St. Joseph Hospital of Orange
1100 West Stewart Dr, Orange, CA 92868714.633.9111
About Us News Room Careers Contact Us
Find St. Joseph Hospital Services Our Doctors Our Services For Patients For Visitors For Community
Heart and Vascular Center
About Us
Outcomes
Clinical Trials and Research Program
How to Contact Us
Our Achievements
Our Experts
Our Facilities
Patient Testimonials
Adult Congenital Heart Disease Program
Our Experts
Our Outcomes
Bacterial Endocarditis
Diagnosis
Patient and Family Resources
Patient Testimonial
Specific Congenital Cardiovascular Defects
Symptoms
Treatment
Cardiac Receiving Center
Clinical Trials and Research Program
The Center for Heart and Vascular Wellness and Prevention
About Us
Our Experts
The Dick Butkus Heart and Vascular Screening Program
The Women's Heart Center
Cardiac Rehabilitation
Diagnostic Services
Angiogram
Cardiovascular CT
Cardiac Catheterization
Cardiac MRI
Echocardiogram
Stress Test / Treadmill
Electrocardiogram (ECG or EKG)
Electrophysiology Test (EP)
Endomyocardial Biopsy
Holter Monitor
Nuclear Studies
Pacemaker Interrogation
Tilt Table
Heart and Vascular Diseases
Arrhythmia
Aneurysm
Angina
Atrial Fibrillation
Cardiomyopathy
Chest Pain
Claudication
Congenital Heart Disease
Coronary Artery Disease
Diabetes
Endocarditis
Hypertension
Heart Attack
Heart Disease Risk Factors
Heart Failure
Rheumatic Heart Disease
Sinus Bradycardia
Ventricular Tachycardia
Heart Failure Program
Our Experts
Our Outcomes
Patient and Family Resources
Diagnosis
Treatment
Interventional Radiology
Our Experts
Our Outcomes
Patient and Family Resources
Interventional Radiology Procedures
Open Heart Surgery
Our Experts
Our Outcomes
Patient and Family Resources
Specific Cardiac Defects
Diagnosis
Preparing for Surgery
The Day of Surgery
Activity after Surgery
Preparing for Home - Discharge Teaching
Pacemaker Center
FAQs
Screening Programs
Valve Heart Center
Our Experts
Our Outcomes
Specific Cardiac Defects
Diagnosis
Treatment
Vascular Care
Our Experts
Our Screening Program
Specific Vascular Defects
Aortic Aneurysms
Peripheral Artery Disease (PAD)
Stroke
Thoracic Outlet Syndrome
Ulcers
Uterine Fibroids
Varicose Veins
Glossary of Terms
Women's Heart Center
About the Women's Heart Center
Our Experts
Risk Factors for Women
EBCT
Screening Program

Share this page:

Facebook
Twitter
Google +

Aortic Aneurysms

An aneurysm develops when a diseased blood vessel dilates or “balloons” outward. Arterial aneurysms can be found in many locations throughout the body but typically involve the abdominal aorta below the kidneys. Risk factors for developing an aortic aneurysm include hypertension, smoking, high cholesterol, emphysema, genetic factors and male gender. An abdominal aortic aneurysm can develop in anyone, but it is most frequently seen in males over 60 with one or more risk factors. Aneurysms usually develop slowly over many years and often have no symptoms. They are frequently discovered during a work-up for vague abdominal or back pain. The larger the aneurysm, the more likely it is to rupture. If an aneurysm expands rapidly, tears open, or blood leaks along the wall of the vessel, symptoms may develop suddenly. Small aneurysms without symptoms can be followed with periodic ultrasound evaluation to detect changes in aneurysm size. Surgery is generally recommended for larger aneurysms and those that rapidly increase in size. The goal is to perform surgery before complications or symptoms develop.

Another condition affecting the aorta is called a "dissection". This problem occurs when there is a split in the layers of tissue that comprise the aortic wall. Blood can then “dissect” between the layers and cause bleeding or obstruction of blood flow to vital organs.

Risk Factors

Men are four times more likely than women to develop an abdominal aortic aneurysm; it's the ninth leading cause of death in men over age 55.

The most common risk factors for an aortic aneurysm or dissection include:

  • Age - Aneurysms usually affect patients who are 50 to 80 years of age

  • Atherosclerosis (aka hardening of the arteries) – The large majority of aortic aneurysms are associated with this condition

  • High blood pressure - Increased pressure inside the arteries can create stress on weakened areas within the wall of the aorta

  • Injuries and hereditary disorders - This includes Marfan's syndrome, a connective-tissue disorder that is occasionally associated with sudden death due to aortic dissection

  • Smoking – Smoking at any time in your life increases your risk for developing an aneurysm and other manifestations of atherosclerosis

Symptoms

Most aneurysms, especially small ones, have no symptoms. In fact, less than one quarter of aneurysms present obvious symptoms until the time that it ruptures. Vague symptoms can occur as the aneurysm begins to enlarge and press on nerves, organs or other blood vessels.

For an aortic aneurysm, common symptoms generally include:

  • Throbbing or pulsation in the abdomen

  • Abdominal pain - if severe, this could mean the aneurysm has ruptured

  • Back or flank pain – if severe, this could mean the aneurysm has ruptured

An aneurysm that occurs in the chest (called a "thoracic aneurysm") may have the following symptoms:

  • Pain between the shoulder blades, lower back, neck or abdomen
  • A dry persistent cough
  • Hoarse voice (due to pressure from the aneurysm on the nerve that stimulates the vocal cords)
  • Symptoms of a thoracic aneurysm or acute aortic dissection are frequently misdiagnosed.

Screening and Diagnosis

Even if an aneurysm does not cause symptoms, it may be detected during a routine physical examination. An abdominal aortic aneurysm can sometimes be felt in the abdomen and thoracic aneurysms can often be seen on a routine chest X-ray. Ultrasound of the abdomen is a highly accurate screening tool that can be used to make the initial diagnosis. More sophisticated imaging technology, such as computed tomography (a "CT scan") or magnetic resonance imaging (an "MRI") is then used to further evaluate a newly found aneurysm.

Treatment

Highly trained and experienced physicians within the St. Joseph Hospital Vascular Institute are able to offer the latest treatments for thoracic and abdominal aortic aneurysms as well as acute (sudden onset) and chronic (long duration) aortic dissections. In short, acute aortic dissection may require immediate surgery, but in some situations aggressive blood pressure control with IV/oral medication is also appropriate for certain types of aortic dissections. Chronic aortic dissections are generally followed with periodic imaging, and repaired if complicating circumstances arise despite good blood pressure control. Large or rapidly growing thoracic aneurysms usually require surgical repair. Without surgery, the risk of life-threatening aneurysm rupture increases with time and with aneurysm size.

There are two types of surgery offered at the St. Joseph Hospital Vascular Institute to repair an aneurysm:

  • Traditional surgery - Involves an incision in the chest or abdomen through which the aneurysm is opened and replaced with artificial graft material. This method of aneurysm repair offers proven and durable results with a low incidence of long-term complications. However, recovery from this relatively invasive procedure usually requires more time than less-invasive alternatives. The vascular specialists in the Vascular Institute can also perform an open abdominal aortic aneurysm repair using a less-invasive approach in which the skin incision is made in either the right or left flank area. This surgical approach offers better exposure of the abdominal aorta and its arterial branches, as well as results in a shorter hospital stay and a quicker recovery than the traditional open repair.

  • Endovascular surgery - Involves two relatively small incisions at each groin to expose the common femoral arteries. A stent graft is then inserted through the femoral arteries and appropriately positioned using catheter/guidewire and video techniques. Once the stent graft is deployed within the aneurysm, it effectively diverts blood flow away from the aneurysm sac. Thus, pressure within the bulging aneurysm sac is reduced and the risk of aneurysm rupture is greatly diminished. This type of minimally invasive surgery has a relatively short recovery time and in general causes less physiologic trauma to the body. However, there is increased risk of blood vessel trauma using this technique and long-term periodic imaging is required because there is a small chance that the stent graft may move (i.e. migrate) or that blood flow may enter the aneurysm sac from the ends of the stent graft or from back-bleeding arteries, causing it to once again become pressurized and potentially rupture.