Whirlwind Tour of an Aortic Aneurysm

What do Lucille Ball, Albert Einstein and John Ritter have in common?  They all died from a ruptured aortic aneurysm. 

Like peripheral vascular disease, most physicians do not routinely screen for aortic aneurysms.  And for most people this is OK, because they do not have the risk factors for having an aortic aneurysm, making their chances for aortic rupture quite slim.  But for those few individuals who have an aortic aneurysm, it is like walking around with a ticking time bomb in your chest or abdomen because if it ruptures, the result is overwhelmingly death.

Your aorta is the primary blood vessel coming out of the heart.  It is about the size of a garden hose.  Aortic aneurysm affects approximately 6-7 percent of people over age 60.  It is the 10th leading cause of death in men over age 65, but unlike peripheral artery disease, an aortic aneurysm is generally symptom free, making a physical exam almost worthless and diagnosis difficult.  If you have any of the following risk factors, then you are a candidate for screening.

-Are over age 60
-Have ever smoked or used tobacco (the longer you have smoked or used tobacco, the greater the risk)
-Have high blood pressure and/or high cholesterol
-Have been diagnosed with atherosclerosis, which is the build-up of plaque in the arteries
-Are male
-Are white
-Are overweight
-Have a family history of aortic disease
-Have certain rheumatologic conditions like ankylosing spondylitis
-Or a family member were born with an abnormal, or bicuspid, aortic valve

In a physician’s mind if you have an aortic aneurysm, it is similar to having heart disease.  The most important part of treating or preventing aneurysm is to make sure you are living right; eat well, exercise, manage your cholesterol and blood pressure and limit alcohol consumption.  Smoking is the biggest risk factor, and if you have an aortic aneurysm and you continue to smoke, then you may be igniting the bomb in your belly.

Aortic aneurysms are treatable and if they are severe enough can be repaired surgically or in the cath lab using an endovascular repair.  The most important thing is to be screened if you have risk factors for the disease.

Dr. Chris Gring, MD, is an interventional cardiologist with Wake Heart & Vascular Associates.