Living With Aortic Aneurysm

An aneurysm may sound like an immediate, life-threatening emergency, but did you know that with the help of your health care team, you can continue living with an aortic aneurysm?

“The aorta is your largest artery, and carries blood from your heart to your brain, and the rest of your body,” explains Ashraf A. Sabe, MD, a Mass General Brigham cardiac and aortic surgeon. “An aortic aneurysm is an abnormal enlargement, or bulge, in the aorta and can be life-threatening.”

A medical issue, genetic condition, or trauma can damage or weaken the walls of your aorta. An aortic aneurysm, a common type of aortic disease, occurs when blood moving through your aorta creates a balloon-like bulge in the damaged wall. If your aneurysm has a diameter of 4 cm or more, then it needs medical attention and your doctor can monitor it.

Dr. Sabe cares for patients at Brigham and Women’s Hospital and is surgical director of Cardiac Surgery Quality. He shares more information about how you can learn how to live with aortic aneurysm by working with your health care team and following your treatment plan.

What are the types of aortic aneurysm?

Follow your aortic aneurysm treatment plan.

When you’re diagnosed with an aortic aneurysm, it’s important to remember that there are treatment options available to help you manage your condition.

Your cardiologist and care team create a treatment plan for you based on the size and location of your aneurysm and the factors that put you at risk. Their goal is to slow the aneurysm’s growth and lower the chances of:

• Rupture, where the aneurysm bursts and causes bleeding inside the body.

• Dissection, where the layers of an aneurysm split so that blood flows through two channels (a true channel and a false channel), instead of one. This can lead to rupture or reduce the amount of blood flow to your organs.

While all aneurysms are potentially serious, your treatment plan may not require surgery. You can make lifestyle changes and take medication to reduce your risk of dissection or rupture.

Monitor your aortic aneurysm

For smaller aortic aneurysms that don’t grow quickly, Dr. Sabe recommends careful monitoring by a primary care provider (PCP), cardiologist, and/or surgeon. Your provider uses imaging like a CT scan, MRI (magnetic resonance imaging), or ultrasound to check your aneurysm on a regular schedule. This helps them see how quickly it’s growing, check for leaks, and decide if you need surgery.

“Your doctor can advise about special considerations as they continue monitoring your aneurysm,” says Dr. Sabe. “For example, you may need to avoid medications that could cause the aneurysm to grow, monitor your blood pressure, and have genetic counseling for you and your family members.”

Make lifestyle changes to improve aortic aneurysm symptoms.

Many people won’t experience symptoms and may not even know they have an aortic aneurysm. If you do have symptoms, they may include:

• Difficulty swallowing or breathing

• Shortness of breath

• A full feeling even when you don’t eat much

• Hoarseness

• Chest, abdomen, or back pain

• Swelling in the neck, face, and arms

Several factors can make your aortic aneurysm symptoms worse. Luckily, there are steps you can take to reduce your risk of rupture or dissection by making healthy lifestyle changes.

To help prevent aortic aneurysm:

• Quit smoking. According to the Centers for Disease Control and Prevention (CDC), a history of smoking accounts for about 75% of all abdominal aortic aneurysms. Follow these tips to stop smoking and improve your heart health.

• Stay active. Exercise, even simply walking, can improve the health of your arteries and heart. However, your doctor may advise against certain exercises that could worsen your aneurysm.

• Maintain a healthy blood pressure. High blood pressure increases your risk of worsening aortic aneurysm. Stress can also affect your heart, so you may be able to lower your blood pressure by taking steps to better manage your stress. Dr. Sabe recommends having a blood pressure cuff at home, so you can keep a log of your pressure at different times of day in the week.

• Control your cholesterol intake. Eat a heart-healthy diet by avoiding foods with high cholesterol, like beef, whole milk, baked goods, and fried foods. Eating foods high in fiber, like sweet potatoes and brown rice, and leafy greens can help lower your cholesterol.

Take medication to manage your aortic aneurysm.

Medication can help improve your symptoms and prevent your aneurysm from getting worse. Your doctor may recommend:

• Aspirin, especially if you have other heart risks

• Blood pressure medication to lower your blood pressure

• A statin or other medications to help control your cholesterol levels

Talk with your care team about surgical options.

While there are possible risks to aortic aneurysm repair, your doctor may recommend surgery depending on the size of your aneurysm and how quickly it’s growing. Encouragingly, Dr. Sabe notes, “A recent study showed that people who choose to have surgery for their ascending aortic aneurysm – the top part of your aorta, closest to your heart – live just as long as people without an aneurysm.”

Types of surgery for aortic aneurysm are:

• Open aneurysm repair, a major surgery where the surgeon removes the aneurysm and replaces that part of the aorta with an artificial graft.

• Minimally invasive endovascular repair, where the surgeon makes a smaller cut, usually in the groin area, to access the aorta through blood vessels in the leg. This involves a shorter hospital stay, less pain, and a shorter recovery.

Know when to seek emergency care for aortic aneurysm.

If you have an aortic aneurysm, it’s important to know the signs of a rupture. Getting treatment as quickly as possible may save your life.

Signs of an aortic aneurysm rupture include:

• Light-headedness

• Rapid heart rate

• A sudden, severe pain in your chest, back, or stomach area

Aneurysm rupture or dissection are life-threatening medical emergencies. Trust your instincts and call 9-1-1 if you think you might be experiencing serious problems related to your aneurysm.

Questions about aortic aneurysm to ask your doctor

If you’ve recently been diagnosed with an aortic aneurysm, you may have lots of questions. Your provider is happy to answer any questions to help you better understand your condition and treatment options.

Some questions you might consider asking at your next doctor’s appointment include:

• What steps can I take to slow the growth of my aneurysm?

• How often will I need to have appointments to monitor my aneurysm?

• What symptoms should I be concerned about? When should I seek emergency medical care for my symptoms?

• Are there any exercises or activities I should avoid?

• What foods should I try to eat more of, and what should I avoid eating?

• Are there any over-the-counter medications that I should avoid taking?

• Do you know any patient support groups or community resources I can use?

While all aneurysms are potentially serious, following your treatment plan can help you manage your symptoms and keep the condition from getting worse. You can continue living a full, productive life with the help of your health care team.