Heart and blood vessel disease is still the leading cause of death in the world, including in Indonesia. One condition that is often not realized until it becomes fatal is an aortic aneurysm. Although it sounds foreign to some people, this disease is a time bomb in the body that can explode at any time.
What Is an Aortic Aneurysm?
An aortic aneurysm is an abnormal widening in the wall of the main blood vessel (the aorta), the large blood vessel that carries blood from the heart to the rest of the body. When the aorta weakens, blood pressure can cause it to balloon and cause the blood vessel wall to become thinner—and if the balloon bursts, the consequences can be fatal.
There are two main locations of aneurysms:
- Abdominal Aortic Aneurysm (AAA): occurs in the abdomen.
- Thoracic Aortic Aneurysm (TAA): occurs in the chest area.
- Thoracoabdominal Aortic Aneurysm: Involves both the thoracic and abdominal parts.
Why is this condition dangerous?
Aortic aneurysms often do not show symptoms until they become large or rupture. When they rupture, they can cause severe bleeding and shock, and can even lead to death if not treated promptly. This is why they are called the "silent killer."
What are the risk factors?
Some factors that increase the risk of aortic aneurysm include:
- High blood pressure (hypertension)
- Smoke
- Age over 60 years
- Genetics or family history of aneurysms
- High cholesterol
- Atherosclerosis disease (hardening of the arteries)
- Trauma (Injury, for example in an accident)
Symptoms to Watch Out For
Although often asymptomatic, some signs that may appear include:
- Persistent abdominal or back pain
- Pulsation (throbbing) in the lower abdomen
- Chest pain that radiates to the back
- Chronic shortness of breath or cough (in thoracic aneurysm)
If an aneurysm ruptures, the symptoms that appear can include:
- Sudden and severe pain
- Blood pressure drops drastically
- Faint
- Cold sweat and pale
Diagnosis
Aneurysms are often discovered incidentally during tests for other conditions. Diagnostic methods include:
- Ultrasound: Commonly used for AAA because it is non-invasive.
- CT Scan or MRI: Provides detailed images of the size and location of the aneurysm.
- Echocardiogram: To evaluate TAAs, especially those close to the heart.
- Angiography: To see blood flow in the aorta.
How to Treat Aortic Aneurysm?
Early detected aneurysms can be monitored regularly. However, if they have reached a certain size or are at high risk of rupture, medical action is needed, such as:
- Open Surgery:
The dilated blood vessels are replaced with grafts (special synthetic tubes). - EVAR / TEVAR (Endovascular Aneurysm Repair/ Thoracic Endovascular Aneurysm Repair):
A minimally invasive procedure that uses a catheter to place a stent inside a blood vessel, strengthening the aortic wall without major surgery. This treatment is performed by a Thoracic, Cardiac, and Vascular Surgeon who specializes in treating large blood vessels such as the aorta.
Can it be prevented?
Although not all aneurysms can be prevented, the risk can be reduced by:
- Control blood pressure and cholesterol
- Quit smoking
- Exercise regularly
- Maintain ideal body weight
- Have regular check-ups, especially if you have a family history of aneurysms.
An aortic aneurysm is a threat that often goes unnoticed, but that doesn't mean it can't be prevented or treated. Recognizing the risk early can be a critical step in saving lives.
Article written by dr. Quincy Romano Rompas, Sp.BTKV (Thoracic, Cardiac and Vascular Surgery Specialist, EMC Pekayon Hospital).