Diseases

Aneurysm – Causes, Symptoms & Treatment

Aneurysm

An aneurysm is a permanent enlargement of an artery in the shape of a spindle or sac. It can be congenital or acquired. This enlargement of the arteries can occur when there are changes in the vessel wall at certain points in the vessel.

What is an aneurysm?

The term aneurysm comes from the Greek and means “expansion”. This is a congenital or acquired, localized, permanent, fusiform or saccular enlargement of an artery due to a bulging or widening of the vessel wall. There is a risk that the dilated blood vessel will rupture and life-threatening internal bleeding will occur.

Aneurysms are more common in older people. Risk factors for this are high blood pressure and hardening of the arteries (arteriosclerosis). If an aneurysm ruptures, only life-saving surgery can help. An extensive aneurysm near the heart or in the brain is life-threatening because it threatens to rupture as a result of the increased pressure on the vessel wall and internal bleeding can result. In this case, life-saving surgery is essential.

Classification:

  • true aneurysm – all three layers of the wall of the artery bulge
  • Split aneurysm – bleeding into the vessel walls splits the vessel walls and injures the middle layer of the vessel
  • Fake aneurysm – the bulge that occurs as a result of vessel wall injuries, for example during catheter interventions for the diagnosis and treatment of heart diseases.

causes

An aneurysm can have a variety of causes. The most common cause of a true aneurysm is hardening of the arteries. Infections are much less common .

For example, syphilis can cause artery dilation in the main artery (aorta), which carries blood from the heart to the systemic circulation. Other infections are more likely to affect arteries distant from the heart.

An aneurysm can form in the wall of the heart as a result of a heart attack or parasitic Chagas disease. A false aneurysm is a possible consequence of catheter procedures. In a ruptured aneurysm, the middle layer of vessels, the media, of the artery is injured.

Symptoms, Ailments & Signs

Many people are affected by an aneurysm and never find out about it in their entire lives. You have no symptoms and the aneurysm does not lead to any disease or complications. The number of unreported cases cannot be recorded statistically.

However, it is more likely that an aneurysm will cause symptoms sooner or later. This usually happens when it grows. This means that the bulge it forms expands and gets bigger. It then presses on other parts of the brain, causing discomfort and disruption there. These depend on the location of the aneurysm.

For example, the speech center can be affected – the patient then increasingly suffers from speech – and also word-finding disorders. He forgets words and concepts and finds it difficult to formulate complete correct sentences. The sentence is often broken off halfway through without the patient realizing this.

For example, if the aneurysm presses on the visual center, visual impairments are to be expected. This can affect both visual acuity and the field of vision itself. Eye flickering and loss of three-dimensional vision are common signs of an aneurysm.

If the sense of balance is impaired, it is difficult for the patient to control his gait and his body. The result is tripping and falling. All of these signs point to neurological deficits and abnormalities.

Course

Symptoms of an aneurysm only appear when there is extensive vasodilatation of a specific artery. An aneurysm of the main artery in the chest area can, for example, cause difficulty swallowing, coughing, hoarseness, breathing difficulties and circulatory problems in the arms or in the brain.

Symptoms of an abdominal aortic aneurysm may include back pain, pain radiating down the legs, alternating urination with diarrhea or constipation. Rarely, the aneurysm also makes itself felt through a throbbing “bump” in the abdomen. If the wall of a split aortic aneurysm ruptures, a sudden, crushing pain occurs.

In this case, the emergency doctor must act immediately. When arteries that are distant from the heart expand, there is a risk of blood clots forming , which can then travel to the heart or lungs and cause an embolism . An aneurysm in the brain can have serious consequences because it can press on cranial nerves and cause them to fail.

complications

An aneurysm can form anywhere in the body and, depending on where it is located, can cause serious complications. If the blood clot is not recognized and treated in time, the blood flow to vital organs and limbs is no longer guaranteed. There is a risk of blood congestion, embolism and stroke.

If a supplying or branching area closes or the vascular wall of the aneurysm bursts, for example at the head or near the heart, the affected person’s life is in danger. The help measures that are then initiated immediately cannot rule out permanent damage such as paralysis or irreparable functioning of the brain.

The risk group for the formation of a blood clot is broad. Older and young people are equally affected, as are accident victims. A blood clot cannot be removed with alternative methods. The doctor alone decides on the type of operation and therapy. A surgical procedure can result in greater blood loss.

If the clot is removed from the head, it may be necessary to prevent cerebrospinal fluid hemorrhage with a ventricular drainage. If the symptom is recognized and removed in time, further measures must be taken to avoid inflammation, cardiovascular problems and bacterial penetration into the wound. Depending on the severity of the procedure, swallowing difficulties and shortness of breath may occur. Patients can counteract complications by following subsequent medication and a healthy lifestyle.

When should you go to the doctor?

If an aneurysm is suspected, medical advice should be sought immediately. A quick visit to the doctor is recommended if you experience chest pain, coughing or abnormal breathing sounds that occur suddenly and cannot be attributed to any other cause. Sudden hoarseness, difficulty swallowing or shortness of breath are also warning signs that should be clarified as soon as possible. If there is severe abdominal pain or bleeding, the aneurysm may have already ruptured – by then at the latest, an ambulance must be called.

In the event of a sudden drop in blood pressure or circulatory shock, first aid measures must be taken before the emergency doctor arrives . A doctor’s visit is almost always necessary for an aneurysm. If the vasodilatation has already been diagnosed by a doctor, the typical warning signs must be observed.

If there is a suspicion that the aneurysm has ruptured, the only option is to go to the emergency room. In general, if you have inexplicable numbness and coldness in your limbs or other symptoms that cannot be attributed to a specific cause, you should consult a doctor. Prompt treatment can usually prevent further complications.

Treatment & Therapy

In the case of an aortic aneurysm: If the aneurysm is not that large or the risk of surgery is too high, the doctor can treat risk factors such as high blood pressure with medication ( beta blockers ) and advise the patient to avoid physical exertion and ensure regular digestion.

Surgery is unavoidable for a larger aneurysm or uncontrollable high blood pressure . The expanded part of the vessel is replaced with a plastic prosthesis. Newer procedures also allow a smaller (minimally invasive) intervention, in which the surgeon inserts a stabilizing stent prosthesis, a kind of umbrella, into an artery via a catheter ], which can then be opened up in the vessel.

In the case of a brain aneurysm: Neurosurgeons take care of an aneurysm in the brain. In the past, they clamped the aneurysm with a clip during open surgery or reinforced the vessel wall with tissue or Teflon. Today it is also possible to intervene in the vessels in the brain via the inguinal artery and stabilize the vessels in such a way that the risk of tearing is averted.

Outlook & Forecast

As a rule, an aneurysm has a very negative effect on the patient’s quality of life and, in the worst case, can even lead to the death of the affected person.

An aneurysm usually causes diarrhea or constipation, along with a strong urge to urinate. In most cases, these symptoms do not go away on their own, so they do not heal themselves. Not infrequently, the aneurysm also leads to coughing and shortness of breath, which can lead to a loss of consciousness. Difficulty swallowing can also occur and thus significantly reduce or complicate the intake of liquids and food.

Whether the aneurysm is treated usually depends on the severity of the disease. In some cases, the risk of an operation is too high, so that the treatment takes place exclusively with the help of medication. In this way, the complaints can be limited. However, it cannot be ruled out that the patient’s life expectancy will be reduced as a result of the disease.

Furthermore, in serious cases, an operation cannot be avoided. Complications cannot be predicted universally. In some cases, the affected person is dependent on a catheter after the operation.

prevention

Preventing an aneurysm is only possible to a limited extent. It is important to avoid or treat risk factors such as high blood pressure, smoking , alcohol , obesity and high blood lipid levels as far as possible. Living a healthy lifestyle, eating right, and getting enough exercise is definitely a sensible approach to preventing aneurysms from developing.

aftercare

After the treatment of an aneurysm, regular follow-up care by a neurosurgeon or neurologist is required in the first few months. A so-called echocardiography is often carried out at the check-up appointments, with which the function of the aortic valve can be checked. In the beginning, these examinations usually take place once a week, then only once a year.

After the operation, many patients also have to take medication such as rhythm-stabilizing drugs or painkillers. After the hospital stay, which normally lasts seven to nine days, rehabilitation often takes place. In addition, those affected should eliminate risk factors as far as possible.

Nicotine should be avoided completely, as this can cause vasoconstriction and the clip can become unstable. Furthermore, the blood pressure should also be adjusted very well. Here, too, regular checks and, if necessary, treatment of the blood pressure with medication are necessary.

If patients suffer from diabetes mellitus, the doctor treating them must also adjust them properly, since diabetes that is not optimally controlled could have negative effects on the blood vessels. In general, a healthy lifestyle should be maintained, which means that those affected should exercise regularly, avoid nicotine and eat a healthy diet.

You can do that yourself

Patients with an aneurysm have regular check-ups with a specialist doctor to monitor the condition of the deformity and to react to critical innovations in a timely manner. Even outside of medical care, the patients pay close attention to their physical condition and register potential changes in the aneurysm.

Since patients with aneurysms can have an emergency at any time, those around them must be informed about the disease and possible first-aid measures . In the case of an aneurysm, a medical emergency usually manifests itself in a collapse of the circulatory system, with the blood pressure dropping rapidly at the same time.

Many patients with aneurysms receive medicinal substances to treat and prevent complications, which must be taken according to the doctor’s prescription. In addition, a healthy lifestyle adapted to the disease helps to potentially avoid or minimize complications and worsening of the disease.

A significant risk factor for an existing aneurysm, for example, is high blood pressure. To help themselves, the patients reduce their excess weight and also adapt their diet to the symptom. If you have an aneurysm, it is also beneficial to stop smoking . Alcohol consumption should also be greatly reduced and, if possible, stopped altogether.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.