Abdominal aortic aneurysms (AAA) develop slowly and may go undetected for many years. AAA often presents with no symptoms until rupture. Aneurysm rupture occurs when the wall of the aorta becomes severely weakened by the expansion of the aneurysm sac and tears open. When the sac ruptures, bleeding occurs inside the body. Aortic dissection, or a tear between the layers in the wall of the aorta, can also occur.
Symptoms of aortic aneurysm rupture include pain in the abdomen (throbbing, aching or sharp pain, often sudden), pain in the back, nausea, vomiting, fainting, and systemic shock. AAA rupture is a life-threatening event with a high risk of severe complications and death. The risk of death from AAA rupture is high and many patients collapse before they can make it to the hospital for help. Ruptured AAAs account for an estimated 6,000 deaths per year in the United Kingdom.
Who is at risk of an AAA?
Abdominal aortic aneurysms are most common in older adults. They occur in up to 6% of men and 1% of women over the age of 65 years. Smoking is a major risk factor for AAAs and the risk is directly related to the number of cigarettes smoked. Individuals are at a higher risk of developing AAAs if they have a family history of AAAs or other aneurysms. People who have a first-degree relative (parent, sibling, or child) with an AAA have a much higher risk of developing an aneurysm and are likely to have aneurysms in more than one area. High blood pressure is also well known to be associated with aneurysm disease and should be controlled. Connective tissue disorders such as Marfan syndrome, Loeys-Dietz syndrome or Familial Thoracic Aneurysm disease are also often associated with the development of aortic aneurysm, which may also include other parts of the aorta.
Abdominal aortic aneurysm is a silent but often fatal disease. Screening for AAA can aid in the early diagnosis and treatment of the disease, reducing complications and death among those affected. Advancements in screening techniques, surgical innovations and graft development strive to further improve patient outcomes and disease management.
Image: abdominal aortic aneurysm. Courtesy of Vascular Medicine 2014, vol. 19(5) 421-424 (authors: Laurie Ann Moennich and Tara M Mastracci)