ANEURYSMS Abnormal widening of an artery

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You often hear of some sudden deaths being attributed to aneurysm. An aneurysm refers to the abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. Aneurysms can occur in any blood vessel.

It is not clear what causes aneurysm but experts say some aneurysms are present at birth (congenital). Defects in some of the parts of the artery wall may be responsible. High blood pressure, high cholesterol and cigarette smoking may raise one’s risk of aneurysm.

The symptoms depend on the location of the aneurysm. If the aneurysm occurs near the body’s surface, pain and swelling with a throbbing mass is often experienced. An aneurysm within the body or brain often causes no symptoms. If an aneurysm ruptures, pain, low blood pressure, a rapid heart rate, and lightheadedness may occur. The risk of death after a rupture is high.

Types of aneurysms

Cerebral aneurysm: Occur when the wall of a blood vessel in the brain becomes weakened and bulges or balloons out. In most cases, cerebral aneurysm develops as one gets older and in particular past the age of 40. They are more common in women than in men.

Thoracic aortic aneurysm: Is the abnormal bulging or ballooning of the portion of the aorta that passes through the chest. The most common cause is atherosclerosis or hardening of the arteries. Thoracic aortic aneurysms are rare, occurring in approximately six to 10 per every 100,000 people. About 20 per cent of thoracic aortic aneurysm cases are linked to family history. Your risk is higher if you have certain genetic syndromes as you age, if you smoke and if you have high blood pressure.

Abdominal aortic aneurysm: Occurs when the large blood vessel (the aorta) that supplies blood to the abdomen, pelvis and legs becomes abnormally large or balloons outward. This type of aneurysm is most often found in men over the age of 60.

The rupture of an abdominal aortic aneurysm is a medical emergency and only about 20 per cent of patients survive. Seek immediate medical attention if you have extreme pain in your belly or back that does not go away.

Common locations for aneurysms include:

The major artery from the heart (the aorta)

The brain (cerebral aneurysm)

In the leg behind the knee (popliteal artery aneurysm)

Intestine (mesenteric artery aneurysm)

An artery in the spleen (splenic artery aneurysm)

Diagnosing an aneurysm

Some of the physical examinations and tests healthcare providers use to diagnose an aneurysm include:

Computed tomography (CT) scan: A CT scan, a specialized X-ray exam, is usually the first test used to determine if you have bleeding in the brain. The test produces images that are 2-D “slices” of the brain.

Screening for brain aneurysm: The use of imaging tests to screen for unruptured brain aneurysm is generally not recommended. However, you may want to discuss with your doctor the potential benefit of a screening test if you must have one.

Ultrasound: A physician may use a special technique called Doppler ultrasound to examine blood flow through the aorta.

Treating the disease

Treatment depends on the size and location of the aneurysm. Your doctor may only recommend regular checkups to see if the aneurysm is growing. Surgery may be done depending on symptoms and the size and type of aneurysm.

Surgery may involve a large (open) surgical cut. However, some patients may have endovascular embolisation – a procedure to treat abnormal blood vessel such as stenting. A stent is a tiny tube used to prop open a vessel or reinforce its wall. This procedure can be done without a major cut, so you recover faster than you would with open surgery.

Expert Advice…

The following precautions can help to prevent aneurysms or their complications:

Keeping one’s blood pressure in check

Eating a healthy diet

Exercising regularly

Keeping your cholesterol at a healthy level

Quitting smoking

Published in March 2017

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