An aortic aneurysm is a weak spot in the wall of the aorta, the large blood vessel that carries blood from the heart to the rest of the body. An aortic aneurysm may result in blood clots and if the wall ruptures, it can result in death if not treated immediately. Some 15,000 Americans die suddenly each year from a ruptured aortic aneurysm, which is the ninth leading cause of death in men over age 55.
Aortic aneurysms can develop anywhere in the aorta, but more than three-quarters of them occur in the abdomen. Those that develop in the chest are called thoracic aneurysms. Unfortunately, most aneurysms are asymptomatic until rupture and few aneurysms are discovered early, making them particularly dangerous. If detected early enough, however, greater than 95 percent of aneurysms can be successfully repaired.
Aneurysms can be caused by pressure on a weakened section of the arterial wall, which creates a bulge that stretches out the walls of the aorta. Atherosclerosis is responsible for most cases, due to the buildup of plaque in the arteries, which can weaken the inner layers of the aortic wall. In addition to atherosclerosis, other major risk factors include smoking, hypertension and inherited disorders, such as Marfan Syndrome.
Diagram of an aortic aneurysm.
How is an Aortic Aneurysm Treated?
Small aneurysms should be monitored regularly by your physician, using imaging exams. Aneurysms never go away by themselves and most (about 80 percent) grow larger over time.
Medications may be prescribed to reduce blood pressure in patients suffering from hypertension, so lessen the force of the blood against the wall of the aorta. Surgery is required to repair large or fast-growing aneurysms, since a ruptured aneurysm is a life-threatening condition that can lead to death in minutes.
AORTIC DISSECTION
Diagram of an aortic dissection.
An aortic dissection results when a split occurs in the wall of the aorta, the main artery that carries blood from the heart to the rest of the body. A dissection differs from an aortic aneurysm, which is a weak spot in the wall of the aorta and is more common.
A dissection allows blood to flow between the inner and outer layers of the aortic vessel, potentially blocking blood flow to vital organs such as the brain. A dissection also places the aortic wall at increased risk for rupture, creating an acute, life-threatening condition that can only be treated by immediate surgery.
There are two types of aortic dissection. In type A, the tear occurs in the ascending, or beginning, part of the aorta. A type B is located in the descending, or lower, part of the aorta. A Type A dissection is the more life-threatening of the two and requires swift surgical attention. A Type B dissection can be treated with medical therapy, new stent grafts or surgery, depending on the severity of the disorder.
What Are the Symptoms of Aortic Dissection?
Symptoms of an acute aortic dissection include the sudden onset of severe chest pain — either in the front or back of the chest — sometimes accompanied by sweating. Other symptoms can include faintness, shortness of breath, weakness and fatigue. Some individuals may display no pre-existing symptoms, however, making this disorder especially dangerous and difficult to detect.
Upon medical examination, a physician may find additional physical problems associated with aortic dissection that could include abnormal blood pressure (either high or low); a loss of pulse in an arm or leg due to aortic blockage, and pulmonary edema (fluid in the lungs). A dissection can also lead to stroke and other neurological conditions due to obstruction of the carotid arteries — the two neck arteries that supply blood to the brain.
As experts in the accurate detection and treatment of aortic dissection, the cardiovascular surgeons at Saint John's Heart Institute employ the latest diagnostic tools, treatments and surgical innovations. We have the sophisticated technology and expertise to detect aortic dissections, and our physicians are highly experienced in the surgical repair of a dissection, should immediate surgery become necessary in a life-threatening emergency.