Aortic aneurysm: understanding a silent disease, and getting screened for it in Tangier

Theaorta aneurysm is one of the most insidious cardiovascular conditions: it usually develops without the slightest symptom, sometimes for years, before announcing itself all at once. The aorta is the body's largest artery: it leaves the heart and carries oxygenated blood to the whole body. When part of its wall weakens, it widens in that spot and forms a permanent bulge, the aneurysm. Properly understood and monitored in time, it can be treated in a planned, safe way. That is what this article is for, written for you by Dr Tber's practice in Tangier.

What is an aortic aneurysm?

We speak of an aneurysm when the diameter of the aorta increases abnormally and permanently, generally beyond 1.5 times its usual calibre. This widening can affect two main regions:

• The abdominal aorta (at the stomach): this is the most common location.
• The thoracic aorta (in the chest, close to the heart): less common, but calling for particular attention.

The danger does not come from the bulge itself, but from its tendency to grow slowly over time. The wider it gets, the thinner the wall becomes and the higher the risk of complications. That is why an aneurysm found early, even a small one, deserves regular follow-up.

Causes and risk factors

Weakening of the aortic wall usually results from a combination of factors acting over years. The main ones are:

• Smoking : this is the single most important risk factor, and the most avoidable one, particularly for the abdominal aorta.
• The advanced age The risk increases significantly after 65 years.
• Male Men are more often involved than women.
• High blood pressure : high pressure is arousing and weakening the wall of the aorta on a daily basis.
• Atherosclerosis and excess cholesterol, which alters the arteries.
• Family history aneurysm or aortic dissection.
• Some connective tissue diseases, such as Marfan or Loeys-Dietz syndrome, which often affect younger patients.

Identifying these factors is what shapes the monitoring. Getting blood pressure under control and stopping smoking are the two most effective levers of prevention.

Symptoms often absent: silent disease

The great majority of aneurysms cause no signs at all. They are often found by chance, on an abdominal ultrasound or a CT scan done for something else. That absence of symptoms is exactly why screening matters so much.

When signs appear, they may include:

• a feeling of beating or pulsating in the abdomen;
• deaf and persistent back, belly or flank pain;
• chest discomfort for aneurysms located near the heart.

Alarm signal to be known: a sudden, severe, tearing pain in the chest, back or abdomen, sometimes with feeling faint, breathlessness or loss of consciousness, can be the sign of a rupture or a dissection. This is an absolute, life-threatening emergency: call the emergency services immediately, without waiting.

Ultrasound screening

Screening is based on simple, painless and non-irradiant examination: ultrasound (Echo-Doppler) of the aorta. It is highly reliable for picking up an abdominal aneurysm, which makes it the test of choice. A CT scan (CT angiogram) is then used to map the anatomy before any operation.

Targeted screening is particularly recommended in:

• men aged 65 to 75, smokers or former smokers;
• men aged 50 to 75 with a family history of aortic aneurysm.

If you recognise yourself in any of these, raise it at a consultation: a single scan may be all it takes to settle the question. You will find the detail of the care we provide on our page aorta surgery.

Routture and dissection: the two complications feared

Two serious complications warrant the full attention to this disease:

• Breaking up : the wall gives way and causes massive internal bleeding. It is an emergency whose outcome depends on how fast treatment starts.
• The dissection : the wall of the aorta splits into layers, with blood forcing its way into the thickness of the wall. It typically announces itself with a sudden, tearing pain that is at its worst straight away.

The risk of rupture rises with the diameter of the aneurysm and with how fast it is growing. It is precisely to get ahead of these complications, before they happen, that monitoring and planned treatment make sense.

Surveillance and surgical treatment

The strategy depends above all on the size of the aneurysm and how it changes. While it stays small, the approach is regular monitoring associated with risk factor correction (smoking cessation, blood pressure and cholesterol control).

When intervention becomes necessary, two broad approaches exist:

Endovascular treatment (EVAR)

Minimally invasive technique performed by the arteries of the groin: an endoprosthesis is deployed inside the aorta to strengthen it, without opening the abdomen. It allows faster recovery and shorter hospitalization, at the cost of a lifetime monitoring by imaging. Minimally invasive.

Open surgery

The widened stretch of the aorta is replaced with a graft. It is the established operation, durable, and suited to certain anatomies. It falls within the expertise of open heart surgery and vascular surgery.

Choosing between these techniques is done case by case, on the anatomy of the aneurysm, your general health and your own preferences. To see everything we treat, visit our page expertise.

Do you have risk factors or have an aneurysm been detected? Do not wait for a symptom to appear. Dr Tber's practice in Tangier is there for screening, for monitoring and, if it comes to it, for the treatment that suits you best. Book an appointment Today to take stock in complete serenity.

Family testing

An aortic aneurysm is not a strictly individual illness. The brothers, sisters and children of an affected patient carry a markedly higher risk than the general population, and that risk climbs further where there is a bicuspid aortic valve or connective tissue disease in the family.

Screening, though, is simple: an abdominal ultrasound, painless, needing no elaborate preparation and quickly done, is enough to settle the question for the abdominal aorta. For the aorta in the chest, an echocardiogram or a CT scan gives the answer. Suggesting this test to relatives is one of the most effective preventive measures there is.

Blood pressure, first lever

Each heartbeat exerts pressure on the dilated wall. The higher the blood pressure, the more this wall is pressed. Therefore, blood pressure control is not a detail of comfort but the main medical treatment of aneurysm under surveillance.

Three things matter more than the rest: taking your blood pressure medication without a break, stopping smoking, which directly speeds the aneurysm's growth, and avoiding sudden straining efforts such as lifting very heavy loads or intensive weight training. Moderate endurance exercise, by contrast, stays beneficial and is encouraged.

Frequently asked questions