Albert Einstein is one of the well known persons to have died from this condition.
It has been referred to as
the silent killer, a ticking time bomb inside the abdomen, or more recently, a
U-boat in the belly. Death is almost certain where this condition is undiagnosed and then ruptures.
AAA is the 13th cause of death in America, killing the same number of persons that die from more well known diseases like breast cancer or HIV.
Being a white male, aged over 60, a smoker and the presence of hypertension and a genetic predisposition are by far the most consistent predicator of vulnerability to this disease.
A simple ultrasound scan can pick up this condition and an effective treatment can be arranged to avert an untimely death.
Abdominal aortic aneurysm (AAA) or aneurism is the abnormal widening and outward ballooning of a part or parts of the big blood vessel that carries blood from the heart down the body, called the aorta as it runs through the abdomen.
The aorta is the main blood vessel that carries blood directly from the heart through the chest and abdomen where it later divides into the right and left iliac arteries, that take blood to the legs. The aorta is the largest blood vessel in the body. It starts off from the left part of the heart, curves or arches downwards and backwards and continues down the chest (thorax).
In the chest, it is known as the Thoracic Aorta. A ballooning or aneurysm can occur here. If it does, it is called thoracic aortic aneurysm.
The aorta continues its downward course, passes through a natural opening in the diaphragm at the level of the tenth thoracic vertebra (spine bone) and becomes the abdominal aorta.
The most common site of ballooning of the aorta all across it's course is in the abdomen, just below the kidneys. The aorta gives off several major branches as it passes from the chest through the abdomen before it divides into iliac vessels. Two of such branches are the arteries to the right and left kidneys called the renal arteries.
Aneurysm of the abdominal aorta has been classified into a number of types. Such classifications are done on the basis of:
This is the most important way of classifying an abdominal aneurysm. Treatment options for aneurism of the abdominal aorta is based mainly on the size. There are three types of AAA described using size classification. They include:
There are two forms of aneurysm of the abdominal aorta based on shape. They are
It is clearly helpful to know the shape, because treatment with antifungal medications may be needed if it is thought to be important in the aetiology of the disease.
Depending on the number of the walls of the aorta involved, aortic aneurysms can be described as true or false aneurysm.
Aneurysm of the abdominal aorta could extend to involve one or both terminal branches (iliac arteries)
The exact cause of aortic aneurysm (AAA) is not known. However, the following factors are thought to contribute to the formation of an abdominal aneurysm:
In the UK and US, abdominal aneurysm is believed to be present in 3 out of every 100 individuals after the age of 50. About 6 men are affected for every woman found with this disorder, and four times commoner in whites compared to blacks. It is also commoner after the age of 50, with a peak incidence around 70 years of age.
Other risk factors for abdominal aneurism include:
It is believed that having diabetes protects you against developing this condition.
Abdominal aneurysm often do not cause any symptoms at the initial stage, unless they become large enough (up to 3 to 5cm). Aortic aneurysms are often accidentally picked up during routine examination or scans or X-ray for other medical reasons.
The common symptoms of abdominal aneurysm include:
These symptoms or combination of them could vary greatly from one person to the other. If you suspect that you might be having abdominal aortic aneurysm, please contact your doctor immediately. It is a serious surgical emergency, if it ruptures.
The exact size or point at which an operation is absolutely necessary for an aneurysm of the aorta is not known with certainty. However, it is generally agreed that a surgical repair of an aneurysm should take place if the abdominal aortic aneurism is more than 4.0cm.
Results from screen programs suggest that at 5.5cm, everyone with this condition should have it repaired. If at 3.5cm though, there is lower abdominal pain, or any symptoms with the aneurysm, then repair is warranted.
A planned repair of an aneurysm is best. The survival rate is about 98%. This is in sharp contrast to an emergency repair, following a burst, where successful operation rate drops from less then 50 percent to zero!
There are two main treatment options for repair of an abdominal aneurysm:
It is generally agreed that the endovascular repair is safer, and more appropriate for a planned surgery especially if the aneurysm is below the kidney level, and it is not already ruptured.
Do you or a close relative suffer with AAA? How was this diagnosed, and what size is it at the moment? Did you suffer with any symptoms? How was it treated - surgery, watchful waiting or EVAR (minimally invasive surgery)? Any complications?
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