ANEURYSM

General Information

DEFINITION--Enlargement or bulge in an artery caused by a weak artery wall. Aneurysms occur most often after a heart attack.

BODY PARTS INVOLVED--Arteries. Aneurysms occur most often in the aorta (major artery in the chest and abdomen), arteries that supply the brain or legs, or heart wall after a heart attack.

SEX OR AGE MOST AFFECTED--Adults of both sexes.

SIGNS & SYMPTOMS--

Often there are no symptoms or symptoms vary according to which artery is affected:

• Thoracic (chest) aneurysm produces a dry cough; pain in the chest, neck, back and abdomen. The pain may be sudden and sharp.
• Abdominal aneurysm produces back pain (sometimes severe), appetite and weight loss, and a pulsating mass in the abdomen.
• Aneurysm in a leg artery causes poor circulation in the leg, with weakness and pallor or swelling and bluish color. A pulsating mass may appear in the groin or behind the knee.
• Aneurysm in a brain artery produces headache (often throbbing), weakness, paralysis or numbness, pain behind the eye, vision change or partial blindness, and unequal pupils.
• Aneurysm in a heart muscle causes heartbeat irregularities and symptoms of congestive heart failure (see Illness section).

CAUSES

• Most common cause is high blood pressure which weakens an artery.
• Atherosclerosis (hardening of the arteries).
• Congenitally weak artery (especially with aneurysms in blood vessels to the brain).
• Syphilis or infection in the aorta caused by syphilis (rare).
• Injury.

RISK INCREASES WITH

Adults over 60; previous heart attack; high blood pressure; smoking; obesity; family history of aneurysms; polyarteritis nodosa (inflam-mation of the small and medium arteries); bacterial endocarditis (infection of the heart lining); marfan syndrome.

HOW TO PREVENT

• Don't smoke; get regular exercise; maintain adequate nutrition and a low fat diet; obtain early treatment for syphilis.
• Follow your treatment program to control high blood pressure; reduce stress.
• If you have a family history of aneurysms, ask your doctor about screening tests.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory blood studies of clotting.
• ECG (See Glossary).
• X-rays of blood vessels (angiography).
• X-rays of the head, including CT scan or ultrasound (See Glossary for both).

APPROPRIATE HEALTH CARE

• Doctor's treatment; hospitalization.
• Surgery to replace the diseased vessel or close off the aneurysm. An aneurysm to the brain may require emergency surgery. Surgery for other types of aneurysms may be scheduled at a convenient time. (See Abdominal-Aortic Aneurysm, Removal of in Surgery section.)

POSSIBLE COMPLICATIONS

• Stroke.
• Rupture of the aneurysm. Symptoms include severe headache, severe knifelike chest, abdominal or leg pain, and loss of consciousness. If not treated, it can be fatal.

PROBABLE OUTCOME--Often curable with surgery to replace the diseased vessel with grafts (artificial vessels). Surgery on a heart aneurysm can stabilize the heartbeat and prolong life. Aneurysms sometimes recur.

How To Treat

GENERAL MEASURES----Early detection and treatment before rupture are essential. See your doctor if you have any signs of an aneurysm-- especially a pulsating mass in the abdomen or leg--even if it does not cause symptoms.

MEDICATION--After surgery, your doctor may prescribe:

• Anticoagulants to prevent blood-clot formation in an aneurysm.
• Pain relievers.

ACTIVITY--Avoid heavy exertion or straining prior to surgery. After surgery, resume normal activities gradually.

DIET--Before surgery, eat a high-fiber diet. After surgery, no special diet.

Call Your Doctor If

• You have symptoms of an aneurysm, especially a pulsating mass in your abdomen or leg, or chest or abdominal pain. This is an emergency! Call for help and rest in bed.
• You have had a heart attack and develop heartbeat irregularity or symptoms of congestive heart failure.
• After surgery, any symptoms return.