Aortic aneurysm

Aortic aneurysm: causes, symptoms, diagnosis and treatment

An aortic aneurysm is a limited expansion of the aortic lumen due to stretching and protrusion of its wall. This is a serious disease that can be asymptomatic or manifest with various symptoms depending on the location and size of the aneurysm. In this article we will look at the causes, symptoms, diagnosis and treatment of aortic aneurysm.

Causes of aortic aneurysm

An aortic aneurysm can occur for various reasons, but most often it is associated with atherosclerosis, a chronic disease of the arteries in which cholesterol plaques form on their walls. In addition, the risk of developing an aortic aneurysm increases with diseases such as syphilis, nonspecific aortoarteritis, trauma, and congenital connective tissue diseases (for example, Marfan syndrome).

Symptoms of aortic aneurysm

Symptoms of an aortic aneurysm depend on its location and size. A thoracic aortic aneurysm may be asymptomatic, but its symptom may be aortalgia, which occurs when the para-aortic nerve plexuses are irritated. This pain can be aching, pressing, sometimes bursting and appears at rest or with little physical activity.

With a significant size of the thoracic aortic aneurysm, signs of compression may appear, such as headache, swelling of the head and neck, swelling of the jugular veins (superior vena cava syndrome), unilateral edema, cyanosis and swelling of the superficial veins of the arm (with compression of the right or left brachiocephalic artery), cough, inspiratory dyspnea, stridor breathing (with compression of the trachea, bronchi), swallowing disorders (with compression of the esophagus), hoarseness, aphonia (with compression of the left recurrent nerve with a cut in the vocal fold), unilateral ptosis, narrowing of the pupil and palpebral fissure, retraction of the eye apple (Horner's syndrome with compression of the thoracic, part of the sympathetic trunk).

In the vast majority of cases, an abdominal aortic aneurysm is located below the origin of the renal arteries. It can be asymptomatic or manifest as pain in the left half of the abdomen, mesogastrium with irradiation to the epigastric and lumbosacral regions (a consequence of compression on the spinal cord). Symptoms associated with poor circulation in the abdominal organs may also be observed, such as abdominal pain after eating, nausea, vomiting, constipation, diarrhea, and impaired renal function.

Diagnosis of aortic aneurysm

To diagnose an aortic aneurysm, various research methods are used, including ultrasound, CT, MRI, and angiography. Ultrasound can be used for screening, but CT and MRI provide more accurate results. Angiography can be used to clarify details of the anatomy and determine the size of the aneurysm.

Treatment of aortic aneurysm

Treatment for an aortic aneurysm depends on its size and location. Small aneurysms may be asymptomatic and require only dynamic observation. However, large aneurysms may require surgery to prevent rupture. Currently, various treatment methods are used, such as open and endovascular surgery. In open surgery, the aneurysm is removed and replaced with an artificial prosthesis. In endovascular surgery, the aneurysm is closed using a special prosthetic system that is inserted through the vessels of the legs.

In any case, treatment of an aortic aneurysm should be individualized and prescribed only by a qualified cardiac surgeon or angiosurgeon based on the diagnostic results and clinical picture.