Aneurysm Causes and Treatment

An aneurysm is a saclike enlargement of an artery, usually the aorta. An aneurysm occurs when the artery is weakened by disease or injury, allowing the artery walls to balloon out and form a sac. Most aortic aneurysms occur in men between the ages of 40 and 70, and they are usually located in the portion of the aorta that passes through the chest and abdomen.

The most common cause of aneurysms is atherosclerosis, a condition in which fatty deposits line the artery walls. Birth defects, trauma, and infections, such as syphilis, are also causes of aneurysms.

Symptoms

The symptoms of an aortic aneurysm depend on its size and location. Sometimes an aneurysm ruptures, causing a hemorrhage. It may also compress the surrounding tissues, producing pain and various other symptoms. A syphilitic aneurysm may cause a painful erosion of the chest vertebrae or breastbone, an obstruction of the windpipe and bronchi, causing shortness of breath and coughing, and an obstruction of the flow of blood in the veins, producing a swelling of the face. An atherosclerbtic aneurysm occurring in the abdominal aorta may stretch suddenly and cause severe pain in the abdomen and back. There may also be massive bleeding.

A dissecting aneurysm occurs when the middle layer of the aortic wall splits. This condition is usually associated with severe chest pain, and it may also obstruct the arteries arising from the aorta, causing a stroke, a heart attack, kidney failure, or gangrene of the intestine. Sometimes, an aneurysm produces no symptoms at all and can be diagnosed only through a physical examination and x-rays.

Treatment

It is often possible for a surgeon to remove an aortic aneurysm and replace the tissue with a graft made of a synthetic material. Generally, an abdominal aneurysm is more easily corrected than one located in the chest. The surgical treatment of an aneurysm that has ruptured is difficult and risky, but under the circumstances there is no alternate treatment. In cases where there is no real emergency, the decision regarding surgical treatment is largely influenced by the patient's general health.

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