Something like a little balloon inside your body? Let's talk about this aneurysm!

Have you ever heard of the word 'aneurysm'? Maybe you've heard of a friend or family member who has one. Or maybe you've heard a doctor talk about it. Although the name may sound a bit scary, if we know exactly what it is, we can avoid unnecessary fear. So, shall we talk about it today?

What exactly is an aneurysm?

Simply put, an aneurysm is a weak spot in the wall of a blood vessel in our body that bulges out like a balloon. You know, our arteries are the big tubes that carry oxygen-rich blood from the heart to the rest of the body. So, if a spot in the wall of this artery becomes weak, the pressure created by the fast-flowing blood causes that weak spot to bulge. That bulge is what we call an aneurysm.

Most of the time, we don't feel that we have an aneurysm, and we don't feel any pain. However, if it suddenly ruptures, it can be very dangerous, and sometimes even life-threatening. Therefore, it is very important to be aware of this.

Are there different types of aneurysms? Where do they form?

Yes, aneurysms can form in any artery in our body. That means they can form in various places like the heart, stomach, brain, and legs. The type of aneurysm depends on where it forms.

The most common type of aneurysm that is seen most often is the aortic aneurysm . Did you know that the aorta is the largest artery in our body? It is the artery that carries blood from the heart to the entire body. Aneurysms that occur in arteries other than the aorta are called peripheral aneurysms.

Let's look at a few main types:

• Abdominal Aortic Aneurysm (AAA): This is the most common type. It develops in the part of the aorta that runs down through the abdomen.
• Cerebral Aneurysm/Brain Aneurysm: As the name suggests, this occurs in an artery in the brain. The most common subtype of this is the saccular aneurysm, also known as a berry aneurysm . It looks like a small sac filled with blood attached to the artery, similar to a berry.
• Thoracic Aortic Aneurysm: This is a little smaller than the abdominal Aortic Aneurysm. It occurs in the upper part of the aorta, in the chest area.
• Carotid Aneurysm: These develop in the carotid arteries, which supply blood to our brain, neck, and face. These are very rare.
• Popliteal Aneurysm: This occurs in the artery that runs behind the knee.
• Mesenteric Artery Aneurysm: This type of aneurysm develops in the artery that supplies blood to our intestines.
• Splenic Artery Aneurysm: This occurs in the artery leading to the spleen.

How common is this aneurysm?

Did you know that unruptured brain aneurysms occur in 2% to 5% of healthy people? And, of those, about 25% have more than one aneurysm. Most often, they develop in adulthood, but they can also occur in children. They are usually diagnosed around the age of 50. But the best part is, the vast majority of brain aneurysms do not rupture.

Aortic aneurysms (AAAs) are more common with age. In particular, abdominal aortic aneurysms (AAAs) are four to six times more common in men than in women. Only 1% of men aged 55-64 have them. However, this percentage increases by 2% to 4% with each decade.

Who is at higher risk of developing an aneurysm?

Different types of aneurysms affect different groups of people. For example, brain aneurysms are more common in women than in men. Similarly, aortic aneurysms are more common in men than in women.

Abdominal aortic aneurysms (AAA) are most common in:

• For men.
• For those over 60 years of age.
• For those who smoke. (This is a very big risk factor!)
• For white people (but can develop in anyone of any race).

What are the symptoms of an aneurysm?

Most of the time, a person doesn't know they have an aneurysm. It can be silently growing inside the body. However, if an aneurysm bursts, it's a medical emergency! You need to get treatment right away. If you or someone you are with shows signs of a ruptured aneurysm, call 911 (1990 Suwaseriya in Sri Lanka) immediately.

Symptoms of a ruptured aneurysm occur suddenly:

• Lightheadedness /dizziness.
• Rapid heartbeat.
• A sudden severe headache, pain in the chest, stomach, or back.
• Sudden Loss of Consciousness after a severe headache.

Important: A ruptured aneurysm is a life-or-death situation, so if you experience these symptoms, don't delay for a second.

Even if an aneurysm does not burst, it can sometimes cause symptoms depending on where it is located. You may experience symptoms of shock, such as low blood pressure, cold sweats, a feeling of faintness, and a fast heartbeat.

Other symptoms may include:

• Feeling confused or dizzy.
• Difficulty swallowing.
• Fatigue.
• Headache (especially in cases of brain aneurysm).
• Nausea or vomiting.
• Pain in your Abdomen, Chest or Back.
• Pulsating Abdominal Mass or Swelling in your Neck.
• Rapid Heart Rate.
• Vision Changes.

What are the possible complications of an aneurysm?

If an aneurysm ruptures, it causes internal bleeding. Depending on where it occurs, the rupture can be very dangerous and even life-threatening.

Imagine, what happens if a blood clot forms in an aneurysm in your neck and travels to your brain? If that blood clot blocks the flow of blood to your brain, a stroke occurs.

If a brain aneurysm bursts, it is called a subarachnoid hemorrhage. Some people call this type of stroke a brain bleed. People usually experience "the worst headache of their lives." This can be followed by numbness, difficulty speaking, and other symptoms.

Why does this aneurysm form? What are the causes?

Sometimes, people are born with an aneurysm. This means they are present at birth. However, they can develop at any time in life. In most cases, it is difficult to find a specific cause for an aneurysm. However, there are several possible causes:

• Atherosclerosis: This is when fatty deposits build up in the walls of the arteries, narrowing them. This can weaken the walls of the arteries.
• Family history of aneurysms: If your mother, father, or siblings have had this condition, you are at risk of developing it too.
• High Blood Pressure: If blood pressure is consistently high, the artery walls can become damaged and weak.
• An accident or injury to the aorta .

How do doctors diagnose an aneurysm? (Diagnosis)

Many aneurysms develop without any symptoms. Your doctor may find them by chance during a routine checkup or other scan.

If you have symptoms that suggest you may have an aneurysm, a doctor will do several imaging tests. Tests that can help find and diagnose an aneurysm include:

• CT Scan
• CT or MRI Angiography: This is used to take a special picture of the blood vessels.
• Ultrasound scan `(Ultrasound)`

How does a doctor classify an aneurysm?

Your doctor will classify an aneurysm based on its size and how it formed. There are different classifications:

• Fusiform aneurysm: In this, the artery bulges out from all sides.
• Saccular Aneurysm: This is when only one side of the artery bulges (similar to the previously mentioned Berry Aneurysm).
• Mycotic Aneurysm: This occurs when an artery wall weakens after an infection (often in the heart valves).
• Pseudoaneurysm or False Aneurysm: In this, only the outermost layer of the artery wall bulges. This can occur after damage to the inner layer of the artery (dissection).

How is an aneurysm treated?

If a doctor finds that you have an unruptured aneurysm, they will monitor you closely. The main goal of treatment is to prevent the aneurysm from rupturing.

Depending on the type, location, and size of the aneurysm, treatment may include medications or surgery. A doctor may prescribe medications to improve blood flow, lower blood pressure, or control cholesterol. These treatments can help control the aneurysm from getting bigger and reduce the pressure on the artery wall.

Large aneurysms that are at risk of bursting may require surgery. Also, if an aneurysm ruptures, surgery is definitely needed. There are several types of surgery:

• Endovascular Aneurysm Repair (EVAR): In this endovascular surgery, a doctor inserts a catheter (a thin tube) into a blood vessel. Through the catheter, the surgeon inserts a graft (a specialized piece of wire) to strengthen or repair the artery. For thoracic aneurysms, this procedure is called Thoracic Endovascular Aneurysm Repair (TEVAR). If a graft with specific openings is created, it is called a Fenestrated Endovascular Aneurysm Repair (FEVAR).
• Open Surgery: In some cases, a surgeon may make an incision (open surgery) to insert a graft or remove the aneurysm.
• Endovascular Coiling: This procedure treats cerebral aneurysms. The surgeon inserts several coils (i.e., platinum wire coils) into the aneurysm through a catheter and fills it. This reduces the amount of blood flowing into the aneurysm and reduces the risk of it bursting.
• Microvascular Clipping: This is also a type of open brain surgery for cerebral aneurysms. The surgeon places a metal clip at the base of the aneurysm to cut off the blood supply.
• Catheter Embolization: This procedure is used to stop the bleeding in an aneurysm. The surgeon inserts a catheter into the affected artery and uses the tube to inject medications or embolic agents that stop the bleeding.

How can I prevent an aneurysm from forming?

Unruptured aneurysms are common. They can't always be prevented. However, you can reduce your risk of developing an aneurysm by maintaining a healthy lifestyle:

• Eat a Heart-Healthy Diet: Eat less oil, salt, and sugar, and more vegetables and fruits. Things like leafy greens, herbs, and fresh fish that are available in our country are very good.
• Exercise Regularly: Do something like walking, running, or swimming for at least 30 minutes a day.
• Maintain a Healthy Weight: Maintaining a weight that is appropriate for your height is very important.
• Avoid or Quit Smoking: This is a must-do. Smoking is one of the biggest causes of aneurysms.

What is the prognosis for someone with an aneurysm?

Ruptured aneurysms are life-threatening emergencies. If an aneurysm ruptures in the brain, it can cause a stroke. It can be fatal if not treated immediately. With prompt treatment, the outcome can vary. Most people recover well with rehabilitation and other treatments.

Doctors can usually help people with small, unruptured aneurysms. Your doctor will monitor your condition closely. Medications or surgery can reduce the risk of rupture.

When should I see a doctor?

If you experience symptoms like these, you should see a doctor immediately:

• Lightheadedness.
• Rapid Heart Rate.
• A sudden severe headache, pain in the chest, stomach, or back.

These symptoms could be a sign of a ruptured aneurysm, so it is important to seek medical advice without wasting time.

What questions should I ask my doctor?

If you suspect you have an aneurysm, or if you already have the condition, you can ask your doctor questions like these:

• Am I at risk of developing an aneurysm?
• Do I need to have imaging tests to find an aneurysm?
• How can I prevent my aneurysm from getting worse or bursting?
• What lifestyle changes can I make to reduce my risk?

Remember, an aneurysm can develop in any artery in our body. Your doctor can monitor an aneurysm and treat it to reduce the risk of it bursting. However, if an aneurysm bursts, it is a medical emergency. You should seek medical help immediately.

Finally, things to remember (Take-Home Message)

Okay, so we've talked a lot about aneurysms today, haven't we? Simply put, they're a weak part of one of our blood vessels that bulges out like a balloon. Most of the time, you don't even notice them, but they can be very dangerous if they burst.

The most important thing is to be aware of your risk factors. If you have things like smoking, high blood pressure, or a family history, it's a good idea to get regular medical checkups.

If you experience emergency symptoms, such as sudden severe headache, chest pain, or loss of consciousness, go to a hospital without delay.

A healthy lifestyle, such as eating well, exercising, and avoiding smoking, can reduce this risk. So, take care of your body too. Because health is the most important thing!

` Aneurysm, blood vessel, aorta, brain aneurysm, abdominal aneurysm, ruptured blood vessel, sudden headache, surgery