Vasculars

Aneurysms are balloon-like bulge in a blood vessel. They can affect any large vessel (artery) in your body. Aneurysms happen in the arteries that supply blood to the brain (cerebral aneurysm) or in portions of the aorta (aortic aneurysm), when the pressure of blood passing through part of a weak blood vessel forces the vessel to bulge outward, forming a thin-skinned blister. Not all aneurysms are life threatening, but if the bulging stretches the artery too far, this vessel may burst, causing a person to bleed to death. An aneurysm that bleeds into the brain can lead to stroke or death. Aneurysms can also occur in the kidney region. They are referred to as abdominal aortic aneurysms (AAA).
Sometimes an aneurysm can also form in the heart's main pumping chamber (the left ventricle) after a heart attack. If a section of the heart wall becomes damaged, it causes scarring and the heart wall grows thinner and weaker. This may cause a ventricular aneurysm to form. The weakened area of aneurysm does not work well, which makes your heart work harder to pump blood to the rest of your body. Ventricular aneurysms may cause shortness of breath, chest pain, or an irregular heart beat (arrhythmia). If a ventricular aneurysm leads to congestive heart failure, left ventricular heart failure, or arrhythmia, your doctor may advise you to undergo surgery.
How do aneurysms happen, and who is at risk?
Any condition that causes the walls of the arteries to weaken can lead to an aneurysm. Atherosclerosis (a build-up of plaque in the arteries that weakens the walls of blood vessels), high blood pressure, and smoking are risk factors. Deep wounds, injuries, or infections also can cause blood vessels to bulge. Sometimes, the aneurysm may be caused by a congenital condition (a condition that you are born with or inherit). An inherited disease such as Marfan syndrome, which affects the body's connective tissue, causes people to have long bones and very flexible joints. People with this syndrome often have aneurysms.

White men over the age of 55 have a greater risk of developing an aneurysm. Aneurysm is one of the top 10 leading causes of death among this group.

How are aneurysms detected?
Aneurysms can be detected by physical exam, on a basic chest or stomach X-ray, or by using ultrasound. The size and location can be found through echocardiography or radiological imaging, such as arteriography, magnetic resonance imaging (MRI) and computed tomography (CT) scanning.

What are the symptoms?
Symptoms are different depending on the type and location of the aneurysm. Symptoms result from the pressure caused by an aneurysm's pressing against nearby organs, nerves, and other blood vessels. For example,

Aortic aneurysms may cause shortness of breath, a croaky or raspy voice, backache, or pain in your left shoulder or between your shoulder blades. Sometimes, an aortic aneurysm can "dissect." When this happens, the pain may be sudden and severe. Patients often feel like something is ripping or tearing inside of them.

Abdominal aortic aneurysms may cause pain or tenderness below your stomach, make you less hungry, or give you an upset stomach.

Cerebral (brain) aneurysms may have no symptoms, although you may have headaches, pain in your neck and face, or trouble seeing and talking.

How are aneurysms treated?
Treatment depends on the size and location of the aneurysm and on the patient's overall health condition. Aneurysms in the upper chest (ascending aorta) are usually operated on right away. Aneurysms in the lower chest or the area below your stomach (descending and abdominal portions of the aorta) may not be as life-threatening. Aneurysms in these locations are watched regularly. If they become about 5 cm long, continue to grow, or begin to cause symptoms, your doctor will suggest surgery to stop the aneurysm from bursting.

For aortic aneurysms or aneurysms that happen in the vessels supplying blood to the arms, legs and head (peripheral vessels), surgery involves relining or replacing the weakened section of the vessel with an artificial tube (a graft).

For patients with smaller or stable aneurysms in the descending aorta or abdominal parts of the aorta those farthest from the heart, doctors usually ask patients to come in for regular check-ups so they can follow the growth of the aneurysm. If the aneurysm does not grow much, patients may live with the aneurysm for years. Doctors also may prescribe medicine, especially medicine that lowers blood pressure (such as a beta blocker), to relieve the stress on the aortic walls. Medicine to lower blood pressure is especially useful for patients where the risk of surgery may be greater than the risk of the aneurysm itself.