Aortic Aneurysm

An aortic aneurysm is a bulge that develops in the wall of the aorta, the artery responsible for carrying oxygen-rich blood from the heart to the rest of the body.

Depending on the affected segment of the aorta, aneurysms are classified as:

• Abdominal aortic aneurysm: The most common type. It occurs in the portion of the aorta that runs through the abdominal cavity.
• Thoracic aortic aneurysm: Occurs in the segment of the artery that extends from its origin in the heart to where it exits the thorax through the diaphragm.

Depending on the shape of the aneurysm, the types include:

• Saccular aortic aneurysm: A sac- or balloon-shaped dilation located on one side of the arterial wall.
• Fusiform aortic aneurysm: A dilation affecting the entire aortic wall. This is the most common type.

Aortic aneurysms continue to grow if left untreated, increasing the risk of rupture and death. However, when detected and monitored in time, the life expectancy of patients is the same as that of healthy individuals with similar characteristics.

Symptoms

Aneurysms generally grow slowly and do not usually cause noticeable symptoms. As the aneurysm enlarges, the following symptoms may appear:

Abdominal Aortic Aneurysm:

• Intense, persistent abdominal pain.
• Back pain.
• Pulsating sensation in the stomach area.
• Early satiety.
• Urinary discomfort.
• Swelling or circulation problems in the lower extremities.

Thoracic Aortic Aneurysm:

• Hoarseness or loss of voice.
• Chronic cough.
• Difficulty or discomfort when swallowing.
• Shortness of breath.
• Back pain.
• Chest pain.

Causes

An aneurysm occurs due to the weakening of the arterial wall caused by an inflammatory process with various origins:

• Hardening of the arteries due to atherosclerosis.
• High blood pressure.
• Diseases that cause inflammation of blood vessels, such as Takayasu arteritis or giant cell arteritis.
• Genetic disorders, such as Marfan syndrome, Ehlers-Danlos syndrome, Turner syndrome, and Loeys-Dietz syndrome.
• Bicuspid aortic valve.
• Bacterial or fungal infections of the aorta.
• Untreated prior infections, such as salmonella or syphilis.
• Trauma or injuries.

Risk Factors

The risk of developing an aortic aneurysm increases in the following cases:

• Smoking: Considered the most significant modifiable risk factor.
• High blood pressure.
• High cholesterol levels.
• Obesity.
• Diabetes.
• Sedentary lifestyle.
• Age: More common after age 60.
• Sex: More frequent in men.
• Use of stimulants, such as cocaine.
• Family history.
• Personal history of aneurysm.

Complications

The primary complication of an aneurysm is its continued growth, which may lead to rupture. A ruptured aortic aneurysm can cause potentially fatal internal bleeding or a stroke. If the aneurysm ruptures, acute symptoms may include:

• Sudden and intense pain in the affected area.
• Rapid heart rate.
• Low blood pressure.
• Difficulty breathing.
• Dizziness or loss of consciousness.

Additionally, aneurysms may lead to aortic dissection, a medical emergency in which a tear occurs, separating the layers of the arterial wall. This can result in wall rupture or a blockage of blood flow.

Aortic aneurysms also increase the risk of blood clot formation, which can detach and travel to block another blood vessel in the body, restricting blood flow and leading to severe consequences.

Prevention

To reduce the risk of developing aneurysms or prevent their growth, it is essential to address modifiable risk factors:

• Avoid smoking.
• Reduce consumption of foods high in salt, saturated fats, and cholesterol.
• Maintain healthy blood pressure levels.
• Avoid the use of stimulant substances.

Which Doctor Treats Aortic Aneurysms?

Aortic aneurysms are evaluated and treated by specialists in cardiovascular medicine and surgery.