What Are the Warning Signs and Symptoms of an Aortic Aneurysm?
Symptoms, causes, risk factors and treatments
Symptoms, causes, risk factors and treatments
An aortic aneurysm is a medical condition characterized by a bulge in the body’s main artery, the aorta. It is caused by a weakened or damaged wall in the aorta and should always be taken seriously.
It's important to know if you are at risk for an aortic aneurysm and understand the symptoms and treatment options. Aortic aneurysms may not show symptoms until they become large, tear or rupture and become life threatening.
A ruptured aortic aneurysm is a serious medical emergency that can cause internal bleeding. Symptoms include sudden, intense pain in the abdomen or back, low blood pressure and a racing pulse.
“When an aneurysm bursts, immediate care is critical,” says Jeffrey Weiss, MD, a vascular surgeon at Scripps Clinic Anderson Medical Pavilion in La Jolla.
“You might experience lightheadedness, dizziness, sharp pain in the chest, back or abdomen,” he says. “Other conditions may be causing these symptoms, so it’s important to find the cause and receive proper treatment.”
Vascular surgeons can diagnose and treat aortic aneurysms before they become serious health problems.
What are types of aortic aneurysms?
Aortic aneurysms can occur anywhere along the aorta in the chest, abdomen, or pelvis. The most common type is abdominal aortic aneurysm. About 200,000 people are diagnosed with this type each year, according to the Society for Vascular Surgery.
Thoracic aortic aneurysms are less common but can also be deadly. They occur in the upper part of the aorta, in the chest area above the diaphragm.
Symptoms of a growing aortic aneurysm
Symptoms of aortic aneurysms can vary depending on their size and severity. Most aneurysms start small and don’t cause symptoms. They are often found during a routine checkup or screening.
Other aneurysms can grow fast and pose problems. The bigger and faster they grow, the more likely they are to burst. If you have a growing aortic aneurysm, you might feel constant deep pain in your back or stomach areas. You may also notice a pulse near your bellybutton.
What is an aortic dissection?
A growing aortic aneurysm can also lead to tear in the aorta's wall, a serious condition called aortic dissection. The tear can allow blood to leak between the artery walls, narrowing the artery. This can block or reduce flow from the heart to other parts of the body. Symptoms of aortic dissection may resemble those of a heart attack and can be life threatening.
Aortic dissections or aortic aneurysms were the cause of nearly 10,000 deaths in 2019, according to the Centers for Disease Control and Prevention (CDC).
Seek emergency help if you or someone else is experiencing aortic dissection symptoms, including:
- Sudden severe chest or back pain
- Stomach pain
- Loss of consciousness
- Shortness of breath
- Stroke-like symptoms, such as sudden vision issues, difficulty speaking and weakness or paralysis on one side of your body
- Weak pulse in one arm or leg compared to the other
- Leg pain
- Difficulty walking
What causes aortic aneurysms?
Several health issues and behaviors can increase the risk, including:
- Tobacco: Smoking is responsible for 75% of abdominal aortic aneurysms, according to the CDC. Smoking can weaken the walls of blood vessels and the more you use tobacco, the greater the risk.
- Atherosclerosis: Also known as hardening of the arteries, this occurs when fat and plaque buildup on the walls of a blood vessel.
- High cholesterol: This condition can contribute to the formation of atherosclerosis.
- Hypertension: Also known as high blood pressure, it can damage and weaken the walls of the aorta, leading to an aneurysm.
- Blood vessel diseases or infections: Some diseases cause inflammation of the blood vessels, which makes them weaker.
- Trauma: Accidents and blunt force trauma can cause an aortic aneurysm.
- Connective tissue disorder: People with genetic connective tissue disorders like Marfan syndrome and Ehlers-Danlos syndrome can get aortic aneurysms.
- Family history: If a parent or sibling has had one, your risk is 10 times greater than average.
“If aortic aneurysms run in your family, speak with your doctor about getting a screening test, which can help detect an aneurysm early before it can become a serious problem,” Dr. Weiss says.
Other risk factors
Age: Aortic aneurysms most often affect people 65 and older.
Sex: Aortic aneurysms are much more common among men than women.
Having other aneurysms: An aneurysm in another large blood vessel may increase the risk of developing an aortic aneurysm.
Screening and diagnosis
Finding aortic aneurysms early is important to prevent issues and improve treatment. Screening is crucial, especially for those with a high risk.
Your doctor will do a physical exam to check for an aortic aneurysm. They may use tests like ultrasound, echocardiogram, CT scans and MRI. These tests take pictures of the aorta. They can show how big the aneurysm is before it can become a problem.
“If you are at risk for an aortic aneurysm, we may prescribe medicine to lower your blood pressure and reduce the stress on your blood vessels,” Dr. Weiss says. “We also may order an ultrasound test to scan for aneurysms, especially if you are over 65 and a former or current smoker.”
Treatment for aortic aneurysm
Aortic aneurysm treatment depends on the size of the aneurysm and how quickly it is growing. “Small aneurysms may be monitored through regular physical exams and imaging tests,” Dr. Weiss says. “Large or ruptured aneurysms may need surgery.”
Types of surgery
There are two main types of surgery for aortic aneurysm: open abdominal or chest surgery and endovascular repair.
Open surgery involves removing the damaged section of the aorta and replacing it with synthetic material, called a graft. Endovascular repair, a less invasive procedure, uses a catheter to insert a stent graft into the aorta to reinforce the weakened section.
Vascular disease care at Scripps
At Scripps, vascular surgeons work with other specialists to help patients with their condition.
“Aortic aneurysm patients benefit from multi-disciplinary care like that found at Scripps,” Dr. Weiss says. “Vascular surgeons, cardiac surgeons, cardiologists and radiologists all collaborate to ensure that the best care pathway is chosen.”