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When Your Backache Is Actually a Ticking Time Bomb

"Abdominal aortic aneurysm"
By: Ivan Olegario, MD, MDevComWhen Your Backache Is Actually a Ticking Time Bomb

Aneurysms are, by their very nature, dangerous and alarming. An aneurysm is when a section of an artery wall weakens and balloons, which puts that part of the blood vessel at risk of bursting and causing a deadly internal hemorrhage. However, not all arteries are created equal. If an aneurysm in a regular artery is dangerous, it is much worse it occurs in the largest, most important artery in your body: the aorta.

This is what an aortic aneurysm is – a dangerous swelling in the body’s main artery, which is the blood vessel that carries all the freshly oxygenated blood from your heart and lungs to all the smaller arteries that deliver blood to all the other parts of your body. When a section of the aorta bursts, you have a gushing leak in your “main pipeline”. That’s a disaster where water pipes and oil pipes are concerned. Imagine what a catastrophe it is when it happens to that pipeline that carries your body’s life-giving blood.

Now what’s with the abdominal? Why are we focusing on abdominal aortic aneurysms? What about aneurysms in other parts of the aorta?

The aorta, as big and important a blood vessel as it is, is actually not very long. It extends only from your chest to your lower abdomen. Therefore, the aorta is divided only into two sections: the abdominal aorta, which is in your abdominal area, and the thoracic aorta, which is in your chest area. Aortic aneurysms can occur either in your thoracic or abdominal area, but they happen more often in the abdominal aorta. Therefore, the risk we all face of getting an abdominal aortic aneurysm is higher than our risk of getting a thoracic aortic aneurysm. But who, really, is at risk for AAA?

The Risk of AAA

There are three factors that significantly raise one’s risk for AAA: male gender, a smoking history, and an age of 65 years of more. If you are a man 65–75 years old and you have ever smoked a cigarette, you are well advised to ask your doctor about AAA screening. Smoking is known to cause damage to the aorta and create weakness in the aortic walls, thus making any blood vessel more prone to aneurysm.

An AAA screening is nothing to be anxious about. It is a simple, quick, inexpensive, and painless ultrasound procedure. If you are a man 60–64 years old who has never smoked but has a family history of AAA, you may want to inquire about the screening procedure as well.

Science does not yet have conclusive evidence that women 65–75 years old with a history of smoking or with a family history of aneurysm will benefit from getting screened for AAA. Women at any age who have never smoked are not advised to get AAA screening because their known risk is too miniscule. Aside from smoking and heredity, other factors that can cause aortic aneurysm are high blood pressure, aortic infections, trauma (such as car accidents), and hardening of the arteries due to fat build-up (atherosclerosis).

Warning Signs

One thing that makes AAA so dangerous is that it can develop very quietly, slowly, and without any symptoms. This is why it is so important to get screened even when you don’t feel anything if you have the risk factors of being male, having a history of smoking, or having AAA in your genes.

Sometimes, AAA does have symptoms. You may feel it as back pain, a deep and constant abdominal pain, or no pain at all but just a pulsating sensation near your navel. If the pain turns intense, or it radiates to your back or legs; if you suddenly feel dizzy, clammy, or nauseous; if your pulse rate skyrockets or your blood pressure plummets, get emergency medical help immediately. These can be signs that your AAA has ruptured.

AAA that has not ruptured yet may be monitored by your doctor, who will advise you on what to do to help prevent the AAA from growing.

A Dose of Prevention

It is important to note that a minimally invasive endovascular procedure is only useful for treating AAA when no rupture has yet occurred.

After a rupture, only an open abdominal procedure can save the day, and even the most experienced surgeons acknowledge the significant dangers of an open abdominal operation.

It therefore bears repeating that, especially in the case of this disease, an ounce of prevention is worth a pound of cure: The avoidance of smoking does much to reduce one’s risk of AAA. If you have any of the risk factors for AAA, ask about screening.

Remember, it is far better to discover your AAA while it is still unruptured and controllable or treatable with minimally invasive surgery, than race with time trying to save your life following a ruptured AAA – the time bomb which, all that time, you thought was a simple backache.

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