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Abdominal aortic aneurysm

An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. The aorta, about the thickness of a garden hose, runs from your heart through the center of your chest and abdomen. Because the aorta is the body's main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding.

Depending on the size and rate at which your abdominal aortic aneurysm is growing, treatment may vary from watchful waiting to emergency surgery. Once an abdominal aortic aneurysm is found, doctors will closely monitor it so that surgery can be planned if it's necessary. Emergency surgery for a ruptured abdominal aortic aneurysm can be risky.

Symptoms Causes Risk factors Complications

Abdominal aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. Others expand quickly. Predicting how fast an abdominal aortic aneurysm may enlarge is difficult.

As an abdominal aortic aneurysm enlarges, some people may notice:

  • A pulsating feeling near the navel
  • Deep, constant pain in your abdomen or on the side of your abdomen
  • Back pain

When to see a doctor

You should see your doctor if you have any of the symptoms listed above.

Anyone age 60 and older who has risk factors for developing an abdominal aortic aneurysm, such as smoking or a family history of abdominal aortic aneurysm, should consider regular screening for the condition. Because being male and smoking significantly increase the risk of abdominal aortic aneurysm, men ages 65 to 75 who have ever smoked cigarettes should have a one-time screening for abdominal aortic aneurysm using abdominal ultrasound.

If you have a family history of abdominal aortic aneurysm, your doctor may recommend an ultrasound exam to screen for the condition.

There are no specific screening recommendations for women. Ask your doctor if you need to have an ultrasound screening based on your risk factors.

Most aortic aneurysms occur in the part of your aorta that's in your abdomen. Although the exact cause of abdominal aortic aneurysms is unknown, a number of factors may play a role, including:

  • Tobacco use. Cigarette smoking and other forms of tobacco use appear to increase your risk of aortic aneurysms. In addition to the damaging effects that smoking causes directly to the arteries, smoking contributes to the buildup of fatty plaques in your arteries (atherosclerosis) and high blood pressure. Smoking can also cause your aneurysm to grow faster by further damaging your aorta.
  • Hardening of the arteries (atherosclerosis). Atherosclerosis occurs when fat and other substances build up on the lining of a blood vessel, increasing your risk of an aneurysm.
  • Infection in the aorta (vasculitis). In rare cases, abdominal aortic aneurysm may be caused by an infection or inflammation that weakens a section of the aortic wall.

Aneurysms can develop anywhere along the aorta, but when they occur in the upper part of the aorta, they are called thoracic aortic aneurysms. More commonly, aneurysms form in the lower part of your aorta and are called abdominal aortic aneurysms. These aneurysms may also be referred to as AAA or triple A.

Abdominal aortic aneurysm risk factors include:

  • Age. Abdominal aortic aneurysms occur most often in people age 65 and older.
  • Tobacco use. Tobacco use is a strong risk factor for the development of an abdominal aortic aneurysm. The longer you've smoked or chewed tobacco, the greater your risk.
  • Atherosclerosis. Atherosclerosis, the buildup of fat and other substances that can damage the lining of a blood vessel, increases your risk of an aneurysm.
  • Being male. Men develop abdominal aortic aneurysms much more often than women do.
  • Family history. People who have a family history of abdominal aortic aneurysm are at increased risk of having the condition. People who have a family history of aneurysms tend to develop aneurysms at a younger age and are at higher risk of rupture.

Tears in the wall of the aorta (dissection) are the main complications of abdominal aortic aneurysm. A ruptured aortic aneurysm can lead to life-threatening internal bleeding. In general, the larger the aneurysm, the greater the risk of rupture.

Signs and symptoms that your aortic aneurysm has burst include:

  • Sudden, intense and persistent abdominal or back pain
  • Pain that radiates to your back or legs
  • Sweatiness
  • Clamminess
  • Dizziness
  • Nausea
  • Vomiting
  • Low blood pressure
  • Fast pulse
  • Loss of consciousness
  • Shortness of breath

Another complication of aortic aneurysms is the risk of blood clots. Small blood clots can develop in the area of the aortic aneurysm. If a blood clot breaks loose from the inside wall of an aneurysm and blocks a blood vessel elsewhere in your body, it can cause pain or block the blood flow to the legs, toes, kidneys or abdominal organs.

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