Aortic aneurysm is the case of the formation of a sac as a result of regional enlargement of the artery originating from the left heart and called the aorta. Sudden tears may occur at these enlargement points, which can often be seen in hypertensive patients over 60 years of age. This is known as aortic rupture, or aortic dissection.
What is the aorta?
The aorta is the largest artery in our body and emerges from the left heart. The aortic vein is located at the point where the cleaned oxygen-rich blood in the lungs is pumped from the heart to the body tissues. In this vein, which is located in the center of the blood circulation, an average of 5 liters of blood per minute is pumped in adults.
The aorta consists of four parts: the ascending aorta, the aortic arch, the descending aorta, and the abdominal aorta. Abdominal aorta is the name given to the abdominal part of the vessel. The severity of the symptoms of aortic vessel rupture varies according to the vessel section where the rupture occurred. Tears that occur in areas closer to the heart progress with more severe symptoms that can be fatal.
Aortic aneurysm causes and risk factors
The risk of developing aortic aneurysm increases with age. This is because the vessel wall structure changes over the years. The vascular wall loses its elasticity as the age progresses and its resistance to pressure on the vessel wall decreases.
In more than 50% of cases, atherosclerosis, ie arteriosclerosis, is the cause of aneurysm. It is also common in patients with high blood pressure. High blood pressure causes tension in the vessel wall and prepares the ground for aneurysm. Hypertension is also a risk factor for atherosclerosis.
Bacterial infections may play a role as another causative factor in aneurysm development. The infection causes inflammation in the vessel wall and paves the way for aneurysm. This marsupization caused by infection is called mycotic aneurysm.
Among the less common causes of aortic aneurysm is vascular wall inflammation seen in diseases such as tuberculosis and syphilis. There is an increased risk of aortic aneurysm in some congenital genetic diseases such as Marfan syndrome and Ehler-Danlos syndrome.
What are the symptoms of aortic aneurysm?
Aneurysm that develops in the abdominal region of the aorta usually does not cause any symptoms at the beginning and therefore cannot be detected at an early stage. However, in the course of time, the size of the aneurysm increases and compresses the surrounding tissues and organs and causes complaints. In this case, symptoms related to the digestive system such as pain on the legs and back and indigestion are seen.
If aneurysm has occurred in the chest area of the aorta, symptoms such as chest pain, cough, shortness of breath, hoarseness and swallowing problems are seen.
What are the symptoms of aortic rupture?
The larger the aortic aneurysm, the higher the risk of rupture. Especially dangerous are abdominal aortic aneurysms more than 6 centimeters in diameter and chest area aneurysms more than 5.5 centimeters in diameter. After the rupture of the aneurysm, a very severe pain occurs in the chest or abdomen that radiates to the back. These complaints are accompanied by nausea. Strong internal bleeding quickly causes circulatory shock. Therefore, fast and effective treatment is essential.
How is aortic aneurysm diagnosed?
Doctors often discover an aortic aneurysm when performed for another purpose or during a routine examination. For example, an abdominal aortic aneurysm is often detected during an abdominal ultrasound examination performed for another reason. During listening with a stethoscope, flow sounds created by the blood on the vessel wall can be heard.
An aortic aneurysm in the chest area is usually discovered incidentally on a chest radiograph taken for other purposes. A more accurate result is obtained by making a heart echo. Other parts of the aorta can also be clearly seen with this examination.
Detailed data on the size and severity of the aortic aneurysm can be obtained by computed tomography (CT), magnetic resonance imaging (MRI) or angiography.
How is aortic aneurysm treated?
Treatment depends on the size of the aneurysm. Small-diameter aneurysms that do not cause any symptoms are followed up at regular intervals. In hypertensive patients, blood pressure values are kept within normal limits with treatment. Aneurysms larger than 6 centimeters in the abdomen and 5.5 centimeters in the chest area are surgically treated. The enlarged vessel area is surgically removed and a stent placed in its place.