How do aortic aneurysms develop

People with this syndrome often have aneurysms. Aortic aneurysms may cause shortness of breath, a croaky or raspy voice, backache, or pain in your left shoulder or between your shoulder blades. An aortic aneurysm in the stomach area may cause pain or tenderness. You may also have an upset stomach or feel less hungry.

Aneurysms can be detected by physical exam, on a basic chest or stomach x-ray, or by using ultrasound. The size and location can be found through echocardiography or radiological imaging, such as arteriography, magnetic resonance imaging MRI , and computed tomography CAT or CT scanning. Treatment depends on the size and location of your aneurysm and your overall health.

The aorta runs from the heart through the center of the chest and abdomen. The aorta is the largest blood vessel in the body, so a ruptured abdominal aortic aneurysm can cause life-threatening bleeding. Depending on the size of the aneurysm and how fast it's growing, treatment varies from watchful waiting to emergency surgery. Abdominal aortic aneurysms often grow slowly without noticeable symptoms, making them difficult to detect. Some aneurysms never rupture. Many start small and stay small.

Others grow larger over time, sometimes quickly. Aneurysms can develop anywhere along the aorta, but most aortic aneurysms occur in the part of the aorta that's in the belly area abdomen. Several things can play a role in the development of an abdominal aortic aneurysm, including:.

If you're at risk of an aortic aneurysm, your doctor might recommend other measures, such as medications to lower your blood pressure and relieve stress on weakened arteries. Tears in one or more of the layers of the wall of the aorta aortic dissection or a ruptured aneurysm are the main complications.

A rupture can cause life-threatening internal bleeding. When blood moves through the aorta, the aortic wall is stretched and weakened, high blood pressure stresses the aortic wall even more, causing a tear. The two types of aortic aneurysms are:. If aortic aneurysms run in your family, your cardiologist may screen you to check for one. However, weaknesses in the aorta are typically discovered while your doctor is performing physical checkups and testing for other issues.

Several tests can detect aneurysms:. Most aneurysms come with few warnings signs until tearing or rupturing occurs. When that happens, these symptoms can emerge:. Aortic aneurysms can be confused with symptoms of a heart attack. If you have risk factors for developing an aneurysm, your doctor may recommend heart-healthy lifestyle changes to help prevent the condition, including: Avoiding stimulants, such as cocaine Heart-healthy eating Managing stress , which can help lower high blood pressure Quitting smoking , especially cigarette smoking, which is a leading risk factor for developing an aortic aneurysm.

Diagnosis will discuss tests and procedures that your doctor may use to diagnose an aortic aneurysm. Living With will discuss what your doctor may recommend to prevent your aortic aneurysm from becoming larger or causing complications.

Research for Your Health will discuss how we are using current research and advancing research to prevent aortic aneurysm. Signs, Symptoms, and Complications - Aortic Aneurysm. Signs and symptoms. If you do have signs and symptoms of an aortic aneurysm, they may include: Difficult or painful swallowing if the aneurysm is pushing on your esophagus Difficulty breathing if it is pushing on your trachea, or windpipe Feeling full after not eating very much Hoarseness Pain in the neck, jaw, back, chest, abdomen or shoulder, depending on where the aneurysm is located Pulsating or throbbing feeling in your abdomen Shortness of breath if the aneurysm is pressing on your lung Swelling of the face, neck, or arms if the aneurysm is pushing on the superior vena cava.

The superior vena cava is the main vein that returns blood from your upper body to your heart. Signs and symptoms of a rupture may include: Light-headedness Rapid heart rate Sudden, severe pain in your abdomen, chest, or back. Complications from aortic aneurysms may be life-threatening and may include: Aortic dissection, which is a tear in the inner layer of the aortic wall. It causes blood to collect between the inner and middle layers of the aortic wall.

This may lead to rupture of the aorta or not enough blood flow to your organs. Aortic insufficiency and aortic regurgitation, both of which occur when the aortic valve does not close properly because a nearby section of the aorta is enlarged.

This allows some backward flow of blood back into the heart. As a result, your heart must work harder, which may lead to heart failure. Aortic rupture, which causes dangerous bleeding inside the body and can lead to shock Cardiac tamponade Kidney failure from lack of blood flow to the kidneys Lack of blood flow to the bowels, which causes inflammation and injury in the large intestine. Diagnosis will discuss tests and procedures used to detect aortic aneurysms and help rule out other conditions that may mimic aortic aneurysm.

Treatment will discuss treatments and their complications or side effects. Diagnosis - Aortic Aneurysm. Physical exam. During a physical exam, your doctor may do the following to look for an aortic aneurysm: Feel your abdomen to see whether an abdominal aortic aneurysm can be felt Listen to your heart for a heart murmur, softer heart sounds, or other changes in your blood flow that could be a sign of an aneurysm Check your pulse in your arms and legs to see whether it feels weaker than normal Look for signs and symptoms of medical conditions that are risk factors for an aortic aneurysm, such as Marfan or Ehlers-Danlos syndromes.

This may include looking at your skin, muscles and bones, eyes, head and face, and heart. Diagnostic tests and procedures.

Your doctor may order some of the following imaging tests to confirm or diagnose an aortic aneurysm: Computed tomography CT to provide information about the location, size and shape of an aneurysm. This may be the first test you get if you have sudden back or abdominal pain, if you already know you have an aortic aneurysm, or if your doctor feels a pulsating bulge in your abdomen while examining you.

CT can provide information about the entire aorta, but for routine screening other diagnostic tests like echocardiography or ultrasound may be done first. Echocardiography to provide information about the size of the aortic aneurysm and about the thoracic aorta, which is close to heart. Other parts of the thoracic aorta are better seen with other imaging studies such as CT or magnetic resonance imaging MRI.

MRI to provide information about the size, shape, and location of the aneurysm Ultrasound to provide information about the size of the abdominal aortic aneurysm. If you have abdominal or back pain, an ultrasound can check for an abdominal aortic aneurysm or other possible causes of your pain.

Once an aortic aneurysm is seen or suspected on ultrasound, you may have a CT scan or an MRI to provide more details about the shape or location of the aneurysm. Tests for other medical conditions. To help diagnose an aortic aneurysm, your doctor may need to perform CT or ultrasound tests to find out whether your symptoms may be caused by other medical conditions, including: Appendicitis , inflammation of the appendix Cholecystitis, inflammation of the gallbladder often caused by gallstones Hiatal hernia , in which a small part of your stomach comes through the opening in your diaphragm Pancreatitis , inflammation of the pancreas Pericardial disorders , conditions that affect the sac that surrounds your heart Pulmonary embolism, a type of venous thromboembolism.

Return to Risk Factors to review medical, genetic, or lifestyle factors that increase your risk of developing an aortic aneurysm. Return to Signs, Symptoms, and Complications to review common signs and symptoms of an aortic aneurysm. Return to Screening and Prevention to review how to screen for an aortic aneurysm. Treatment - Aortic Aneurysm. Healthy lifestyle changes. Your doctor may recommend heart-healthy lifestyle changes , such as the following: Quitting smoking to slow the growth of the aneurysm Heart-healthy eating to help lower high blood pressure or high blood cholesterol Managing stress to help control high blood pressure, especially for thoracic aortic aneurysms.

Your doctor may also suggest that you avoid heavy weightlifting and powerful stimulants, such as cocaine. Your doctor may recommend medicines to treat an aortic aneurysm, including: Aspirin , especially if you have other cardiovascular risks Blood pressure medicines to lower blood pressure, slow down aneurysm growth, and lower the risk of rupture.

These medicines include beta blockers, angiotensin-converting enzyme ACE inhibitors, and angiotensin receptor blockers ARBs. Statins to control cholesterol levels, and stop or slow the growth of aortic aneurysms. Procedures or surgery. Open surgical repair is the most common type of surgery. You will be asleep during the procedure.

Your surgical team first makes a large incision, or cut, in your abdomen or chest, depending on the location of the aneurysm, then removes the aneurysm and sews a graft in its place. This graft is typically a tube made of leak-proof polyester. Recovery time for open surgical repair is about a month.

Endovascular aneurysm repair EVAR is less invasive than open surgical repair. This is because the surgical cut is smaller, and you usually need less recovery time. EVAR is used to repair abdominal aortic aneurysms more often than to repair thoracic aortic aneurysms.

During the procedure, your surgical team makes a small cut, usually in the groin, then guides a stent graft—a tube covered with fabric—through your blood vessels up to the aorta. The stent graft then expands and attaches to the aortic walls. A seal forms between the stent graft and the vessel wall to prevent blood from entering the aortic aneurysm. Endovascular repair.

The illustration shows the placement of a stent graft in an abdominal aortic aneurysm. In figure A, a catheter is inserted into an artery in the groin.

The catheter is threaded to the abdominal aorta, and the stent graft is released from the catheter. In figure B, the stent graft is expanded and allows blood to flow through the aorta. Possible surgery-related complications. These include: Bleeding and blood loss Blood clots in blood vessels leading to the bowel, kidneys, legs, or in the graft Damage to blood vessels or walls of the aorta when placing the stent graft.

The stent graft may also move after it is placed. Endoleak, which is a blood leak around the stent graft into the aneurysm. Endoleak may cause rupture of the aneurysm if not treated.