Aneurysm and dissection

Aneurysm and dissection

Description aneurysm and dissection


Under the word aneurysm bulge to understand pathologicalvessel. Its formation is possible for several reasons, among which we can mention the inherent changes in the vascular wall,especially its attenuation further wall may be impeded by a disease from its surroundings, for example due to tuberculosis, cancer or large deposits of inflammation, or may be a blood vessel damaged by trauma .

In former times it was an aneurysm most often associated with the disease syphilis. The most important cause of aneurysm is presently atherosclerosis. Why her? Because its incidence is increasing, it begins to evolve already in young adults. It has been associated with smoking, high blood pressure and high levels of blood fats (such as cholesterol).

Aneurysms most commonly occur either on the largest artery in the body which withdraws straight from the heart and is called the aorta or cerebral arteries.

For a better idea – aorta was divided into parts. The first part is called the ascending aorta, it is the part that follows immediately after the interval of the heart. This is then bends to the right and generates a second portion, the aortic arch. The arc continues to run aorta downward runs parallel vertebral bodies lying directly ahead. The portion of the aorta that passes through the chest, is logically called the thoracic aorta and the part that follows it is termed the abdominal aorta.Abdominal aorta in the area below the sacrum branches into two iliac arteries.

Both localization, whether aorta or cerebral arteries, are dangerous only because of the high pressure of blood flow. If a crack (rupture) of the aneurysm, which is not timely correctly identified and treated, can result in rapid death due to exsanguination.

Aneurysms are several species, listed here are only the most severe form with which it is an opportunity to meet in a “normal” life.

Aneurysm caused by infection with syphilis (syphilis, syphilis) occurs at a later stage of the disease, especially when the disease unless treated. Most often affects the aortic arch and the thoracic portion of the aorta. Mostly former these aneurysms of large dimensions, and reached a size of around 15 cm.

Speeches were based on location – such aneurysm pressured to nearby structures, causing impaired breathing, trouble swallowing, or pressure on the bone and their subsequent decline. Rupture leading to bleeding into the chest.

Aneurysm caused by atherosclerosis. Atherosclerosis is a process of deposition of fatty plaques in the vessel wall. These are deposited in the form of pads and can lead to a variety of adverse effects. First, they are bulky pads, narrows the diameter of the blood vessel and thus to the authorities coming less blood. The second problem that can occur is that these pads are fragile and vulnerable make the vascular wall. When atherosclerosis added extra high pressure, it is trouble brewing. Thus pathologically altered vessel wall is thinned and allowed to its normal flexibility and thus is unable to sustain pressure and begins to bulge outward. As a rule, this type of aneurysm affects the lower part of the abdominal aorta. Clinically as palpable resistance (resistance) at the site of the aneurysm.

Cerebral aneurysm – in the case of cerebral artery aneurysms have such large dimensions are smaller and often multiple. Their size is about 5-20 mm and typically find them a larger number.Formed on the basis of congenital weakness of the vascular wall, but be careful not innate!Congenital is a disposition to their origin. They mostly show up when it comes to their rupture (rupture) and a sudden onset and very severe headache or transient loss of consciousness.Mortality during the first rupture of a cerebral artery aneurysm is approximately 50% and individuals who survive are at risk of coming days withdrawal cerebral vessels and subsequent cerebral infarction.


Dissection is another name can name a dissecting aortic aneurysm. The vascular wall consists of three tightly adjacent layers. In case that the influence of the pathological process there is a violation of integrity, it may happen that due to the blood pressure fall between these layers.

Layers also splits lengthwise and spread to different distance from the first point of damage. This may result in two parallel adjacent lumen through which blood flows. Which is dangerous in that the wall is very thinned out and a change of pressure again may burst. Unlike true aneurysm but no caving and bulging of the vascular wall. It most often occurs in the aortic arch.


Risk factors for aneurysm and dissection

At this point it is necessary to mention genetic predispositions, which arise as a result of various defects in the vascular wall – thinning or lack of flexibility. It’s good to know that someone in the family did not suffer from vascular disease, which could have a genetic origin.

Other risk factors is clearly atherosclerosis. That is now experiencing a large part of the population, but its occurrence can be prevented. In connection with the development of atherosclerosis risk factors are smoking, increased blood lipids (hyperlipidemia), and high blood pressure.


Prevention of aneurysm and dissection

From a genetic standpoint is not party to prevent many things to do. It’s good to alert the physician to the incidence of the disease in the family, so that was a timely treatment and preventive measures such that the vessel wall as possible protected from adverse effects. Jimi is meant ashigh blood pressure, and the resulting bursts, perhaps by greater physical exertion or sports. It is also necessary to keep blood fat at normal levels. It will be appreciated that the vessel wall has been damaged without their fault and you need to try not to damage even more.

Prevention of atherosclerotic changes in the vascular wall is clear. Smoking has a clear impact, so it is definitely avoided. Furthermore, high blood pressure, which may relate, inter alia, a poor lifestyle, plenty of stress or untrained body.

Obesity and high amount of lipids (fats) in the blood plasma is another possible creator atherosclerosis. Generally prevent the deposition of fatty plaques in arteries requires an overall lifestyle change, including a change of diet and inclusion into everyday life, a sufficient amount of movement. This is not to just exercise but also daily exercise in the form of a long walk, and the like. Just anything healthy “stir up” the bloodstream.


Signs and symptoms of aneurysm and dissection

Unfortunately, the symptoms are so pronounced that when they vote, it was clear that this is an aneurysm or aortic dissection. Generally, the aneurysm may present with pain in the shoulder and back pain, bad breath, especially with exertion (dyspnea) is palpable pulsation of the aorta in the abdomen (which is normally only possible in lean individuals – but they are definitely not an aneurysm, palpable pulsation because of their small physical construction allows palpate the aorta and through the abdominal wall).

In the event of a rupture of the aneurysm abdominal aorta, it will appear as an acute abdomen – associated with severe pain. In such case it is necessary to act very rapidly, especially if they are informed that the patient was diagnosed aneurysm. The solution is only by surgery.

If the aneurysm bursts of a cerebral artery, there is a sudden severe headache with no previous symptoms and may even brief loss of consciousness. Often the rupture of a cerebral artery occurs due to a sharp increase in blood pressure – Sudden physical exertion additionally associated with changing the position of the head or body, or great emotional experience.


Treatment of aneurysm and dissection

Therapies such as aneurysm dissecting aortic aneurysm is surgical. Another way, for example, conservative treatment with drugs can not achieve positive results.

Before surgical treatment is necessary to confirm the diagnosis and determine the exact place where the aneurysm or dissection occur. This is done by either CT focused on the blood vessels (angio CT) and X-ray investigation of the administration of the contrast agent.

Surgical treatment in both cases is reconstructed vessel, which is performed in the case of aneurysm of the abdominal aorta, so-called stitching aortobifemorální vascular prosthesis. It consists mainly of synthetic materials, but which is well tolerated by the body, they are strong and flexible and its shape accurately follow the shape and size of the aorta, which is to be replaced. For dissection is a possibility of several surgeries, but all lead to the goal to restore the original lumen (interior) vessels.


How do I help myself

First, take precautions.


Complications of aneurysm and dissection

The most serious and also life-threatening complication is rupture of the aneurysm (ruptured aneurysm), which due to the fact that it is usually a large artery, threatening acute man to life, there is a possibility of hemorrhage from a ruptured aneurysm – either into the abdominal cavity or into the brain tissue.

Another possible complication is the formation of thrombi, clots. Blood usually begins to precipitate in places where it is slowed down by the stream. The normal value of the speed of blood flow prevents the creation of blood clots. In the case of aneurysm or dissection blood gets into space, where it can flow, sometimes its original speed, more likely, however, slowed down, or worse, completely stops (especially if it arises when pouch aneurysm, filled with blood, which the original blood vessel is connected to a thin shaft. In this case blood precipitated thrombi and can get into the circulation, where they are often the cause of massive embolism.

Embolism is carried off blood clot to another place circulation, most often to the lungs, where it causes clogging bloodstream.

Other names: aneurysm, aortic aneurysm, aortic dissection, dissecting aortic aneurysm

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