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Abdominal Aortic Aneurysm (AAA) in the Elderly

Abdominal Aortic Aneurysm (AAA) in the ElderlyWhat is an abdominal aortic aneurysm?

An abdominal aortic aneurysm (AAA) is a weakening and bulging of the largest artery in the body and specifically the part of it that runs through the abdominal cavity. This condition can be fatal especially in older people as the weakened part can burst. Although an abdominal aortic aneurysm can occur in any person, it is more likely to be seen in people over the age of 50 years. Men are much more likely to have an abdominal aortic aneurysm than women but after the age of 80, both men and women are equally affected.

The Aorta

The aorta is the largest artery in the body. It originates from the left ventricle of the heart, curves around in the chest and runs down to the abdomen until it finally forks out into small arteries to the leg. Along its course, the aorta gives off many branches. It is by far the most important artery as it supplies the entire body with blood laden with oxygen and nutrients through its branches. The part of the aorta lying in the chest is known as the thoracic aorta while the part running through the abdomen in known as the abdominal aorta.

Causes of Abdominal Aortic Aneurysm

As with many other medical conditions, the cause of an abdominal aortic aneurysm is unknown. However, various risk factors have been identified. Large arteries like the aorta have a strong and elastic wall. In this way it can withstand the high pressure blood running through it and provide some recoil to help push the blood along. An aneurysm is when a portion of the artery wall becomes weakened. It then bulges outwards like a balloon.

Most small and medium-sized aneurysms never rupture. However, large aneurysms can rupture at any time and death will occur shortly thereafter. Since most people with an abdominal aortic aneurysm never realize that they have the problem, it is important to look at who may be at risk. You are more likely to have an abdominal aortic aneurysm if you have one or more of the following risk factors.

  • Older than 50 years (men) or 60 years (women).
  • Cigarette smoker, even an ex smoker.
  • Family history of abdominal aortic aneurysm.
  • High blood pressure.
  • Fatty plaques in the artery wall (atherosclerosis).
  • Diseases of the blood vessels and arteries in particular.

Race may be risk factor as well since abdominal aortic aneurysms are more commonly seen in Caucasians.

Symptoms of Abdominal Aortic Aneurysm

Aortic aneurysms grow slowly in size over time. There are usually no symptoms to alert a person to small and medium sized aneurysms. Even large abdominal aortic aneurysms may be missed altogether until a person goes for diagnostic screening for some other condition and the aneurysm is detected.

When present, symptoms include tenderness of the area over the aneurysm with a pulsating feeling especially when lying still. Pain occurs with larger aneurysms and many patients report back pain. Low blood pressure and a rapid heart rate are some of the other symptoms of an aneurysm but can occur with many other more common medical conditions.

Treatment of Abdominal Aortic Aneurysm

Surgery is needed to treat an abdominal aortic aneurysm. However, it is important to note that surgery may not be immediately necessary in every case. A small aneurysm may not require immediate attention and instead your family doctor and a vascular specialist may opt for a wait-and-watch approach. This simply means that your doctor or doctors will continue to monitor the aneurysm over time to see how fast it is progressing and if there are any imminent dangers.

Medium sized aneurysms may sometimes be operated on but it is the larger aneurysms that warrant immediate surgery. These aneurysms are usually at a high risk of rupturing with often fatal consequences. Procedures to repair the aneurysm may be done through open surgery or through less invasive methods like endovascular surgery. The aneurysm is reached during surgery, and removed in open surgery with a synthetic graft used to strengthen the site. These grafts will provide strength and support to the weakened part of the aorta.

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