Abdominal aortic aneurysm (AAA) involves an abnormal widening or stretching of the abdominal portion of the aorta, usually due to a weak or damaged area in the wall of the artery. The exact cause is unknown, but risks include atherosclerosis and hypertension. Some causes of an abdominal aortic aneurysm are injury, infection, or congenital weakening of the connective tissue component of the artery wall.
Abdominal aortic aneurysm can affect anybody, but it is most often seen in men over 40 years of age. AAA occurs less frequently in white women and African Americans of both sexes. A common complication is "ruptured" aortic aneurysm. This is a medical emergency where the aneurysm breaks open, resulting in profuse bleeding. Ruptured aneurysm occurs in approximately 5 out of 10,000 people. Aortic dissection occurs when the lining of the artery tears and blood leaks into the wall of the artery. An aneurysm that dissects is at even greater risk of rupture.
Aneurysm may develop slowly over many years and often have no symptoms. If the aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel the above symptoms may develop suddenly.
Listening to the abdomen with a stethoscope shows a "blowing" murmur over the aorta or a "whooshing" sound. Physical examination of the abdomen is performed. If a rupture is suspected, physical examination for signs of blood loss and an evaluation of lower extremity pulses and circulation are performed.
If the aneurysm is small and there are no symptoms (for example, if the aneurysm is found during a routine physical examination, periodic evaluation to watch for changes may be recommended. Symptomatic aneurysms may require treatment to prevent complications. Antihypertensive medications may be prescribed to reduce blood pressure. Other medications may include analgesics to relieve pain. Surgical repair or replacement of the section of aorta is often recommended. The goal of treatment is timely surgical intervention before complications develop. The risk of complications increases as the size of the aneurysm increases. Because surgery for abdominal aortic aneurysm is risky, the surgeon may wait for the aneurysm to expand to a certain size before operating (that is, when the risk of complications exceeds the risk of surgery).
The probable outcome is good when an aneurysm is monitored carefully and if surgical repair is performed before the aorta ruptures. Aortic rupture is life threatening. Less than 50% of all people with a ruptured abdominal aortic aneurysm survive.
You should go to the emergency room or call the local emergency number if you develop severe abdominal pain or other symptoms that are suggestive of an abdominal aortic aneurysm. Immediate medical attention is crucial.