Beware, the silent killer

Beware, the silent killer

Around 15,000 deaths in the world are caused by aortic aneurysm. Dr NN Khanna shares information about this majorly asymptomatic disease and the remedial procedures.

An aortic aneurysm can be essentially defined as a bulge or dilation in a section of the aorta. The section which is affected by aneurysm becomes weak and overstretched leading the aorta to burst or rupture causing excessive internal bleeding, eventually resulting in quick death, or the layers of the artery wall can split allowing the blood pumping to enter and leak between them (aortic dissection).

Eight out of ten people suffering a rupture die before they are able to reach the hospital or fail to survive the surgery.

Aneurysms can occur in any part of the body, but the most vulnerable and commonly affected areas include the abdominal aorta (abdominal aortic aneurysm), specifically the segment of the abdominal aorta below the kidneys, and the upper body (thoracic aortic aneurysms), which can be further divided into ascending and descending aorta. 

Abdominal Aortic Aneurysms (AAA) are found most commonly in men aged 65 and above.

Therefore, it is always advisable for them to undergo a screening test, which involves an ultrasound scan. They are found to be less common among females. However, evidence suggests that women suffer worse prognosis.

Due to their low probability of being diagnosed with AAA, they are often excluded from the screenings and thus those suffering from the disease go undetected. 

Approximately 15,000 deaths are caused by ruptured aortic aneurysm every year. 

Symptoms

Usually, aortic aneurysm goes undetected due to its lack of prominent and distinguished symptoms. About three of every four abdominal aortic aneurysms are asymptomatic. Doctors often happen to diagnose it on examination of the patient or on routine ultrasound or CT examination.

Usually, it presents with pain and discomfort in abdomen, chest, lower back or groin.

A sudden and severe pain in the back or abdomen may signify rupture of the aneurysm, which is a life-threatening medical emergency. It may also cause a pulsating effect or feeling similar to a heart beat in the affected area. The aneurysm ruptures before it can be diagnosed and it is precisely because of this that it is referred to as a ‘silent killer.’

Treatment

It is possible to follow up small-sized aneurysms with the help of regular scans and ultrasounds to monitor their size. The risk of rupturing escalates with increase in size, and the relative risk of repairing the aneurysm reduces.

Elective repair can be done either by open abdominal surgery, which is the traditional method or by Endovascular Aneurysm Repair (EVAR) using a stent graft. In this procedure, a stent graft (which is non-porous to blood) is introduced into the aorta through the femoral arteries (main arteries of groin), through two short incisions, one in each groin. It is then positioned and deployed across the aneurysm and seals the aneurysm at the top and bottom.

This relines the aorta from the inside and prevents blood from flowing into the aneurysm and causing further enlargement and rupture. Another thing to remember here is that people suffering from aortic aneurysm should keep a strict check on their blood pressure.

Precautions

People diagnosed with aortic aneurysm require close medical attention and treatment. The patient should start going for regular check-ups to monitor the size of aneurysm and avoid further damage. You can also take the following precautions right in your own home:  

n Keep your blood pressure and cholesterol levels in check by eating low-sodium, low-fat diet. Include fruits, vegetables and other fibre-rich foods.  

n Make exercise a regular part of your life. Consult the doctor to learn about the right exercise. If aerobics is recommended, indulging in activities that would raise the heart rate would be helpful. Dedicating thirty minutes every day can be beneficial.

n Manage your weight as this lowers the risk of complications when there is need for a surgery.

n Total abstinence from smoking and tobacco helps to maintain a healthy body.

(The author is a senior consultant of interventional cardiology at Indraprastha Apollo Hospitals, Delhi) 

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