Aortic Abdominal Aneurysm

Aortic Abdominal Aneurysms (AAA) or Triple ‘A’ as they are commonly known as an incidence of 21 cases per 100,000 person-years in the west. There are about 15,000 deaths every year from this disease. What is worse than the incidence of rupture in about 4.4 % and is many cases proves fatal. It is the thirteenth leading cause of death in the west.

An aneurysm is a dilated artery and the aorta is the size of the garden hose pipe connecting the heart with the rest of the body and passing through the mid-line of the chest and the abdomen.

Since it is the main supplier of the blood to the entire body, its rupture leads to life-threatening bleeding.
Depending on its size and the rate of its growth the treatment varies from observation to emergency surgery which is not only very risky but has an exceptionally high mortality.

How do they present?

Mostly the patients are asymptomatic and are diagnosed on an ultrasound of the abdomen performed for some other problem.

Some, however, grow rapidly and it is not possible to predict which ones shall behave this way.

Once large then the patient may note:

  • A pulsatile mass around the belly button.
  • Deep constant ache in the abdomen.
  • Backache.

When to see a doctor?

  • Should you have any of the complaints listed above.
  • Anyone over 60 years who is a smoker and has a family history of AAA should be screened regularly.
  • There are no specific guidelines for females.

Why does it happen?

The exact cause is unknown but there are aggravating factors:

  • Tobacco use – this is the leading cause and directly affects the arteries. It promotes plaque formation, high blood pressure, and causes the aneurysm to grow faster by further damaging the aorta.
  • Atherosclerosis – it is the deposit of fat in the wall of the artery thus increasing the risk of aneurysm.
  • Vasculitis – it is the infection of the arterial wall. It leads to the weakening of the arterial wall leading to the formation of the aneurysm.

Who is more prone?

  • Age – over 65 years is commoner.
  • Tobacco abuse – this is a strong risk factor and the damage to the aorta is directly proportional to the length of smoking.
  • Atherosclerosis –deposit fat in the arterial wall which damages it and increases the risk of the aneurysm.
  • Sex – it is commoner in males.
  • Family history – those with a strong family history have a higher incidence of AAA, at a younger age and greater chances of rupture.

How does one know that the AAA has burst?

  • Sudden pain in the abdomen or back which persists
  • Sweating – cold and clammy
  • Dizziness
  • Nausea and vomiting
  • Unrecordable blood pressure
  • Rapid pulse
  • Loss of consciousness

How can you help yourself?

You can help yourself by making lifestyle changes – by quitting smoking, eating a healthy diet, and exercising daily