Abdominal aortic aneurysm

What is an aortic aneurysm?

An aneurysm is a bulge or weakness in your blood vessel. When this happens in the aorta (one of the main blood vessels in the body), it’s called an aortic aneurysm.

The bulge in the aorta happens when part of your blood vessel wall grows weak. Aneurysms usually start small and then get bigger. They usually grow slowly.

Sometimes aneurysms burst and cause bleeding inside your body. Because the aorta is such a large blood vessel, this can be very dangerous and is often fatal (causes death).

What are the types of aortic aneurysm?

The aorta is a blood vessel about the thickness of a garden hose. It carries blood from your heart through the centre of your chest and into your abdomen (tummy).

Aortic aneurysms can form anywhere along the length of your aorta. But they are most common in the lower part. This is called an abdominal aortic aneurysm.

An aneurysm that forms in the upper part of your aorta (in the chest) is called a thoracic aortic aneurysm.

What are the symptoms of an abdominal aortic aneurysm?

Sometimes people with an abdominal aortic aneurysm may have:

• pain in their abdomen, groin or back
• a throbbing feeling near their belly button

But aortic aneurysms usually don’t have any symptoms until they burst.

Signs of a possible aortic aneurysm in the chest include:

• pain in your chest or back
• difficulty swallowing
• difficulty breathing
• coughing or being hoarse

What causes abdominal aortic aneurysms?

People with abdominal aortic aneurysms have problems with the wall of their aorta. Several different mechanisms are thought to cause these problems with the artery wall.

Things that can increase your risk of abdominal aortic aneurysms include:

• smoking
• having a family member with an abdominal aortic aneurysm
• increasing age
• being male
• having certain conditions, such as Marfan syndrome
• having high blood pressure
• having cardiovascular disease (for example, coronary heart disease or peripheral vascular disease)
• having high cholesterol

Research into the cause of abdominal aortic aneurysms is ongoing.

When should I see my doctor?

If you have symptoms of a burst aortic aneurysm, call triple zero (000) for an ambulance.

Symptoms of a burst abdominal aortic aneurysm include:

• severe pain in your tummy, back or side
• a pulsating mass in your tummy
• swelling of your tummy

You may also have other symptoms including:

• being pale and sweaty
• feeling fai

How are abdominal aortic aneurysms diagnosed?

Because most people do not have any symptoms, abdominal aortic aneurysms are usually found:

• when they burst (rupture)
• during a medical examination for another reason
• through screening tests

Screening tests are tests that are done to find a condition early, before it causes symptoms.

There is no official screening program in Australia for abdominal aortic aneurysms. But your doctor might suggest an ultrasound scan of your tummy if you have a higher chance of having an abdominal aortic aneurysm.

Imaging tests used to detect an abdominal aortic aneurysm include:

• ultrasound scan
• CT scan
• MRI scan

These imaging tests can show an abdominal aortic aneurysm and how big it is.

How are abdominal aortic aneurysms treated?

Monitoring

Small aneurysms that are not causing symptoms don’t usually need treatment. You will need to see your doctor and have ultrasound or CT scans regularly to keep an eye on the aneurysm.

Surgery

Surgery may be recommended for larger abdominal aortic aneurysms. That’s because they are more likely to burst. You might also need surgery if your aneurysm is smaller but is growing quickly or causing other problems.

Until recently, the only treatment for an aortic aneurysm was open surgery. This is a major operation that repairs the faulty part of the aorta with a graft (an artificial blood vessel).

Some people may now be able to have a graft inserted into the aneurysm through small cuts in the groin. This is called endovascular surgery. It is not suitable for all types of aortic aneurysm.

Ruptured abdominal aortic aneurysm

Ruptured abdominal aortic aneurysms are a medical emergency. They need immediate treatment with surgery. Unfortunately, the chances of survival are small once an aneurysm has burst.

Can abdominal aortic aneurysms be prevented?

Smoking is the most important risk factor for developing an abdominal aortic aneurysm. So, if you are a smoker this is another reason to quit.

Treatment to lower your blood pressure and cholesterol can also help slow the growth of an abdominal aortic aneurysm.

Complications of abdominal aortic aneurysms

If you have an abdominal aortic aneurysm, your doctor may recommend tests to check for other aneurysms. This includes thoracic aortic aneurysms.

Surgical treatment for abdominal aortic aneurysms can lead to complications. Your surgeon will discuss possible side effects with you.

Blood clots are another possible complication of abdominal aortic aneurysms.