Bringing Attention to Abdominal Aortic Aneurysm

You are experiencing shortness of breath, dizziness and nausea. Your stomach has a pulsing feeling. You feel a slight bulge in that area. You could have an abdominal aortic aneurysm.

An abdominal aortic aneurysm (AAA) occurs when a portion of the aorta, the large blood vessel that supplies oxygen-rich blood to the abdomen, pelvis and legs becomes abnormally large or bulges outward. The aorta runs from the heart through the chest and abdomen. An aneurysm can develop anywhere along the aorta. When they occur in the upper portion of the aorta, they are known as thoracic aortic aneurysms.

Similarly, when they occur in the lower portion of the aorta, they are called abdominal aortic aneurysms. While an unusual occurrence, when one develops between the upper and lower portion, they are known as thoracoabdominal aneurysms.

Most small and slow-growing aneurysms will not rupture and there will be few, if any, symptoms. The larger the aneurysm, the more likely it will rupture.

Anyone can develop an aneurysm, but they are most commonly seen in males over the age of 60 who have at least one risk factor, such as high blood pressure, obesity, high cholesterol levels, a history of smoking, atherosclerosis or specific genetic factors such as Marfan syndrome, Ehlers-Danlos syndrome, heart-valve problems and injury.

Symptoms of a rupturing AAA can include nausea, vomiting, low blood pressure, loss of consciousness, abdominal or back pain that presents rather suddenly but persistently, clammy skin and a rapid heart rate. Examination by a doctor might reveal a rigid abdomen, a pulsating sensation near the navel or a mass. While a doctor might be able to palpate a mass, he or she may choose to do nothing for a nonrupturing one but monitor its size to determine whether it enlarges.

If it is extremely slow growing, the aneurysm may not require any intervention other than monitoring; however, should blood from the aneurysm leak into the abdominal cavity or if it grows rapidly, surgical repair will likely be necessary unless the risks outweigh the benefits.

If a doctor determines surgery can be avoided, at least temporarily, he or she may prescribe a beta blocker to slow the rate of growth of the aneurysm. You may be prescribed medication to lower your cholesterol level. High levels are associated with plaque, fat deposits (from dietary choices or genetics) and a buildup of atherosclerosis and pressure on arteries.

The best way to detect an AAA is to get a simple, painless, 10-minute ultrasound screening test. All men over age 65 who have ever smoked, and anyone over 65 who has a first-degree relative (father, mother or sibling) who has had an AAA, should be tested. Talk to your doctor about your risks and getting screened.

The surgery is performed “inside out.” Instead of major abdominal surgery, the surgeon makes a small incision in the groin and then with the help of catheters (small tubes) and X-ray machines, he or she inserts an endograft into the AAA, thus repairing it from the inside.