An abdominal aortic aneurysm (AAA) is a condition where a section of the abdominal aorta—the large blood vessel that supplies blood from the heart to the rest of the body—becomes enlarged or weakened. This bulging or ballooning of the artery wall can grow over time, and if left untreated, it can rupture, leading to life-threatening internal bleeding. AAAs are most common in men over the age of 65, especially those with a history of smoking or heart disease.
Symptoms and Causes
Symptoms: AAAs often grow slowly and may not cause noticeable symptoms in their early stages. However, as the aneurysm enlarges, symptoms may develop, such as:
- A pulsing sensation in the abdomen, similar to a heartbeat
- Deep, constant pain in the abdomen or the side of the abdomen
- Lower back pain
- Pain radiating to the groin or legs
In some cases, the first sign of an AAA may be a sudden rupture, which is a medical emergency and can cause:
- Sudden, severe abdominal or back pain
- Dizziness or fainting
- Rapid heart rate
- Sweating and shock
Causes: While the exact cause of AAA isn’t always clear, certain risk factors increase the likelihood of developing the condition:
- Smoking: The biggest risk factor for AAA, as it weakens the aortic walls.
- Age: Risk increases with age, particularly in people over 65.
- Gender: Men are more likely to develop AAAs than women.
- Family History: A family history of aneurysms increases your risk.
- High Blood Pressure: This increases the pressure on the aortic walls, potentially causing them to weaken.
- Atherosclerosis: The build-up of plaque in the arteries can damage the aortic walls, contributing to aneurysm formation.
Diagnosis and Treatment
Diagnosis: Since AAAs may not cause symptoms, they are often detected incidentally during imaging tests for other conditions, such as ultrasounds, CT scans, or MRIs. If AAA is suspected, your doctor may recommend:
- Abdominal Ultrasound: The most common test used to screen for and diagnose AAA. It’s non-invasive and quickly shows the size and location of the aneurysm.
- CT Scan or MRI: These provide more detailed images and are used to assess the aneurysm’s size and potential risk of rupture.
Treatment: The treatment approach depends on the size and rate of growth of the aneurysm:
- Monitoring: Small aneurysms (less than 5 cm in diameter) that are not causing symptoms may only require regular monitoring with ultrasounds every 6-12 months to check for changes in size.
- Lifestyle Changes and Medication: For small or stable aneurysms, doctors may recommend lifestyle changes (such as quitting smoking and controlling blood pressure) and medications (like blood pressure or cholesterol-lowering drugs) to prevent further growth.
- Surgery: If the aneurysm is large (greater than 5.5 cm) or growing rapidly, surgical intervention is typically recommended. There are two primary surgical options:
- Open Surgery: The damaged section of the aorta is replaced with a synthetic graft.
- Endovascular Aneurysm Repair (EVAR): A less invasive procedure where a stent graft is inserted through small incisions in the groin and guided to the aneurysm to reinforce the weakened area.
When to See a Physician
You should seek medical advice if you experience any of the following:
- A pulsing sensation or unexplained pain in your abdomen or lower back.
- Family history of abdominal aortic aneurysm, especially if you’re over 65.
- Risk factors such as smoking, high blood pressure, or atherosclerosis, particularly if you’re over 65.
- You’ve been told you have an aneurysm and need guidance on managing it.
Immediate medical attention is necessary if you experience sudden severe abdominal or back pain, dizziness, fainting, or other signs of a possible aneurysm rupture, as this is a life-threatening emergency.
Benefits of Early Diagnosis and Treatment
- Prevention of Rupture: Early detection allows for timely treatment, significantly reducing the risk of rupture, which can be fatal.
- Minimally Invasive Options: If diagnosed early, less invasive procedures like EVAR can be performed, resulting in shorter recovery times and lower risk compared to open surgery.
- Improved Outcomes: Regular monitoring and lifestyle changes can slow or stop the aneurysm’s growth, allowing many patients to avoid surgery altogether.
