Aneurysm – types, causes, symptoms and treatment [WE EXPLAIN]

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Tętniak to stan patologiczny tętnic i bardzo rzadko żył. Tętniaki rozwijają się bezobjawowo, dlatego w wielu przypadkach pacjenci nawet nie wiedzą, że ich zdrowie i życie jest zagrożone. Niezdiagnozowany tętniak może pęknąć, co stanowi bezpośrednie zagrożenie życia. Jak rozpoznać tętniaka i jakie badania warto wykonać? Jakie metody leczenia tętniaka są najskuteczniejsze?

What is an aneurysm?

An aneurysm is a pathological dilatation of an arterial vessel. This widening is over 50% larger in diameter compared to the pathologically unchanged section. The aneurysm is filled with blood and most often appears in the artery section, but the problem may appear much less frequently in the venous section.

Ściany tętniaków są bardzo cienkie i słabe, dlatego stwarzają zagrożenie dla zdrowia i życia pacjenta. Przepływ krwi przez tętniaka bardzo często jest zaburzony, a w samych naczyniach tworzą się skrzepliny.

The artery walls are reinforced with elastic fibers that make them resistant to the effects of arterial pressure. These fibers resemble intertwined spirals arranged in a tight mesh. When elastic fibers deteriorate, collagen fibers appear in their place, which are very stretchy and susceptible to blood pressure. In this case, in the damaged section, the diameter of the artery increases and this is how an aneurysm is formed.

When a given section of an artery increases in diameter, the blood flow is disturbed, which causes further damage to the vessel walls. As the aneurysm increases in diameter, the walls of the artery become less resistant to blood pressure.

At the climax it comes to aneurysm rupturewhich is associated with a very intense hemorrhage. Aneurysm rupture is a direct threat to the patient’s life and requires immediate medical intervention and first aid.

Czym są tętnice i na czym polega ich rola w naszym ciele? Sprawdź: Artery – What are arteries and what functions do they perform in the body?

Types of aneurysms

Aneurysms are pathological changes that can occur in all arteries and the heart, rarely in the veins. Aneurysms differ from each other and their pathogenetic division is described as follows:

1. true aneurysm – is a type of aneurysm that is associated with a congenital defect in the structure of the artery wall. It can also result from trauma, inflammation, or the weakening of the fibers that protect the walls of the arteries. Treatment of a true aneurysm usually consists in clipping it. If it occurs in smaller vessels, it is left untreated. Larger aneurysms are only treated if they are in danger of rupturing;
2. pseudoaneurysm — to typ tętniaka, który powstaje w efekcie przerwania ciągłości ściany tętnicy, która jest otoczona przez mięśnie, powięzi i tkankę łączną. Przerwanie ciągłości jest najczęściej następstwem krwiaka. Krew z naczyń dostaje się do sąsiadujących tkanek, które przez ucisk ograniczają dalsze krwawienie. Po pewnym czasie krwiak przeobraża się i zostaje otoczony torebką łącznotkankową. Tętniaki rzekome powstają po zabiegach kardiologicznych lub w wyniku nakłuć przy wprowadzaniu cewnika;
3. dissecting aneurysm – is a type of aneurysm in which the continuity of the intima is ruptured. As a result, blood seeps between the layers of the vessel and a pathological channel is formed in the vessel wall. Aortic aneurysm usually affects the aorta and is caused by severe overpressure or defects in the structure of the vessel walls. The inner membrane breaks and detaches from the rest of the wall. The dissection increases in the direction of blood flow.

also types of aneurysms can be specified based on their location. When using this criterion, the following are listed:

1. aortic aneurysm;
2. heart aneurysm;
3. femoral artery aneurysm;
4. popliteal artery aneurysm;
5. renal artery aneurysm;
6. aneurysm of the cerebral arteries.

Jeśli chcesz wiedzieć o budowie i roli aorty, przeczytaj: Aorta – the main human artery

Aneurysm – causes of formation

Aneurysms can appear in vessels for many different reasons. However, specialists list a few of the most important direct reasons for the formation of aneurysms. Among them, the following are indicated:

1. a weakened structure in the blood vessel wall as a birth defect;
2. wieloletnie podwyższone ciśnienie krwi, które rozpycha ściany naczyń krwionośnych, przez co je osłabia i uszkadza;
3. rozwój miażdżycy, której przebieg powoduje osłabienie ścian naczyń krwionośnych;
4. injuries, e.g. to the chest;
5. polycystic kidney disease increases the risk of an aneurysm of the cerebral arteries;
6. infections that weaken blood vessels.

What is worth knowing about the circulatory system? Check: The functions of the circulatory system

Aneurysm – characteristic symptoms

The vast majority of aneurysms develop and are completely asymptomatic up to the critical moment of rupture. Due to their asymptomatic nature, aneurysms are diagnosed most often by accident during tests performed for a completely different reason.

In order to identify specific possible symptoms of an aneurysm, it is necessary to focus on the location of the pathological lesion. Different symptoms will be associated with a brain aneurysm and others with an aneurysm of the heart or thoracic aorta.

It is worth noting, however, that aneurysms are much more common in men than in women. It is estimated that about 5-6 times more aneurysms are diagnosed in men.

What diseases affect the circulatory system? Check: Diseases of the circulatory system and circulation

Brain aneurysm – characteristics and symptoms

A brain aneurysm is known as an intracranial aneurysm or an aneurysm of the cerebral vessels. It is most often formed at the bifurcation of arteries into further branches or at the point of departure of individual arteries. Brain aneurysms are formed as a bulging of the artery wall and resemble a pouch.

This is why the aneurysms that most often develop in the brain are called baggy aneurysms. They constitute 80% of all brain aneurysms and in many cases they are multiple pathologies. These types of aneurysms rupture more often than not spindle aneurysmswhich are usually located on the basilar and middle arteries of the brain. Spindle aneurysms are most often formed as a result of atherosclerotic lesions, which is why they are diagnosed mainly in the elderly.

Very often, an aneurysm of the brain does not give any symptoms until it ruptures, which poses a threat to the patient’s health. However, you can point to non-specific aneurysm symptomswhich occur in some patients.

Symptoms of a brain aneurysm may include headaches, dilatation of one pupil, double vision, drooping eyelid. The moment an aneurysm ruptures, there is a very severe and sudden headache. The pain may be accompanied by a stiff neck, photophobia, nausea and vomiting. Some patients become unconscious, have speech disorders and, in very severe cases, fall into a coma.

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What are the most common brain tumors, and what should you know about them? Check: Brain tumors

Aneurysm of the thoracic and abdominal aorta – characteristics and symptoms

The aorta is the main artery in the bloodstream that distributes blood throughout the body. Due to its course, the aorta is divided into abdominal and thoracic. Aortic aneurysm occurs where the artery wall has stretched and is weak.

Aortic aneurysm, as in the case of a brain aneurysm, may be asymptomatic, but as the lesions in the aorta enlarge, the patient may experience increasing pain in the chest and back pain. There is also hoarseness, coughing and the characteristic feeling of lack of air.

Much more severe symptoms occur when the thoracic aortic aneurysm ruptures. In this case, the following is observed:

1. sudden and severe pain in the chest and back pain;
2. pain in the jaw, neck or shoulder area;
3. pain radiating to the back;
4. dyspnoea;
5. low blood pressure;
6. fainting or passing out;
7. trouble swallowing;
8. limb weakness or paralysis;
9. difficulty speaking.

In the case of an abdominal aortic aneurysm, the symptoms most commonly affect the lower back and abdomen. You have abdominal swelling, nausea, vomiting, excessive sweating, a fast heart beat and a throbbing sensation in the abdomen.

You can read more about an abdominal aortic aneurysm in this article: Abdominal aortic aneurysm – causes, symptoms, treatment

Heart aneurysm – characteristics and symptoms

A heart aneurysm is a fairly rare complication of a heart attack that one in ten patients may experience. A heart aneurysm may also be caused by ischemic heart disease, sarcoidosis or American trypanosomiasis.

A heart aneurysm is a bulging of the heart wall that is characterized by scarring changes. The infarct scar lacks the ability to contract, so the area with the scar stretches as the heart beats. This leads to changes in the heart wall and an aneurysm.

Heart aneurysms can be divided into true and pseudo-aneurysms. Real heart aneurysms they are made up of endocardium, heart muscle and pericardium. Pseudoaneurysms instead, they are composed of the epicardium and the pericardium.

A heart aneurysm may be asymptomatic for a very long time. This type of aneurysm most often develops in the left ventricle. One symptom a patient may notice is difficulty exercising. This is because an aneurysm can block blood flow to peripheral tissues, which will reduce the patient’s physical capacity.

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In addition, a blood clot can form inside the heart aneurysm, causing vascular obstruction and tissue ischemia. This can cause a stroke or painful limb ischemia. Symptoms that a patient with a heart aneurysm may notice include weakness, shortness of breath and a dry cough which may be accompanied by coughing up blood.

What is an aortic dissection? Check: Aortic dissection

Aneurysm of the femoral and popliteal arteries – characteristics and symptoms

The causes of an aneurysm of the femoral artery are usually degenerative changes in the wall of the femoral artery, reconstructive procedures or mechanical injuries of the artery. You can recognize an aneurysm with the naked eye because a subcutaneous tumor forms on the skin. In addition, the patient experiences local pain.

The popliteal aneurysm is a result of microtraumas, infections or congenital collagen defects. This type of aneurysm ruptures very rarely, but relatively often leads to embolism, which results in peripheral thrombosis.

The most common symptom of a popliteal aneurysm is deep vein thrombosis. Patients are diagnosed with swelling of the foot or lower leg. The aneurysm itself can be felt as a subcutaneous, pulsating tumor. In advanced cases, there are skin changes in the foot, including gangrene of the fingers.

What are the causes and symptoms of gangrene? Check: Gangrene (gangrene)

Pulmonary Aneurysm – Characteristics and Symptoms

A pulmonary aneurysm is a very rare type of aneurysm. In a pulmonary aneurysm, the pulmonary artery widens by more than 50% of its normal diameter. A pulmonary aneurysm is a congenital or acquired condition. Very rarely, patients are diagnosed with a congenital type.

Z kolei nabyty tętniak tętnicy płucnej jest konsekwencją choroby naczyń płucnych. Wzrost naczyniowego oporu płucnego oraz nadciśnienie krwi prowadzą do poszerzenia tętnicy płucnej i powstania tętniaka.

As with the previously described aneurysms, a pulmonary aneurysm may also show no obvious symptoms. However, with the course of the disease and the enlargement of the diameter of the artery, the patient may experience exercise dyspnea, weakness, cough, haemoptysis and decreased physical function.

Who is a vascular surgeon and when is it worth consulting your ailments with him? Check: When to see a vascular surgeon?

Aneurysm of visceral and renal arteries – characteristics and symptoms

Aneurysms of visceral and renal arteries are pathological changes that are very rarely diagnosed, yet they pose a serious threat to the health and life of the patient. Tętniak trzewny most often it is located on the splenic or hepatic artery. Vascular changes can also occur in the gastroduodenal artery and in the pancreatic branches.

Visceral and renal aneurysms arise as a result of degenerative changes in the vessels. Specialists also point out that the causes of visceral aneurysms may be connective tissue diseases, atherosclerosis, hypertension or fibro-muscular dysplasia.

As previously described, visceral and renal aneurysms develop asymptomatically for the patient. The first symptom is usually an aneurysm rupture followed by a hypovolemic shock. Renal aneurysm may be manifested by arterial hypertension, abdominal pain, hematuria or pain in the loin area. A renal artery aneurysm ruptures very rarely.

What is the Doppler ultrasound examination? Read: USG Doppler – na czym polega, kiedy wykonać i co diagnozuje [WYJAŚNIAMY]

Rupture of the aneurysm – causes and consequences of the complication

One of the most serious complications of an aneurysm is rupture. An aneurysm rupture usually presents with very severe and sudden pain where the aneurysm was developing. People who have experienced an aneurysm rupture have often admitted that the pain they experienced was the strongest pain they experienced in their life.

In addition to pain after aneurysm rupture, weakness, pallor, sweating, palpitations, disturbance of consciousness, limb ischemia and loss of consciousness or coma may occur.

Depending on where the aneurysm was, complications from rupture may include:

1. powstanie tętniaka rozwarstwiającego;
2. formation of a clot inside the aneurysm;
3. blood flow disorder;
4. subarachnoid hemorrhage;
5. stroke;
6. paralysis;
7. an epilepsy attack;
8. heart failure;
9. death as a result of internal hemorrhage.

Jakie są najczęstsze przyczyny pęknięcia tętniaka? Sprawdź: Coffee and sex are among the most common causes of brain aneurysm rupture

Aneurysm – diagnosis

As already mentioned, the aneurysm develops asymptomatically. Therefore, it rarely happens that its diagnosis is based on deliberately ordered tests. The vast majority of aneurysm is detected during other routine tests or after a recent injury.

Jednak w przypadku podejrzenia tętniaka, lekarz może zlecić wykonanie poniższych badań:

1. ultrasound examination (ultrasound);
2. computed tomography (CT) – a painless and non-invasive examination. Allows you to identify possible intracranial bleeding;
3. magnetic resonance imaging (MRI) – this test is performed to more accurately visualize intracranial bleeding and to diagnose any damaged area of ​​the brain;
4. radiological examination (X-ray);
5. arterial angiography – this test is performed during computed tomography – allows you to visualize the cerebral vessels: their course and diameter, possible narrowing and widening;
6. examination of the cerebrospinal fluid, i.e. lumbar puncture.

What is coronary angiography and when is it performed? Check: coronary angiography

Aneurysm – methods of treatment

Aneurysm treatment methods depend on the size of the lesion as well as where the aneurysm is located.

1. Aneurysm of the cerebral arteries – there are two methods of treating cerebral arterial aneurysms. These are: surgical insertion of a clip on the neck of an aneurysm or embolization, i.e. a neuroradiological procedure. Embolization is the introduction of material through the vessels, which closes the changed part of the blood vessel. It is an endovascular method that does not require opening the skull. Clipping is a surgical procedure in which the bones of the skull are cut, the aneurysm is reached and the clipped with a metal clip.
2. Thoracic aortic aneurysm – treatment consists of taking antihypertensive drugs, i.e. drugs that lower blood pressure. If necessary, a decision may be made to perform a surgical operation. Unfortunately, an undiagnosed thoracic aortic aneurysm is often fatal because rupture of the aneurysm causes a massive and rapidly spreading hemorrhage into the body cavities;
3. Abdominal aortic aneurysm – treatment is based on taking medicines to lower blood pressure. As with a thoracic aortic aneurysm, the decision to undergo surgery may be made.

How to choose medications for arterial hypertension? Check: Drugs for hypertension – selection and effectiveness

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