aneurysm include headaches, seizures, visual defects, weakness, and facial pain.
If the aneurysm has ruptured, the most common symptom is a subarachnoid hemorrhage or bleeding into the space between the brain and the membranes surrounding it.
Abdominal aneurysms usually occur in the aorta in the section that passes through the abdomen. The most common risk factor is atherosclerosis, which is when plaque builds up inside the arteries.
Other risk factors include advanced age, smoking, connective tissue disease, HIV, and syphilis. These aneurysms are most common in white males.
Most abdominal aneurysms are asyptomatic and discovered incidentally during an evaluation for something else. As the aneurysm grows, it may cause pain in the abdomen, back, or flank or problems with the bowel and bladder.
A ruptured abdominal aneurysm is a medical emergency, but the symptoms vary. Some people go into shock after previously experiencing abdominal pain and distentions, but most die before they arrive at the hospital.
Depending on location and size, there are multiple ways to treat an aneurysm. Stent placement reinforces the arterial wall while diverting blood from the weakened area, making it less likely to rupture.
A clipping procedure involves the surgeon placing a clip across the neck of the aneurysm, preserving blood flow and preventing any more blood from entering the space. Another option is coiling, when a coil is placed inside the aneurysm to take up space and prevent more blood from entering.
Femoral artery aneurysms affect the femoral artery in the hip and may develop on both sides, although true femoral artery aneurysms are rare.
Popliteal artery aneurysms are rare, too, and may be a symptom of an abdominal aortic aneurysm. Anyone with a popliteal artery aneurysm, which occurs in the artery behind the knee, should also be examined for an abdominal aortic aneurysm.
A false aneurysm or pseudoaneurysm is caused by damage to the arterial wall that results in a hematoma in the vessel. This hematoma creates turbulent blood flow, which leads to the development of a wall from a buildup of clotting factors. Catheter insertion and trauma are two common causes of false aneurysms.
The main complications of any aneurysm are bleeding and rupturing. When this happens, internal bleeding results and, depending on the size of the aneurysm, can be life-threatening. Signs of a rupture include rapid heart rate, low blood pressure, and sudden pain or a tearing sensation.
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