Everything You Need To Know About Aneurysms

Aneurysms happen when an area on an artery wall expands like a balloon. Left untreated, the bulging vessels weaken and may eventually burst.

"Aneurysms typically happen in diseased blood vessels," says Loay Kabbani, M.D., a vascular surgeon at Henry Ford Health. "There's a structural defect that weakens the arterial wall and causes them to expand over time."

Unfortunately, most aneurysms grow slowly and silently, which means rupture can come on without any obvious warning signs. Here's what you need to know to ensure the best possible outcomes.

What Are The Different Types Of Aneurysms?

Arteries are large blood vessels that transport oxygenated blood from your heart to other parts of your body. When part of the arterial wall weakens, the pressure of blood coursing through the vessels can cause a bulge-an aneurysm.

Since arteries run through your entire body, aneurysms can happen anywhere. An aneurysm can develop in your chest, heart, abdominal cavity, legs and brain. Here's how they break down:

• Aortic aneurysms form in the aorta, which carries blood out of the heart through your chest and abdomen.
• Thoracic aortic aneurysms develop in the upper part of your aorta in the chest.
• Abdominal aortic aneurysms develop in the area where your aorta transports blood through your abdomen to your legs.
• Popliteal aneurysms form in the artery behind the knees.
• Mesenteric artery aneurysms happen in the artery that transports blood to the intestine.
• Splenic artery aneurysms form in an artery in your abdomen that transports blood to your spleen.
• Carotid aneurysms form in the major arteries in your neck (called the carotid arteries). These large vessels carry blood to your brain, neck and face.
• Cerebral aneurysms occur in the brain. The most common type of brain aneurysm is called a saccular or berry aneurysm because it forms as a sack of blood that looks like a berry attached to the artery.

Aneurysms usually aren't painful, but they can rupture and cause internal bleeding, leading to pain in the area of the rupture. They may also give rise to blood clots that block the flow of blood through the artery.

Who Is At Risk Of Developing An Aneurysm?

Different types of aneurysms have different risk factors. Cerebral aneurysms, for example, tend to affect women more than men while aortic aneurysms are more likely to strike men.

In general, the following risk factors apply to nearly all types of aneurysms:

• Smoking
• Genetics
• Hypertension (high blood pressure)

What Are The Signs Of An Aneurysm?

Symptoms of an aneurysm typically come on quickly, often without warning. "It's common for people to not realize they have an aneurysm," Dr. Kabbani says. "But an aneurysm that ruptures requires immediate treatment."

When an aneurysm does sound alarm bells, it usually causes pain, blood loss and a sudden drop in blood pressure, which may cause you to feel clammy, or even cold.

Other symptoms of an aneurysm include:

• Sudden and severe pain in one of the arterial areas (head, chest, abdomen and back)
• Pain in your belly that radiates into your back
• Rapid heartbeat
• Feeling lightheaded
• Loss of consciousness
• Confusion
• Nausea or vomiting

What Happens If Your Doctor Detects An Aneurysm?

Aneurysms sound terrifying, but not all aneurysms are dangerous. In fact, if the aneurysm is small, it has a low risk of rupturing. Your doctor may take a "wait and see" approach to treatment for this kind of aneurysm.

Doctors determine whether an aneurysm is at risk of rupture based on the following:

• The location and size of the aneurysm
• Your family and medical history
• Genetic testing

When an aneurysm needs treatment, doctors use surgery or medication to improve blood flow, lower blood pressure and manage cholesterol levels.

"Once patients are treated for an aneurysm, they need to be followed for the rest of their lives because there's a demonstrated weakness in the arteries," Dr. Kabbani says. "Some patients will require follow-up testing every six months. Others will only need to be assessed every year or every two years."

Can Aneurysms Be Prevented?

While not all aneurysms can be prevented, there are things you can do to enhance the health of your arteries and reduce the risk of developing an aneurysm. Key strategies include:

• Eat a heart-healthy diet
• Maintain a healthy weight
• Get regular exercise
• Avoid smoking

"It's important to work with your doctor to monitor your cholesterol levels, make sure you don't have plaque buildup on your arterial walls, and that your blood pressure is well controlled," Dr. Kabbani says.

If you have a family history of aneurysm, genetic mutations linked to aneurysms, or you're a current or former smoker, get your arteries checked. The United States Prevention Task Force also recommends that men who have ever smoked should undergo ultrasound screening for aneurysm beginning at age 65.

Reviewed by Dr. Loay Kabbani, a vascular surgeon who sees patients at Henry Ford Hosptial in Detroit.