The aorta is the body's major blood vessel; it is the largest and main blood vessel in the body that carries and transports blood that contains oxygen from the heart and distributes it to the rest of the body. This blood vessel also distributes hormones and nutrients around the body. The function of the aorta is crucial because this blood vessel is the primary source for supplying blood and oxygen from the heart to all the organs in the body. Furthermore, an aortic aneurysm, also known as an irreversible dilation of the blood vessel, is where the vein or the artery swells to an abnormal size that affects all three wall layers: the intima, media, and adventitia. It is a balloon-like dilatation of the major artery that supplies the chest and torso with blood from the heart. In addition, aortic aneurysms are a condition in which the walls of your aorta, a powerful, durable workhorse, occasionally become weak and swollen. This could cause blood to leak into your body, which is rare, but if it does rupture, it requires immediate surgery to repair the aorta. These types of cases are fatal in about 80% of the cases, and they are most common in men who are over 65.
Types of Aortic Aneurysms
1. Abdominal aortic aneurysm (AAA)
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An abdominal aortic aneurysm starts in the "handle" of your aorta, which is the part of the descending aorta that is situated in the abdomen. It is a swelling of the aorta in the abdomen part of the body. Only the abdominal aorta beneath the diaphragm is affected by abdominal aortic aneurysms. The deterioration of the elastic media of the atheromatous aorta is associated with abdominal aortic aneurysms. The fundamental processes of this illness are unknown; however, an inflammatory cell infiltrate, neovascularization, and the synthesis and activation of numerous proteases and cytokines all contribute to its development.
2. Thoracic aortic aneurysm (TAA)
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A thoracic aortic aneurysm (cardiac aneurysm) can harm the aortic root, climbing aorta, aortic curve, and upper portion of the aorta. This occurs within the area of the aorta that's shaped like an inverted U near the top of your chest. The aortic root, ascending aorta, aortic arch, and descending aorta are the four major segments that make up the thoracic aorta. One or more thoracic aortic segments may be affected by thoracic aortic aneurysms (TAAs).
3. Thoracoabdominal Aortic Aneurysm
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A thoracoabdominal aortic aneurysm, which spreads from the thoracic to the abdominal portions of the aorta because of continuous dilation, can occur in either the chest or the abdomen. Thoracoabdominal aneurysms encompass the descending aorta along with a segment of the abdominal aorta, whereas abdominal aortic aneurysms pertain solely to the abdominal aorta below the diaphragm. The typical diameter of the ascending aorta varies based on factors such as a patient's age, gender (male or female), and body size. An aneurysm denotes the expansion of the aorta to a size that exceeds 1.5 times the anticipated dimension.
Risk factors
Aortic aneurysm risk factors include smoking, advanced age, being born a male, a history of the illness in your family, high blood pressure (hypertension), plaque buildup in the arteries, having a bicuspid aortic valve, suffering a sudden traumatic injury, having high blood cholesterol, and atherosclerosis (hardening of the arteries).
What is the cause of this disease?
The causes of an aortic aneurysm can involve:
Arteritis of the arteries (arterial inflammation): Arthritis is inflammation, swelling, or pain in one or more joints, and the leading cause can be shown by pain and stiffness in the joint that can get worse as you grow older. This can occur when the cartilage undergoes inflammation. The cause of arthritis can vary based on the type.
Atherosclerosis: Atherosclerosis is the narrowing and hardening of the blood vessels caused by plaque accumulation on the walls of the vessels. This can occur due to high blood pressure, diabetes, obesity, high cholesterol, and smoking habits.
Syphilis: Syphilis is an infection that can spread through sexual activity and is caused by the bacteria Treponema pallidum. This can develop in several stages, and the signs and symptoms in every stage are different
Aorta damage: A damaged, punctured, torn, or bruised aorta is called a traumatic aortic injury. This occurs most commonly because of an accident, gunshot, or knife wound.
Hereditary conditions that affect connective tissue, such as Marfan, Loeys-Dietz, and Ehlers-Danlos syndrome
All of the inherited conditions above affect connective tissue.
Marfan syndrome is a genetic mutation issue caused by the FBN1 gene that results in people having abnormally long arms, fingers, and legs.
Loeys-Dietz syndrome is a genetically inherited condition that is caused by several changes in genes associated with the LDS2B gene. Some of the symptoms are eyes that spread widely apart, flat feet, and bruising easily.
Ehlers-Danlos syndrome can affect any connective tissue, such as cartilage, fat, bones, and blood vessels. This condition is usually caused by the gene COL5A1 or COL5A2, but rarer ones can be caused by COL1A1.
How common is this disease?
People who are born with the gender designation "male" have an aortic aneurysm 4 to 6 times more often than women and those who were born as females. Only 1% of men between the ages of 55 and 64 are affected by them. They increase in frequency every ten years. Every ten years of life, the likelihood can rise by as much as 4%. Thoracic aortic aneurysms, on the other hand, are uncommon, occurring in just 6–10 out of every 100,000 people. About 20% of those instances had a family history component.
What are the growth rates of this disease?
Thoracic aortic aneurysms (TAA) are genetically activated and exhibit different behavior from atherosclerotic aneurysms. TAAs have a 0.1–0.2 cm/year growth rate and exhibit significant individual heterogeneity. For thoracic aortic aneurysms, 2% was the average rupture or dissection rate every year for aneurysms with a diameter less than 5 cm, 3% annually for those with a diameter of 5.0–5.9 cm, and 7% annually for those with a diameter of 6 cm or beyond. The extent of body surface area and sex may also be crucial indicators of aneurysm problems. Furthermore, in abdominal aortic aneurysms, the mean annual growth rate is 2-3 mm, and in thoracoabdominal aortic aneurysms, the annual mean can reach up to 0.19 cm, depending on the size of the aneurysm.
What are the methods for diagnosing this disease?
To diagnose an aortic aneurysm, doctors can order one or more cardiovascular diagnostic tests, such as:
CT scan (computed tomography): A screening that uses specialized computer technology and X-rays to see tissues and structures in the body from different angles.
MRI) Magnetic resonance imaging: A medical screening that uses magnetic technology and radio waves to identify the condition of the body
Angiogram (arterial scan): A screening procedure with the help of a roentgen photo to see the condition of the blood vessels, arteries, and veins.
Ultrasound: one of the electrical and physical sources that uses sound waves with frequencies of 1 and 3 MHz.
Echocardiogram: A medical procedure that is carried out to check the condition and structure of the heart, starting from the chambers, valves, and muscles to the blood vessels.
Transesophageal echocardiogram (TEE): An examination procedure that produces images of the heart using sound waves to create images of the muscles and chambers of the heart, as well as the blood vessels connected to the heart.
Chest X-ray: Thorax radiography is often called chest X-ray (CXR), which radiographically depicts the respiratory organs contained in the chest cavity.
Symptoms of aortic aneurysms involve:
Trouble with respiration, such as shortness of breath
It's easy to feel full, even with just a small meal.
Pain in your neck, back, chest, or belly, depending on where the aneurysm is forming.
Swallowing pain or difficulty
Swelling in arms, legs, and neck.
Indicators:
Similar symptoms to various illnesses that cause chest or abdominal pain can be seen in the indicators. Some of these conditions include coronary artery disease, gastroesophageal reflux disease (GERD), and peptic ulcer disease. You might not be aware that you have a thoracic aortic aneurysm since symptoms frequently do not appear until the aneurysm enlarges and puts strain on adjacent organs or bursts, whichever comes first. The most obvious symptoms occur when an aneurysm forms at the aortic arch, where the aorta bends downward. If the aneurysm is near the lungs, symptoms may include coughing or shortness of breath, hoarseness, difficulty swallowing, or pain while swallowing. Immediately after an aortic aneurysm ruptures, there is severe pain, a sudden decrease in blood pressure, and symptoms similar to shock. If it is delayed in being treated, it can swiftly result in death.
Prevention
Controlling high blood pressure, ensuring that you eat healthy foods, engaging in regular exercise, and quitting smoking are all preventative measures that can be implemented to avoid aortic aneurysms.
What are the methods used to treat this disease?
The two primary treatments for aortic aneurysms are medication and surgery. Drugs are capable of lowering blood pressure and reducing the risk of an aortic aneurysm forming. Surgery can replace the damaged portion of the aorta and strengthen the artery wall with a stent. Aortic aneurysms may be treated with one of two types of surgery, such as:
1. Open aneurysm repair
The aneurysm is removed during an open aneurysm surgery, and the artery is then repaired with a graft (a segment of specialized tubing).
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2. Endovascular aneurysm repair (EVAR)
Aortic aneurysms can be repaired with endovascular aneurysm repair (EVAR), a minimally invasive technique. A graft will be inserted during the procedure using a catheter (a tiny tube) to strengthen or mend the artery. Other names
for this surgery are TEVAR (for the treatment of thoracic endovascular aneurysms) and FEVAR (for fenestrated endovascular aneurysms). An operation to clip or coil an aneurysm that has expanded out of the side of the blood vessel may be performed to close the region. Depending on the aneurysm's size and location, your condition may also require regular checkups, such as monitoring with an MRI or CT.
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Conclusion
Aortic aneurysms are a condition in which the walls of your aorta, a powerful, durable workhorse, occasionally become weak and swollen. This could cause blood to leak into your body, which is rare, but if it does rupture, it requires immediate surgery to repair the aorta. There are three types of aortic aneurysms: thoracic, abdominal, and thoracoabdominal. It is fatal in about 80% of cases; it is most common in men over 65. Only 1% of men between the ages of 55 and 64 are affected by them. Thoracic aortic aneurysms occur in just 6–10 out of every 100,000 people. The extent of body surface area and sex may also be crucial indicators. Symptoms of aortic aneurysms involve problems with respiration, such as shortness of breath. Pain in your neck, back, chest, or belly, depending on where the aneurysm forms. Immediately after an aneurysm ruptures, there is severe pain.
Written By: Kenny
Edited By: Tarleen Chhatwal
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