What is Abdominal Aortic Aneurysm (AAA)
An abdominal aneurysm is a bulge or swelling in the abdominal aorta, which is the main blood vessel that carries blood from the heart to the lower body. The abdominal aorta passes through the abdomen and supplies blood to the organs and tissues in the abdomen and pelvis.
An abdominal aneurysm occurs when the walls of the aorta weaken and bulge outwards, forming a balloon-like sac. The size of the aneurysm can vary, but larger aneurysms are more likely to rupture and cause internal bleeding, which can be life-threatening.
AAA can develop slowly over time and may not cause any symptoms until they become large or rupture. Some people may experience symptoms such as a pulsating sensation in the abdomen, abdominal pain or discomfort, back pain, or a feeling of fullness after eating a small amount of food.
How Common Are AAA?
The incidence of AAA varies depending on the population studied, but it is estimated to be around 1-2% in men and less than 1% in women. The incidence increases with age, with the highest incidence occurring in men over the age of 65 who have ever smoked.
In the United States, AAA is the 15th leading cause of death in men over the age of 55, and it is estimated that approximately 200,000 people are diagnosed with AAA each year. AAA is more common in developed countries, and it is thought that lifestyle factors such as smoking, diet, and physical activity may play a role in its development.
How Are AAA Diagnosed?
An abdominal aortic aneurysm can be diagnosed through a variety of tests, including:
• Physical exam: During a physical exam, a doctor may feel a pulsating mass in the abdomen, which may indicate the presence of an AAA.
• Imaging tests: Non-invasive imaging tests, such as an ultrasound, CT scan, or MRI, can provide detailed images of the abdominal aorta and can help to diagnose an AAA.
• Angiography: In some cases, an angiogram may be used to diagnose an AAA. This involves injecting a contrast dye into the blood vessels and taking X-rays to visualize the arteries.
• Blood tests: Blood tests may be ordered to check for signs of infection or inflammation, which could indicate the presence of an AAA.
Criteria For AAA Diagnosis:
The normal size of the abdominal aorta can vary depending on an individual's age, gender, and body size, as well as other factors such as smoking history and medical conditions.
In general, the diameter of the abdominal aorta is considered normal if it measures less than 3 centimeters in diameter. However, it's important to note that the normal range can vary slightly depending on the individual's age and gender.
If the diameter of the abdominal aorta measures between 3 and 4 centimeters, it is considered a small aneurysm, which may require monitoring and follow-up imaging. If the diameter measures 4.5 centimeters or larger, it is considered a large aneurysm and may require immediate medical attention and treatment.
The screening test is typically an ultrasound examination of the abdomen, and it is recommended every two years for individuals with an aortic diameter of 3.0 to 3.9 cm and annually for those with an aortic diameter of 4.0 cm or larger.
If an AAA is suspected or diagnosed, further testing such as computed tomography (CT) or magnetic resonance imaging (MRI) may be required to determine the size, location, and severity of the aneurysm and to determine the appropriate course of treatment.
What Are Symptoms of AAA?
Many people with AAA do not experience any symptoms, especially in the early stages of the disease. However, as the aneurysm grows, it may start to cause symptoms, including:
Abdominal pain: This is the most common symptom of an AAA. The pain may be constant or intermittent and may be felt in the abdomen, back, or flank.
Pulsating sensation: Some people may feel a pulsating sensation in the abdomen, which may be a sign of an AAA.
Back pain: AAA can cause pain in the back, especially in the lower back.
Abdominal fullness: Some people with an AAA may feel a sense of fullness in the abdomen, even after eating a small amount of food.
Nausea and vomiting: These symptoms may occur in some people with an AAA, especially if the aneurysm is large and pressing on the stomach.
Low blood pressure: A ruptured AAA can cause a sudden drop in blood pressure, which can lead to dizziness, lightheadedness, or fainting.
What Are Risk Factors For AAA?
There are several risk factors associated with AAA, including:
Age: The risk of developing AAA increases as you get older, particularly after the age of 65.
Gender: Men are more likely than women to develop AAA.
Smoking: Smoking is a significant risk factor for AAA, and quitting smoking can help to reduce the risk.
High blood pressure: High blood pressure can increase the risk of AAA, hence it is important to control blood pressure through lifestyle changes.
Atherosclerosis: Atherosclerosis, or the buildup of plaque in the arteries, which can increase risk for disease.
Family history: People with a family history of AAA are at increased risk of developing the condition.
Connective tissue disorders: Certain genetic disorders can increase the risk that affect the connective tissue, such as Marfan syndrome and Ehlers-Danlos syndrome.
Obesity: Obesity is a risk factor for AAA, and maintaining a healthy weight through diet and exercise can help to reduce the risk.
Male pattern baldness: Some studies have suggested that male pattern baldness may be associated with an increased risk of AAA.
What Are Long Term Complications?
AAA can lead to several serious complications, including:
Rupture: The most serious complication of AAA is rupture, which can cause life-threatening internal bleeding. Ruptured AAA requires emergency surgery and can be fatal.
Blood clots: Blood clots can form within the aneurysm, which can increase the risk of a heart attack or stroke.
Embolism: Pieces of blood clots or plaque from the aneurysm can break off and travel to other parts of the body, causing blockages and damage.
Bowel ischemia: A large AAA can press on the blood vessels that supply the intestines, causing reduced blood flow and leading to bowel ischemia, which can cause abdominal pain, nausea, and vomiting.
Kidney damage: An AAA can press on the renal arteries that supply the kidneys, leading to reduced blood flow and potential kidney damage.
Aortic dissection: In rare cases, an AAA can lead to aortic dissection, which is a tear in the aortic wall that can be life-threatening.
Infection: An AAA can become infected, which is a serious condition that requires prompt treatment with antibiotics and surgery.
How to Reduce Risks?
There are several steps you can take to reduce your risk of developing AAA, including:
Quit smoking: Smoking is a major risk factor for AAA, and quitting smoking is one of the most effective ways to reduce your risk.
Maintain a healthy weight: Being overweight or obese can increase the risk of AAA, so maintaining a healthy weight through diet and exercise can help.
Control high blood pressure: High blood pressure is a risk factor for AAA, and controlling blood pressure through lifestyle changes can help to reduce the risk.
Eat a healthy diet: Eating a diet rich in green vegetables, and lean protein like seafood/fish can help to reduce the risk of many health problems, including AAA.
Exercise regularly: Regular exercise can help to maintain a healthy weight, reduce blood pressure, and improve overall health.
Manage stress: Chronic stress can contribute to many health problems, including AAA, so finding ways to manage stress, such as through meditation or yoga, can be helpful.
Know your family history: If you have a family history of AAA, you may be at increased risk, so talk to your doctor about screening and other ways to reduce your risk.
Get screened: Men between the ages of 65 and 75 who have ever smoked should be screened for AAA, as early detection and treatment can help to prevent complications.
What About Screening?
The most common screening test for abdominal aortic aneurysm is an ultrasound scan, which is a painless and non-invasive test that uses sound waves to create images of the abdominal aorta. During the test, a technician will apply a special gel to your abdomen and use a handheld device called a transducer to create images of your aorta. The images can help to show if there is an aneurysm present, how large it is, and whether it is likely to rupture.
The United States Preventive Services Task Force recommends that men between the ages of 65 and 75 who have ever smoked should be screened for AAA through a one-time ultrasound. However, screening may also be recommended for other high-risk groups, such as those with a family history of AAA or those with certain genetic disorders.
If an AAA is detected during screening, your doctor may recommend monitoring the aneurysm with regular ultrasounds or other imaging tests, or they may recommend surgery to repair the aneurysm. Treatment options will depend on the size and location of the aneurysm, as well as your overall health and preferences.
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The contents of this website are based upon the views of Dr. Walker and his experience. This product is not intended as medical advice nor to diagnose, treat, cure or prevent any disease. The information is likewise not to replace the advice of a qualified health care provider. The information provided herein is intended as a sharing of general knowledge only and is not intended to be, nor is it, medical advice or a substitute for medical advice. That being said, please consult your healthcare provider before using supplements or providing supplements to children under the age of 18. If you have or suspect you have, a specific medical condition or disease, please consult your healthcare provider.
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