About 15,000 Americans die each year due to an Abdominal Aortic Aneurysm (AAA). An aneurysm is a weakening of the arterial wall, causing it to expand. AAA’s are often referred to as the “silent killer” because the vast majority of people who have an aneurysm have no symptoms. Generally, AAA’s are silent until they rupture, in which case only 10-25% of patients survive to be discharged at the hospital following repair. This means that AAA’s have a 75-90% fatality rate. It is for this reason that AAA screenings are such an important part of prevention. The screening exam will include an ultrasound of your abdomen to evaluate the size of the abdominal aorta. Results of your health scan exam will be available immediately.
Preparation for your (AAA) health screening:
- To ensure accurate results, please fast for a minimum of four (4) hours prior to your screening.
- If necessary, you may consume a moderate amount of water during the fasting period prior to your screening.
- Please refrain from eating a heavy and greasy meal prior to fasting.
- Please continue to take all medications as prescribed by your doctor.
- Please wear a loose fitting two-piece clothing item. You will be asked to lie on a table and raise your shirt so that we can examine your abdominal area.
- If you are diabetic and cannot fast for four hours please limit yourself to a light "diabetic meal" such as a piece of toast and glass of juice. However, do not push your limits. If you have questions please follow your care plan as prescribed by your doctor.
What is an abdominal aortic aneurysm?
AAA is when the aorta (also referred to as the main artery) gets wider as it moves through the stomach. As an aneurysm grows in size it partially destroys the wall of the aorta and could result in a ruptured aorta causing very dangerous circumstances. When it reaches 2 1/2 inches surgery is usually necessary.
Who is most likely to have a AAA?
Five men out of 100 over 60 will have an aortic aneurysm and only one woman in 100 will develop this type of aneurysm. Aneurysms are most common after the age of 60.
What are the most common cause?
Arteriosclerosis. At least 80% of aortic aneurysms are from arteriosclerosis (hardening of the arteries). Hardening of the arteries weakens the main artery wall and the pressure of the blood pumped through the aorta causes an increase in pressure and expansion of the wall at the point of weakness. There are several things that can cause, or increase your risk. Diabetes, High Cholesterol, High Blood Pressure, Smoking, Genetics, Trauma, Artenitis, and Myocitic Infection.
Early detection of abdominal aortic aneurysms (AAA) can save lives! Each year approximately 200,000 people in the US are diagnosed with AAA. Because many do not experience any symptoms, it’s estimated that more than one million people are living with undiagnosed AAA. Fortunately, at least 95 of these AAAs can be successfully treated if detected prior to rupture.
What are the symptoms?
AAA is called a "silent killer" because commonly there are no obvious symptoms and only 25% show symptoms at the time they are diagnosed. When symptoms are present, they may include:
- Abdominal pain (that may be constant or come and go)
- Pain in the lower back that may radiate to the buttocks, groin or legs
- The feeling of a "heartbeat" or pulse in the abdomen
- Severe back or abdominal pain that begins suddenly
- Dry mouth/skin and excessive thirst
- Nausea and vomiting/Paleness
- Signs of shock, such as shaking, dizziness, fainting, sweating, rapid heartbeat and sudden weakness
In some, but not all cases, AAA can be diagnosed by a physical examination in which the doctor feels the aneurysm as a soft mass in the abdomen (about the level of a belly button) that pulses with each heartbeat. The most common test to diagnose AAA is ultrasound, a painless and safe examination in which a device (a transducer) about the size of a computer mouse is passed over the abdomen. Sound waves are computerized to create "pictures" of the aorta and detect the presence of AAA. Other methods for determining the aneurysms' size are CT scan (computerized tomography), MRI (magnetic resonance imaging), and arteriogram (real time x-rays).
If you have no symptoms, and if you have a small aneurysm, your doctor will need to decide whether the risk of having surgery is smaller than the risk of bleeding if you do not have surgery. Your doctor may recommend checking the size of the aneurysm with a yearly ultrasound test, which is a very good option. If your aneurysm is 2 inches or growing quickly surgery is the best option usually. The goal is to perform surgery before complications or symptoms develop.
When found early, AAA can be effectively managed in order to keep the aneurysm from bursting or rupturing. A vascular specialist will determine the best course of treatment depending on the size and shape of the aneurysm and other medical conditions. One of the following may be recommended: “Watchful Waiting” – If the aneurysm is small, a doctor may decide to wait and watch carefully to see if there are any changes. In this method, patients are monitored every 6-12 months for changes in the size of the aneurysm. In addition, a doctor may suggest lifestyle changes such as quitting smoking, lowering blood pressure, modifying diet or increasing daily exercise.
Open surgical repair – Through an abdominal incision, a surgeon replaces the section of the aorta where the aneurysm has formed with a synthetic fabric tube, or “graft”. Open surgical repair is performed under general anesthesia, usually taking 3-4 hours and may require a hospital stay of 7-10 days. Endovascular grafting – This is a less-invasive alternative to surgical repair, because the procedure occurs without surgical opening of the aorta. Instead, the surgeon places a synthetic fabric tube (graft) supported by a metal scaffold (stent) inside the aneurysm. Because endovascular aneurysm repair is less invasive than open surgery, hospital stays can be shorter – typically lasting 2 to 4 days. But Endovascular repair is rarely done for a leaking or bleeding aneurysm.
Author: Robin Badillo