Abdominal Aortic Aneurysm (AAA)

An abdominal aortic aneurysm (AAA) is a condition where the aorta, the main blood vessel that carries blood from the heart to the rest of the body, becomes weakened and bulges out in the abdominal region. This bulge, or aneurysm, can rupture and cause severe bleeding, which can be life-threatening.

What is the Aorta?

The aorta is the largest artery in the body, originating from the heart and extending down to the abdominal region, where it divides into two smaller arteries that supply blood to the legs. The aortic wall is made up of three layers: the intima (the innermost layer), the media (the middle layer), and the adventitia (the outermost layer). In an AAA, the media layer becomes weakened, allowing the aneurysm to form.

Symptoms

Many people with an abdominal aortic aneurysm do not experience any symptoms until the aneurysm ruptures. However, some individuals may notice:

• Pain in the abdomen or back
• Tenderness or a pulsating sensation in the abdomen
• Difficulty walking or standing due to pain
• Shortness of breath
• Coldness or numbness in the legs
• Weakness or fatigue

Risk Factors

Certain factors increase the risk of developing an abdominal aortic aneurysm, including:

• Aging (AAA is more common in people over 60 years old)
• Smoking
• High blood pressure
• High cholesterol
• Obesity
• Family history of AAA
• Previous heart disease or stroke
• Diabetes

Diagnosis

An abdominal aortic aneurysm can be diagnosed using:

• Ultrasound imaging: to visualize the aorta and measure the size of the aneurysm
• Computed Tomography (CT) scan: to provide detailed images of the aorta and surrounding structures
• Magnetic Resonance Imaging (MRI): to create detailed images of the aorta and surrounding structures
• Angiography: to visualize the blood vessels and diagnose any blockages or aneurysms

Treatments

The goal of treatment is to prevent the aneurysm from rupturing. Treatment options include:

• Watchful Waiting: monitoring the size and growth of the aneurysm with regular ultrasound scans, usually recommended for small aneurysms (less than 5.5 cm in diameter)
• Surgical Repair: open surgery to replace the weakened section of the aorta with a graft, usually recommended for large aneurysms (greater than 5.5 cm in diameter) or those that are growing rapidly
• Endovascular Aneurysm Repair (EVAR): a minimally invasive procedure where a stent-graft is inserted through the femoral artery and guided to the aneurysm, usually recommended for patients who are not good candidates for open surgery
• Lifestyle Modifications: quitting smoking, exercising regularly, maintaining a healthy weight, and managing blood pressure and cholesterol levels to reduce the risk of aneurysm growth and rupture

Complications

If left untreated, an abdominal aortic aneurysm can rupture, leading to:

• Severe internal bleeding
• Shock
• Organ failure
• Death

Prevention

To reduce the risk of developing an abdominal aortic aneurysm, it is essential to:

• Quit smoking
• Maintain a healthy weight
• Exercise regularly
• Eat a balanced diet low in saturated fats and high in fruits and vegetables
• Manage blood pressure and cholesterol levels
• Get regular check-ups with a healthcare provider, especially if you have a family history of AAA

Frequently Asked Questions (FAQs)

What is an abdominal aortic aneurysm?
A bulge in the aorta, the main blood vessel that runs from the heart through the abdomen.

What causes an abdominal aortic aneurysm?
Usually due to atherosclerosis, high blood pressure, or genetic conditions.

What are the symptoms of an abdominal aortic aneurysm?
Often none, but may include abdominal pain, back pain, or tenderness.

How is an abdominal aortic aneurysm diagnosed?
Typically with ultrasound, CT scan, or MRI.

What is the treatment for a small abdominal aortic aneurysm?
Monitoring with regular imaging tests.

What is the treatment for a large abdominal aortic aneurysm?
Surgery to repair or replace the aorta.

What are the risks of an untreated abdominal aortic aneurysm?
Rupture, which can be life-threatening.

Can an abdominal aortic aneurysm be prevented?
Controlling risk factors like high blood pressure and smoking may help.

Who is at risk for an abdominal aortic aneurysm?
Men over 60, smokers, and those with a family history.

Is an abdominal aortic aneurysm painful when it ruptures?
Yes, severe abdominal or back pain often occurs.