What Is an Aneurysm?

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An aneurysm is a disorder of the vascular system. It involves a weakening in part of an artery wall, causing the artery to stretch and balloon out. When the artery wall is weak enough to bulge out, there is a risk that it could eventually burst, or rupture (break open suddenly), which could cause some serious complications, such as internal bleeding.

The larger the aneurysm, the higher the risk for it to rupture. The severity of a ruptured aneurysm depends on many factors, such as which artery is involved and where in the body the aneurysm is located. For example, a ruptured brain aneurysm could result in a stroke. Depending on the location of the aneurysm, other serious complications could include a heart attack, kidney damage, or even death.

It’s very important to see your healthcare provider if you suspect that you have an aneurysm. If you have signs of a ruptured aneurysm, seek emergency medical care right away.

aneurysm

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Types of Aneurysms

Aneurysms can occur anywhere in the body. Common types of aneurysms include:

  • Abdominal aortic aneurysm (AAA): The most common type of aneurysm that occurs in the aorta
  • Thoracic aortic aneurysm: Occurs in the area where the aorta travels through the thorax (chest area)  
  • Cerebral aneurysm: Occurs in the brain
  • Popliteal artery: Occurs in the artery located behind the knee
  • Mesenteric artery aneurysm: Occurs in the artery that supplies blood to the intestine
  • Splenic artery aneurysm: Occurs in an artery of the spleen

Aneurysm Symptoms

The symptoms of an aneurysm vary greatly depending on which type of aneurysm a person has.

Abdominal Aortic Aneurysm (AAA) Symptoms

An abdominal aortic aneurysm may not involve any symptoms at all. In fact, most people with an AAA do not have symptoms unless the aneurysm ruptures. But a large aneurysm can put pressure on the organs surrounding the artery, causing symptoms such as:

  • Abdominal discomfort
  • Weight loss
  • A pulsating sensation in the abdomen
  • Pain in the abdomen (either continuous or intermittent pain)
  • Chest pain
  • Lower back or flank pain (which often spreads to the buttocks, groin area, or legs)
  • A bruised looking, painful toe (which occurs if a blood clot blocks the flow of blood to the lower extremities)
  • Fever (if linked with an infection or inflammation, called an inflammatory aortic aneurysm)

The pain from an AAA is often experienced as throbbing, aching, or gnawing deep pain that may last hours or days. The pain does not increase with movement, but some positions of the body can impact the pain (such as lying on the back).

The symptoms are similar to those of:

Ruptured Abdominal Aortic Aneurysm Symptoms

If an abdominal aortic aneurysm ruptures, it can cause symptoms such as:

  • Sudden, severe pain (stabbing abdominal or back pain)
  • Chest and jaw pain
  • A dramatic drop in blood pressure
  • Difficulty breathing
  • Fainting
  • Weakness (on one side of the body)
  • Symptoms of shock (such as cold, clammy skin, weak pulse, rapid heart rate, sweatiness, confusion, or unconsciousness)

A ruptured aortic aneurysm can very quickly result in death, particularly if emergency treatment is not provided. Symptoms of a ruptured aortic aneurysm are sometimes mistaken for a heart attack because many of the symptoms are similar.

Thoracic Aortic Aneurysm Symptoms

Just like an abdominal aortic aneurysm, symptoms of a thoracic aortic aneurysm may not be present unless the aneurysm is large, or in instances where the aneurysm ruptures.

When symptoms do occur, they differ depending on the size, location, and rate of progression (growth) of the aneurysm.

Symptoms of a large thoracic aneurysm may include:

  • Wheezing, coughing, or shortness of breath (due to pressure on the trachea or windpipe)
  • Difficulty swallowing (from pressure on the esophagus)
  • Tenderness or pain in the chest area
  • Upper back, jaw, or neck pain
  • Hoarseness in the throat (from pressure on the vocal cords)

Symptoms that may indicate that a thoracic aneurysm has ruptured include:

  • Sudden, severe chest or back pain (which spreads to the back)
  • Dyspnea (difficulty breathing)
  • Trouble swallowing
  • Low blood pressure
  • Loss of consciousness

Note, sudden severe pain linked with a thoracic aneurysm could be fatal without immediate emergency medical intervention.

Cerebral (Brain) Aneurysm Symptoms

Most unruptured cerebral aneurysms are asymptomatic, meaning there are no symptoms unless the aneurysm becomes very large. When a cerebral aneurysm does become large in size, it increases pressure on the nerves or brain tissue adjacent to the aneurysm.

Symptoms of large brain aneurysms may include:

  • Headaches (the most common sign of a brain aneurysm that has not yet ruptured)
  • Vision problems (particularly of the peripheral vision)
  • Thinking problems
  • Trouble processing information
  • Speech deficits
  • Sudden change in behavior
  • Loss of balance
  • Short-term memory problems
  • Fatigue

People have described the pain associated with a ruptured aneurysm as the worst headache ever experienced.

Symptoms of a ruptured cerebral aneurysm—which causes bleeding of the brain (also called a subarachnoid hemorrhage)—include:

  • Severe headache
  • Nausea and vomiting
  • Stiff neck/neck pain
  • Blurred or double vision
  • Pain, located behind the eye
  • Dilated pupils
  • Light sensitivity
  • Loss of sensation in an arm or leg
  • Coma

Any symptoms of a cerebral aneurysm require prompt medical intervention, but a ruptured brain aneurysm can be life threatening if immediate emergency care is not provided.

Causes

Causes of an aneurysm include any factors that damage or weaken the artery walls, for example:

Genetics

People with an inherited condition called Marfan syndrome have a higher risk of developing aneurysms. Also, a person with a family history of heart attacks and other types of heart disease is at higher risk of having an aneurysm than those who do not have a genetic link to heart disease.

Other risks linked with the development of aneurysms include:

  • Being a male (men are more likely to have aneurysms than females)
  • Aging (people aged 65 and older are more at risk than younger people to get aneurysms, and the risk continues to increase with age)
  • Eating a diet high in fats and cholesterol
  • Being obese
  • Being pregnant (may increase the risk of having a splenic artery aneurysm)
  • Having major trauma (such as from a car accident; serious injuries can damage the blood vessels and could potentially lead to aneurysms)

Diagnosis

Most often, aneurysms are found during screening for other types of illnesses. Regular aneurysm screening tests are available for those who are at risk of having an aneurysm, even when symptoms are not present.

Those who have had a diagnosis of an aneurysm need to have close medical supervision to ensure that the aneurysm isn’t growing larger, which increases the risk of a ruptured aneurysm. 

Tests

Common diagnostic tests used to identify aneurysms include:

  • An angiography: This X-ray image utilizes a special type of dye and takes images of the blood vessels via a particular type of camera.
  • An ultrasound: This test utilizes sound waves to make images of the body’s organs. Ultrasounds are instrumental in screening for abdominal aortic aneurysms. 
  • An MRI scan: This uilizes very strong magnetic fields and radio waves to produce detailed images of the brain.
  • CT scan: This takes a series of images that are exhibited by a computer as very detailed 3D images of the brain.
  • A lumbar puncture: This may be performed when the CT scan is unable to detect a ruptured aneurysm, but a person’s symptoms suggest that a rupture has occurred. The lumbar puncture involves a needle that is inserted into the lower spine to remove some of the fluid, called cerebral spinal fluid (CSF). If blood is present in the CSF, it suggests that a brain bleed has occurred.

Treatment

The treatment of an aneurysm depends on several different factors, including the size, location, and type of aneurysm.

Treatment modalities—such as surgery—are dependent on the location of the aneurysm (those in some locations of the brain may be inoperable), as well as the severity of the aneurysm.

Small aneurysms that are not causing any symptoms do not usually require treatment. If an aneurysm is large and/or symptomatic, treatment modalities that may be recommended by your healthcare provider include:

  • Medication: This can help lower blood pressure and relax the blood vessels.
  • Surgery: A surgical procedure can be done to replace the weakened artery as well.

Prevention

Several preventive measures aim at lowering the risk of getting aneurysms, as well as slowing down the progression of existing aneurysms. Because aneurysms are largely linked with unhealthy lifestyle factors, there are many things that a person can do to help with prevention measures, such as:

  • Managing blood pressure
  • Eating a healthy diet
  • Managing blood sugar
  • Exercising regularly
  • Taking medications as prescribed

Prognosis

The prognosis (outcome) of treatment for an aneurysm is dependent on many factors, such as where the aneurysm is located, the size of the aneurysm, and whether it has ruptured.

A Word From Verywell

Having the knowledge that you have some type of aneurysm can be very stressful. While it’s vital to pay attention to your symptoms, it’s also important to avoid obsessing about your illness.

Staying socially active, and maintaining hobbies and interests are important aspects of staying mentally and physically healthy. The main thing is to try to do things that create balance. Implementing lifestyle changes and exploring ways to cope with stress will help to empower you by enabling you to do things you can, to improve your overall health and wellbeing.

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Article Sources
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  1. American Heart Association. What is an aneurysm?  Updated January 22, 2021.

  2. Stanford Healthcare. Abdominal aortic aneurysm symptoms.

  3. Penn Medicine. Types of aneurysms. Updated June 21, 2018.

  4. Johns Hopkins Medicine. Thoracic aortic aneurysm.

  5. American Stroke Association. What you should know about cerebral aneurysms. Updated December 5, 2018.

  6. Aurora Healthcare. Aneurysm.

  7. Johns Hopkins Medicine. Brain aneurysm: 4 things you need to know.