Abdominal Aortic Aneurysm- Symptoms and Repair
It is possible to feel the pulse just above the navel area especially in thin individuals. This pulse actually originates from the aorta, the main artery which supplies blood to the entire body. Aorta comes out directly from the heart and goes downwards.
Most of the time it is normal to feel aortic pulse in thin individuals. But occasionally, it may signify a serious problem called Abdominal Aortic Aneurysm (AAA).
What Is Abdominal Aortic Aneurysm?
Abdominal aortic aneurysm involves a widening, stretching, or ballooning of the aorta. The exact cause is unknown, but risks include atherosclerosis and hypertension. Some causes of an abdominal aortic aneurysm are injury, infection, or congenital weakening of the connective tissue component of the artery wall.
Abdominal aortic aneurysm can affect anybody, but it is most often seen in men 40 to 70 years old.
Complications
A common complication is ruptured aortic aneurysm. This is a medical emergency where the aneurysm breaks open, resulting in profuse bleeding.
Aortic dissection occurs when the lining of the artery tears and blood leaks into the wall of the artery. An aneurysm that dissects is at even greater risk of rupture.
Prevention lies in avoiding blunt trauma to the abdomen, atherosclerosis, and hypertension.
Symptoms
- Presence of abdomen hernia or mass in midline , pulsating (rhythmic throbbing) with pain to touch.
- Pulsating sensation in the abdomen.
- Pain in the abdomen – severe, sudden, persistent or constant; not colicky or spasmodic; may radiate to groin, buttocks, or legs;
- Abdominal rigidity
- Pain in the lower back; severe, sudden, persistent; It may radiate.
- Paleness
- Rapid pulse
- Dry skin/mouth
- Excessive thirst
- Anxiety
- Nausea & vomiting
- Lightheadedness occurs with upright posture.
- Fainting occurs with upright posture.
- Excessive sweating
- Clammy skin
- Fatigue (tiredness or weariness) developing recently.
- Heartbeat sensations
- Rapid heart rate (tachycardia) when rising to standing position.
- Impaired ability to concentrate
- Shock symptoms
Aneurysms may develop slowly over many years and often have no symptoms. If the aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel (aortic dissection), the above symptoms may develop suddenly.
Signs and Tests
Listening to the abdomen with a stethoscope (auscultation) shows a blowing murmur over the aorta or a whooshing sound (bruit). Physical examination of the abdomen is performed.
Abdominal aortic aneurysm may show on these tests:
- Abdominal X-ray
- Abdominal ultrasound
- MRI of abdomen
- CT scan-abdominal
- Angiography of aorta
Treatment
If the aneurysm is small and there are no symptoms (for example, if the aneurysm is found during a routine physical examination), periodic evaluation to watch for changes may be recommended.
Symptomatic aneurysms may require treatment to prevent complications.
Antihypertensive medications may be prescribed to reduce blood pressure.
Surgical repair or replacement of the section of aorta is often recommended. The goal of treatment is timely surgical intervention before complications develop.
The risk of complications increases as the size of the aneurysm increases. Because surgery for abdominal aortic aneurysm is risky, the surgeon may wait for the aneurysm to expand to a certain size before operating (that is, when the risk of complications exceeds the risk of surgery).
Expectations (Prognosis)
The probable outcome is good when an aneurysm is monitored carefully and if surgical repair is performed before the aorta ruptures. Aortic rupture is life threatening. Less than 50% of all people with a ruptured abdominal aortic aneurysm survive.
Complications
- Aortic rupture
- Bleeding from the aorta
- Hypovolemic shock
- Arterial embolism
- Insufficient circulation past the aneurysm
- Irreversible damage to the kidneys (kidney failure)
- Myocardial infarction
- Stroke
- Aortic dissection
