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Aortic aneurysm is an abnormal expansion of aorta, main artery of the body, due to weakening of its walls. Abdominal aortic aneurysm is manifested by abdominal pain. Aortic aneurysm develops if there was irreversible expansion of blood stem lumen.
Doctors differentiate true and false aorta aneurysm. True aneurysm is mainly characterized by thinning and extreme bulging of all layers of aorta. False aneurysm has the same symptoms as true aneurysm with a difference that it is formed by connective tissue. False aneurysm usually develops because of pulsating hematoma, which could be a result of trauma or postoperative complications.
Other specific complications of aortic aneurysms are gaps of aneurysmal sac, which are in most cases accompanied by internal bleeding and extreme bruising. A person can also develop aneurysm thrombosis and thromboembolism of the arteries.
Although this disease can be asymptomatic, in general, aneurysms have unfavorable prognosis due to high risk of death from aortic rupture or thromboembolic dysfunctions. Probability of rupture of an aortic aneurysm with a diameter of 5 cm is 50%, with a smaller diameter is 25% per year. Early detection and surgical treatment of the aortic aneurysms can lower significantly mortality rate and bring good long-term results.
Aortic aneurysms can be completely asymptomatic or accompanied by painful symptoms. Aortic aneurysm symptoms are:
Symptoms may be accompanied by compression of stomach and duodenum. Often patients complain of increased pulsation in abdomen. Patients with aortic insufficiency can also have shortness of breath, tachycardia, and dizziness. If aneurysm is large, there can also be swelling of face and upper body. In some cases aneurysm of aorta leads to compression of esophagus, and then a person has such manifestations of disease as hoarseness (dysphonia), dry cough, bradycardia, and excessive salivation.
Diagnostic methods for detection of the aortic aneurysm mainly include X-ray, general examination, ultrasound, and tomography. Auscultatory sign of aneurysm is the presence of systolic murmur in the place of aorta expansion. Such murmur can be heard through stethoscope. Abdominal aortic aneurysm can, in most cases, be detected by palpation of abdomen.
In case of asymptomatic non-progressive aortic aneurysm only limited dynamic observation and constant X-ray control are required. To reduce the risk of complications, a patient can also be advised to undergo hypotensive and anticoagulant therapy to eliminate the risk of clot forming and to lower cholesterol.
Surgical intervention is necessary in abdominal aortic aneurysms with a diameter greater than 3.5 cm. Also aneurysms of thoracic aorta need to be surgically repaired. Surgical treatment of aneurysms includes aneurysmal excision of the modified portion of the vessel. Some patients need replacement of vascular prosthesis. Usually surgery is done under local or general anesthesia. Most common types of surgery are:Replacement of prosthetic abdominal aorta is a sutureless resection of aorta and its replacement with plastic tube.
If not treated on time, aortic aneurysms can be complicated by rupture with the development of massive bleeding, collapse and acute heart failure. Rupture of aneurysms can occur in pericardial and pleural cavity, esophagus and abdomen. At the same time a person can develop severe, sometimes fatal condition of hemopericardium.