Battling the Bulge: Abdominal Aortic Aneurysms

Ballooning of the body’s main artery may cause trouble
thoracic aorta and abdominal aortic aneurysm

An abdominal aortic aneurysm (AAA) is a bulge that can form in a section of the aorta, the body’s main artery, occurring in the belly area. This part of the aorta feeds blood to the lower body. The aneurysm can cause the walls of the aorta to become overstretched and weak.

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These aneurysms develop slowly over the years and often have no symptoms — but if left untreated may become very dangerous.

AAA risk factors to watch for

The U.S. Physicians Task Force recently endorsed the concept of AAA screening for high-risk patients. These high-risk patients include men over the age of 65 who have:

If you have these risk factors, talk to your doctor about getting screened. If the aneurysm becomes too large, it may rupture and cause bleeding that can lead to death.

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What you should know about aneurysm screenings

The screening for AAA is easily done using ultrasound to provide information about the size and shape of the aorta through the abdominal cavity. The screening can’t determine the length of time the aneurysm has been present, however, and is not very good at predicting how rapidly the aneurysm may be expanding.

  • If an aneurysm is found on the ultrasound screening, it doesn’t necessarily mean that you need to have anything done to the aneurysm. In most cases, finding an aneurysm simply provides for patients and physicians the identification of a problem which needs to be followed over a period of time.
  • If the screening test is positive, you should see a vascular specialist who can discuss with you the risks that the aneurysm poses for you as well as the options available for evaluation over the long run and potential treatment if the aneurysm is large enough.
  • If a screening test is negative, then you won’t need to be re-screened for at least five years for the presence of an AAA.
  • Smoking increases the risk of aneurysm development. If a person has smoked just 100 cigarettes during his/her lifetime, the risk of aneurysm development is increased by a factor of 5.

3 things to do if your screening finds an aneurysm

Having an aneurysm identifies you as someone who has atherosclerotic vascular disease, and you should have aggressive treatment of your risk factors. You’ll want to work with your doctor to reduce your risk of long-term expansion of the aneurysm.

The best ways to do this:

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  1. Stop smoking completely. Smoking is the highest risk activity associated with aneurysm expansion and rupture.
  2. Get your blood pressure under control. The finding of an aneurysm should generate a discussion between you and your primary care physician to assure that your blood pressure is regularly monitored and is well controlled. Ideally, we would like you to have the systolic blood pressure below 120 and the diastolic blood pressure below 80.
  3. Begin an exercise program under your doctor’s guidance. The concept of exercise in the setting of aneurysm development has been a topic of debate; in many instances, physicians instruct patients not to proceed with an exercise regimen. But while blood pressure does rise during exercise, the overall effect of a regular aerobic exercise program is to reduce blood pressure in the long run. A regular exercise program should also normally lead to weight reduction — which further reduces BP.

We think it’s beneficial for a person with an aneurysm to begin a strictly overseen regular exercise regimen to help reduce blood pressure and the risks of stroke and heart attack — as well as improve overall fitness and health.

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