aortic aneurysm

description

About 40 out of every 100,000 people suffer from an aortic aneurysm every year. Most often people over the age of 65 are affected. Men develop an aortic aneurysm about five times more often than women. The abdominal aortic aneurysm is particularly common – in about 75 percent of cases, the aneurysm in the region of the abdominal aorta forms below the exit of the renal vessels (infrarenal abdominal aortic aneurysm).

But the main artery in the chest can also be affected by an aortic aneurysm (thoracic aortic aneurysm). Even an aneurysm in the heart is possible. Normally, the aorta in the chest has a diameter of 3.5 centimeters, in the abdominal region of 3 centimeters, but the diameter can more than double by the aortic aneurysm.

Aortic aneurysm: causes and risk factors

The risk of an aortic aneurysm increases with age. The reason is that the structure of the vessel wall changes over the years. It is less elastic and can absorb the high pressure in the main artery more.

In more than 50 percent of cases, vascular calcification (arteriosclerosis) is the cause of an aortic aneurysm. It is also common in people with high blood pressure (hypertension). The high blood pressure loads the vessels and is also a risk factor for arteriosclerosis.

Bacterial infections can also be causally involved in the development of an aneurysm. The infection causes the wall of the vessel to become inflamed and eventually change so that the vessel bulge develops. This is called mycotic aneurysm designated.

Aortic aneurysm: rare causes

Very rare causes of aortic aneurysm are inflammation of the vessel wall, for example in advanced syphilis or tuberculosis. Another possible cause of an aortic aneurysm is a so-called type B dissection, ie a splitting of the individual layers of the vessel wall in the aorta. Doctors also speak of one in the split arterial wall Aneurysm dissecans.

Congenital disorders such as Marfan syndrome or Ehlers-Danlos syndrome can also lead to an aortic aneurysm in congenital connective tissue weakness.

Aortic aneurysm: warning sign

Aortic aneurysm: symptoms in the abdominal area

Usually an aortic aneurysm of the abdominal aorta initially causes no symptoms and is therefore not recognized early. However, when the aneurysm becomes so large that it presses on surrounding structures, discomfort often arises.

An abdominal aortic aneurysm can cause back pain with radiance in the legs as well as indigestion. In rare cases, the doctor palpates the aneurysm in the abdomen as a pulsating tumor under the abdominal wall.

Aortic aneurysm: chest symptoms

An aortic aneurysm in the chest can cause the following symptoms:

• chest pain
• to cough
• hoarseness
• dysphagia
• difficulty in breathing

Bursted aortic aneurysm

The greater the aortic aneurysm, the greater the risk of a tear (rupture). An abdominal aortic aneurysm of more than six centimeters and thoracic aneurysms over five and a half centimeters in diameter are particularly dangerous. The person feels the “bursting” of the aneurysm very severe pain in the chest or abdominal area, which radiate into the back. There are also nausea and nausea. The strong internal bleeding quickly causes a circulatory shock.

Aortic aneurysm – diagnosis and examinations

Doctors often discover aortic aneurysm as part of a routine examination. For example, an abdominal aortic aneurysm is often detected by ultrasound examination of the abdomen. When listening with a stethoscope, flow noises above the vessel lining can be noticed. In lean people, a larger aneurysm of the abdominal aorta may be felt with your hands.

An aortic aneurysm of the thoracic aorta is also usually discovered by chance, most commonly in a chest X-ray. A more accurate picture gives the doctor by heart ultrasound; Parts of the aorta are also clearly visible during this examination.

Details about the size and danger of an aortic aneurysm can be obtained by computed tomography (CT) or magnetic resonance imaging (MRI) and possibly angiography (representation of the vessels).

U-65 screening for abdominal aortic aneurysms

For men over the age of 65, a one-time ultrasound scan for an abdominal aortic aneurysm is recommended. These affect nine out of every one hundred men between the ages of 65 and 75 – and rising. For example, the over-85s are already 22 percent affected. Although an aneurysm rarely tears, but if it does, the patient is in danger of bleeding to death.

Women develop significantly less often an abdominal aortic aneurysm. Affected are 2 percent of women between 65 and 75 and just over 6 percent of over 85-year-olds. Therefore, the investigation is currently not part of the statutory benefits catalog. However, experts also recommend that women with higher risk are also examined. These include smokers and ex-smokers as well as women who have a first-degree relative with an abdominal aortic aneurysm.

Aortic aneurysm: treatment

Aortic aneurysm – OP or wait?

The correct treatment of an aortic aneurysm depends mainly on its size. The doctor controls smaller, asymptomatic aortic aneurysms once a year, larger ones twice a year by means of ultrasound. It is important that the blood pressure remains in the lower normal range (120/80 mmHg). For this purpose, a blood pressure lowering drug may be used.

Other risk factors for an aortic aneurysm such as lipid metabolism disorders, diabetes mellitus or nicotine consumption should be optimally treated or avoided. People with an aneurysm should not lift heavily and should learn to breathe properly under exercise. Concomitant diseases such as bronchial asthma or chronic bronchitis must be treated, as coughing increases the pressure in the vessels.

If an aortic aneurysm reaches a diameter of six centimeters in the abdominal aorta or five and a half centimeters in the chest, the danger of the vessel wall tearing up increases. In this case, an aortic aneurysm must be treated.

Treatment for abdominal aortic aneurysm

In an abdominal aortic aneurysm, there are basically two treatment methods. Which of them is used depends on the location of the aortic aneurysm and the condition of the vessel.

• Stent (endovascular procedure): Via the inguinal artery, the doctor pushes a small tube (stent) up to the wall dressing – with the stent he can stabilize the vessel and bridge the aortic aneurysm.
• Operation: During surgery, the surgeon abdominally removes the dilated portion of the arterial wall and replaces it with a tubular or Y-shaped vascular prosthesis.

Treatment for thoracic aortic aneurysm

When an aortic aneurysm in the chest area is operated in most cases and a vascular prosthesis used. If there is an enlargement close to the heart, the aortic valve often has to be replaced additionally (artificial flap).

Aortic aneurysm: prevention

Healthy diet, adequate exercise, good blood pressure, blood sugar and cholesterol levels and non-smoking can prevent an aortic aneurysm. Have regular check-ups with the doctor, because usually the diagnosis is a chance finding. Through regular health checks, the chance increases aortic aneurysm recognize it before it develops a life-threatening size.