You might not have had any symptoms, but during a routine physical exam, your doctor felt a soft mass inside your abdomen that pulsed with your heartbeat. After an ultrasound, you received the diagnosis: You have an abdominal aortic aneurysm (AAA).
You’re fortunate the condition was detected: Although AAAs are often harmless, ruptured AAAs cause 15,000 deaths each year in this country. Sometimes, as when television actor John Ritter died from the condition, the aneurysm occurs in the chest. But about 90 percent of the time an aneurysm forms in the abdomen. Three out of four people with an AAA have no symptoms, although some patients may feel kidney pain; intense, intermittent abdominal pain; or a pulsating sensation in the stomach.
As the body’s largest blood vessel, the aorta has the important job of carrying blood from your heart throughout the rest of your body. When the aortic wall in your abdomen weakens or becomes damaged by plaque buildup, it enlarges, causing an aneurysm, or bulge. Aneurysms that grow too large can burst, causing potentially fatal internal bleeding.
Aortic aneurysms occur most often in men older than 65, particularly among those who smoke. Most aneurysms are caused by atherosclerosis—hardening of the arteries, which can result from a fatty, high-cholesterol diet. Other conditions that increase risk besides a poor diet and smoking are high blood pressure, illnesses such as diabetes or syphilis, congenital defects and a family history of aneurysms.
Treatment will depend on the aneurysm’s size and whether it is life-threatening. Most aneurysms are less than 2 inches in diameter and seldom rupture. If you are diagnosed with this type of AAA, your doctor will likely monitor it and prescribe blood pressure–lowering medication. But if you have an AAA that leaks, is small but grows quickly, expands greater than 2 inches or seems about to burst, your doctor can surgically repair the damaged part of your aorta.
During open-abdominal or chest surgery, your doctor will remove the damaged section and sew a synthetic tube, or graft, in its place. Although recovery time is lengthy, this type of surgery is generally successful. Doctors can also use endovascular surgery to reinforce the damaged section by inserting a synthetic tube, or stent, into your bloodstream through an artery in your leg. Because this technique is less invasive than open surgery, it requires a shorter recovery time.
When an aneurysm ruptures, the results can be fatal, so immediate medical attention is needed. Symptoms of a ruptured aneurysm include sudden, severe pain with rapid pulse, sweatiness or clamminess, anxiety, nausea and vomiting, low blood pressure, dizziness, fainting, dry mouth and paleness. Fewer than half of patients whose aneurysms rupture and who make it to emergency surgery survive.
Fortunately, most AAAs rarely reach the point of rupture. Your best bet is to stay as healthy as possible and schedule regular medical exams so your doctor has the chance to detect the condition.