Without warning

| June 01, 2006

Knowing the signs of an aneurysm might save your life.

Many health problems are easily detectable, but you might be at risk for an aneurysm and not even know it. This stealthy condition, often called the “silent killer,” can appear without warning and cause severe problems and even death unless treated immediately.

An aneurysm is an abnormal bulge or widening of an artery, usually in the main arteries of the heart and brain. It occurs when the pressure of blood passing through part of a weakened artery pushes the vessel outward, forming a type of blister. Although doctors are unclear on what causes aneurysms, congenital and acquired factors can put you at risk.

Aneurysms are uncommon in people under 20, but are increasingly common in older people and most common in people over 65. High blood pressure, cholesterol buildup in the arteries and even pregnancy are often associated with the development and eventual rupture of aneurysms. Smokers also have a much higher risk of developing aneurysms, because any weakness in the walls of the arteries contributes to the condition. The carcinogens in cigarettes abnormally constrict blood vessels, interfering with the flow of blood. Smokers die four times more often from ruptured aneurysms than non-smokers. Any wound, injury or infection to the blood vessels can lead to an aneurysm.

Congenital factors, or conditions a person is born with, can also contribute to the risk. People with Marfan syndrome, a congenital disease that affects the body’s connective tissue, often have aneurysms.

Symptoms and detection
Aortic aneurysms may cause shortness of breath, a raspy voice, backache, or pain in the left shoulder or between your shoulder blades. The pain may also be severe, like something is ripping apart inside, if the aneurysm “dissects,” or pulls apart.

Abdominal aortic aneurysms cause stomach pain, loss of appetite and an upset stomach.

Symptoms of a ruptured aneurysm include signs of shock, dizziness, dry mouth and excessive thirst, fainting, sweating, rapid heartbeat and sudden weakness.

Cerebral, or brain aneurysms, are the most dangerous type because they may have no symptoms apart from severe headaches, pain in the neck and face, or vision impairment and nausea.

Thoracic aortic aneurysms are in the part of the aorta that passes through the chest. Symptoms of these aneurysms may be included in a group, called Horner’s Syndrome, which include constricted pupils, drooping eyelids and sweating on one side of the face. Abnormal pulsations in the chest may also be an indicator. Excruciating pain runs from the top of the back to the bottom and may also be felt in the chest and arms.

Doctors can detect aneurysms in a basic physical exam with an x-ray or ultrasound. The size and location of the aneurysm can be detected through radiological imaging by arteriography, magnetic resonance image (MRI) and computed tomography (CT scanning).

Dangers
Aneurysms can burst and cause internal bleeding in the brain, heart or other areas, causing strokes and even death. This is called a hemorrhage, or rupture, and approximately 30,000 people in the United States suffer from a ruptured aneurysm each year. Aneurysms can also cause hydrocephalus, or water on the brain, as well as constriction of other blood vessels. Also, aneurysms can grow. If they reach a certain size, usually more than 25 mm, or one inch, they put pressure on the surrounding areas and cause further problems.

Treatment
Treatment depends on the size, growth and location of the condition. Aneurysms in the upper chest are usually operated on immediately, but aneurysms in the lower chest and area below the stomach may not be as dangerous. Diagnosis and treatment vary according to the person’s age, general health and condition. Treatment can prevent hydrocephalus and rebleeding of the aneurysm, but early detection is crucial.

Though research is inconclusive on the causes of aneurysms, regular physical exams, a healthy diet, exercise, and control of high blood pressure can play a role in the prevention of aneurysms. If you are experiencing any unusual symptoms or pain, or notice a new mass or lump on your body, contact your doctor immediately.

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