What is an abdominal aortic aneurysm (AAA)?
Abdominal aortic aneurysm (AAA) involves an abnormal widening
or stretching of the abdominal portion of the aorta, usually due to a weak
or damaged area in the wall of the artery. 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 over 40 years of age. AAA occurs less frequently in white women
and African Americans of both sexes. A common complication is "ruptured" aortic
aneurysm. This is a medical emergency where the aneurysm breaks open, resulting
in profuse bleeding. Ruptured aneurysm occurs in approximately 5 out of 10,000
people. 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.
Symptoms:
- abdomen hernia mass, midline, pulsating, with
tenderness 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
- severe, sudden or persistent pain in the lower back
- paleness ·
- rapid pulse or heartbeat sensations
- dry skin/mouth, excessive thirst
- anxiety · nausea & vomiting
- lightheadedness and fainting can occur with upright
posture
- excessive sweating or clammy skin
- recently developed fatigue or tiredness
Aneurysm 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 the above symptoms may develop suddenly.
Signs and Tests:
Listening to the abdomen with a stethoscope shows a "blowing" murmur over
the aorta or a "whooshing" sound. Physical examination of the abdomen is performed.
If a rupture is suspected, physical examination for signs of blood loss and
an evaluation of lower extremity pulses and circulation are performed.
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. Other medications may include analgesics to relieve
pain. 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:
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
- kidney failure
- myocardial infarction
- stroke
- aortic dissection
Prevention
- stop smoking
- control your blood pressure
- begin an exercise program
You should go to the emergency room or call the local emergency number if
you develop severe abdominal pain or other symptoms that are suggestive of
an abdominal aortic aneurysm. Immediate medical attention is crucial.
