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AORTIC ANEURYSM

WHAT IS AORTA ?

Aorta is the large and major artery arising from the left heart otherwise called left ventricle,first courses up giving blood vessels to brain and both upper arms, arches down in the chest,travells down,pierces down the diapragm,become abdominal aorta, gives branches to all abdominal visera and end up dividing into two branches to lower limb vessels.

All blood vessels have a three layer wall, tunica adventitia, tunica media and tunica intima respectively from outside in. Arteries, arterioles , capillaries and veins have variations in their walls respective to their function. They are classified  as impedence vessels, resistance  vessels, exchange vessels and capacitance vessels.

AORTIC ANEURYSM   -CT SCAN

AORTIC VALVE

 Aorta is the impedence vessel as it has to withstand the tremendous kinetic energy  which it is imparted while getting ejected forcefully from the left ventricle. So unlike the other small vessels ,it is provided with much amount of elastin fibres in its tunica media. 

A combination of lifelong exposure to this kinetic energy and possible disruption of elastin architecture make it liable for meechanical dilatation which is called aneurysm.

A vessel is said to be aneurysmal if it gets dilated one and half times its original diameter.

WHAT IS AORTIC ANEURYSM ?

Normal diameter of an adult aorta is around 2 to 3cm. If the aorta got dilated to one and half its diameter ,ie 4.5 cm and above it is called aneurysmal.

Anerysm can be tubular, fusiform or saccular in its shape.

WHAT IS PSEUDO - ANEURYSM ?

Usually an aneurysm wall has all its three layers, but sometimes a vessel appear enlarged due to disruption in its adventia or media and occupation of a hematoma.

WHAT ARE THE TYPES OF AORTIC ANEURYSM ?

According to its shape it may be tubular, fusiform or saccular. And depending upon the part of aorta involved it can be called Ascending aortic aneurysm, Arch aorta aneurysm, Thoracic aorta aneurysm, Thoraco-abdominal aneurysm, supra-renal abdominal aortic aneurysm and Infra-renal abdominal aortic aneurysm

abdominal aortic aneurysm

WHAT ARE THE SYMPTOMS OF AORTIC ANEURYSM  ?

The symtoms of aneurysm is mainly due to its pressure effects and so will depend on its site. The most serious complication of aorta is its rupture in which case it will present with a dramatic picture of internal hemorrhage, hemodynamic collapse and a possible loss of life.

The symptoms of an unruptured thoracic aortic aneurysm may be a dull aching chest pain, breathing difficulty or difficulty in swallowing. Similarly the symptoms of an abdominal aortic aneurysm may be dull aching abdominal pain, fullness of abdomen, alteration of bowell habits.

WHAT ARE THE COMPLICATIONS OF AORTIC ANEURYSM ?

The most serious complication of aortic aneurysm is its possibility of rupture, which has  catastrophic manifestations. The aneurysm can form blood clots inside, which can be thrown off occluding an important distal vessel resulting in ischemia of that part.

WHAT ARE  THE CAUSES  OF AORTIC  ANEURYSM ?

The basic cause is disruption in its media which may be by birth, mechanical trauma, infection, atherosclerosis, chronic hypertention,chronic wear and tear and so on.

WHEN SHOULD AN  AORTIC ANEURYSM BE TREATED ?

When the size of aneurysm crosses 5 cm, the likelyhood of a sudden rupture and possible death is high, so should think of getting it treated.

WHAT ARE THE TREATMENTS OF AORTIC ANEURYSMS  ?

When the aneurysm pauses a danger to life it has to be treated . Before few years most aneurysms were entirely treated by surgeries.. However nowadays another treatment modality called aortic stenting has come up in a big way. Many aortic aneurysms can be treated by stenting alone.  Some aneurysms need a combined surgical and stenting approach which is called Hybrid procedure.

WHY SHOULD WE TREAT AORTIC ANEURYSM   ?

Aortic aneurysm has this fatal complication called rupture which is why they should be screened for and should be treated when it crosses certain size.