The aorta is the body’s largest artery, carrying oxygen-rich blood from the heart to the rest of the body. In some people, a portion of this vital vessel can weaken and bulge, forming an abdominal aortic aneurysm (AAA). While small aneurysms may not cause symptoms, larger ones can become serious if they continue to grow. Detecting an AAA early allows careful monitoring and timely intervention to reduce complications.
What Is an Abdominal Aortic Aneurysm?
An abdominal aortic aneurysm occurs when the wall of the aorta weakens and expands in the abdominal region. Several factors, including high blood pressure, smoking, and aging, can cause this weakening. Over time, the pressure of blood flowing through the artery can cause the aneurysm to enlarge, making it more vulnerable to rupture.
The progression of an AAA is often unpredictable. Some remain small and stable for years, while others expand more rapidly. When an aneurysm reaches a certain size, the wall of the aorta may become too thin to withstand the pressure of blood flow, leading to a sudden rupture. This is a medical emergency requiring immediate attention, as internal bleeding can be life-threatening.
Risk Factors
While anyone can develop an AAA, certain individuals are more prone to it due to specific risk factors:
- Age – More common in individuals over 65
- Smoking – A major contributor to arterial damage, making aneurysms more likely
- High Blood Pressure – Increases stress on the aortic wall, accelerating its weakening
- Family History – If a parent or sibling has had an AAA, the risk is significantly higher
- Atherosclerosis – Plaque buildup in the arteries can weaken the aortic wall
- Male Gender – Men are at a higher risk than women, though women with AAAs may have a greater risk of rupture
Symptoms
One of the most concerning aspects of an AAA is that it often develops without noticeable symptoms. Many people are unaware they have one until it is found during a routine medical scan or after it has already ruptured. However, some individuals may experience warning signs such as:
- A pulsating feeling in the abdomen, similar to a heartbeat
- Persistent back or abdominal pain that does not go away
- A sudden, sharp pain in the abdomen or lower back, which may indicate a rupture
Investigations and Diagnosis
Because AAAs can be silent for years, screening is crucial. A simple, painless ultrasound can detect an aneurysm early. Guidelines recommend screening for men over 65, particularly those with a history of smoking or a family history of AAA. Women with risk factors may also benefit from screening. Additional imaging tests, such as CT or MRI scans, may be used to assess the size and growth rate of an aneurysm.
Treatment Options
The management of an AAA depends on its size, growth rate, and the individual’s overall health:
Small AAAs (under 5 cm) – These are usually monitored through regular imaging to track any changes. Lifestyle modifications, such as quitting smoking, maintaining a healthy diet, and controlling blood pressure, can help slow progression.
Larger or Rapidly Growing AAAs – If an aneurysm is growing quickly or has reached a size where rupture risk is high, surgical intervention is often recommended.
The two main treatment options are:
- Open Surgery – The damaged section of the aorta is replaced with a synthetic graft. This is a more invasive procedure but can be a long-term solution.
- Endovascular Aneurysm Repair (EVAR) – A minimally invasive approach where a stent graft is placed inside the aorta through small incisions in the groin. This reinforces the artery and helps prevent rupture.
Prevention and Lifestyle Modifications
Preventing an AAA largely involves reducing risk factors. Making heart-healthy lifestyle choices can make a significant difference. These include:
- Quitting smoking to protect the blood vessels
- Keeping blood pressure under control with diet, exercise, and medication if necessary
- Eating a balanced diet rich in fruits, vegetables, and whole grains while reducing saturated fats
- Staying physically active to maintain good cardiovascular health
Conclusion
Abdominal aortic aneurysms are often discovered incidentally during scans for unrelated conditions. Since rupture can be fatal, awareness and early detection are important. By understanding the risk factors, recognizing potential symptoms, and discussing screening options with your doctor, you can take proactive steps toward protecting your health. If you or a loved one have risk factors, talk to your doctor about screening. A simple test could provide peace of mind.
