Discussion of Abdominal Aortic Aneurysm

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Introduction

An abdominal aortic aneurysm or AAA, as it is commonly known, is the irreversible swelling of the aortas in the abdomen that is beyond 50% which is the normal diameter in radius. The majority of the AAA is located around the aortic branching within the inferential aorta. An AAA rupture risk is even higher as the diameter of the aorta increases, after the AAA raptures, the death rate is substantial. 80% of the patients who manage to get to the hospital, and approximately 50% of the patients that undergo surgery due to a ruptured AAA, most certainly die (Golledge, 2019). The rapture of an AAA is known all over for its substantial death rate, preventing its development, swelling and rapture has become the primary goal and objective in the treatment methods.

Pathophysiology, Signs and Symptoms, and Predispositions of AAA

Pathophysiology

Instead of being a fixed chronic condition, aortic dissection illness is a complicated and evolving pathophysiological process. Three major processes largely contribute to the AAA observable characteristics; nameley swelling, smooth muscle cell death, and proteolysis. Understanding the causes of aortic dissection degeneration and the elements that cause the shift from a mildly inflated abdominal aorta to a significant clinical AAA is crucial, but it is also complex. The vasculature’s swelling and tissue breakdown are critical for AAA development. Reactive nitrogen and oxygen species may be responsible for the gradual tissue and cellular damage associated with oxidative stress, which is a key component of AAA development.

Signs and Symptoms

The aortic aneurysm that occurs in the abdomen has a slow growth rate with no signs and symptoms, which makes it a little hard to identify. Aneurysms do not always rapture, most of them begin small and remain small throughout, while others expand over time, sometimes rapidly. The majority of persons with AAA are asymptomatic, however, if the aneurysm swells and exerts pressure on adjacent organs, symptoms start to develop. The most clinical manifestation is general stomachaches, which can be intermittent or continuous. Other symptoms include sharp pain in the stomach or back, increased heartbeat, sweaty skin, loss of consciousness, and pain around the pelvic region, legs, or the posterior that spreads from the abdomen.

Predispositions of AAA

Predispositions refers the likelihood of an individual to suffer from an abdominal aortic aneurysm. AAA is assumed to be a multifactorial disease, which means that either one or even more genes combine with environmental variables to create it. It can also happen as an inherited condition in some situations. Having a family member with a history of abdominal aortic aneurysm, one is more likely to suffer from it. Since AAA is inherited in such a complicated way, it is hard to anticipate whether or not a given person will get the disease (Golledge, 2019). Age is also a predisposition of AAA, there is a low mortality rate that results from AAA in individuals below the age of sixty-five as compared to those above that age. The risk is said to increase every five years for those beyond the age of sixty-five. Other predispositions of AAA include smoking, lipid levels, hypertension, obesity, and gender.

Magnetic Resonance Imaging and Computed Tomography Angiography Diagnostic Tests for AAA Patients

CTA scanning of the abdomen is a medical diagnostic test used to diagnose disorders of the colon, small intestines, and other vital body organs. It is frequently used to help figure out the cause of unexplained plains in the abdomen, the test is a noninvasive, painless, quick, and precise procedure. CTA scanning can help identify bleeding and injuries that are internal soon enough to save patients’ lives in real emergencies. MRI on the other hand is aims at obtaining images that assist doctors in determining whether or not there are any unusual tissues internally. The images produced by an MRI are more detailed since it uses radio waves and magnets which map out the image of the abdomen. This allows the doctors and nurses to check for organ and tissue abnormalities without cutting the patient open. Laboratory tests to be used to diagnose AAA in a patient would include, ultrasound, angiography, and plain radiography.

Pre-Srgical Medications and the Surgical Intervention for AAA

As the swelling of the aorta increases in diameter, the lining grows increasingly weak, necessitating surgical treatment. The objective of any therapeutic approach is to avoid the rupturing of the aorta by regulating the aneurysm’s progression. Before the surgery, the patient might be asked to quit drinking and smoking, and attend pre-surgery tests like x-rays and blood work. An AAA that is over 2 inches wide warrants surgery for it to be repaired. The surgeon will make a big cut in the belly to expose the swollen aorta during the procedure. After opening the abdomen, the ruptured aorta can be repaired with a graft. In most cases, an AAA is asymptomatic; it is a disorder that goes unnoticed. It can burst if it remains unattended and becomes big enough, resulting in a rather unlikely abrupt death.

Patient Education on Abdominal Aortic Aneurysm and Implications for Family Members

Patients might avoid an aortic aneurysm by lowering the risk variables that are within their control. This can be achieved through maintaining their heart and arteries health, avoiding alcohol and smoking, eating well-balanced meals, exercise regularly, and keeping their blood pressure, weight, and cholesterol levels in check. Patients asking their doctors about scanning or ultrasound if they have concerns for an aortic aneurysm can come in handy too. The patients need to be informed of the risk factors that are likely to increase their chances of suffering from AAA. These risk variables include High blood pressure, obesity, age (over 65 years), smoking, and alcoholism (Golledge, 2019). Being educated on such variables offers the patient a chance to do everything in their power to avoid getting the disease.

The emotional implication, residing and caregiving for someone sick, has a huge psychological effect on the family, with the costs of some sicknesses often felt by everybody in the household. An AAA is not easily detected, some may live with it without ever realizing, and when the aorta ruptures, it may result in sudden death since no one was ever prepared on how to deal with it. This sudden death of a loved one takes a toll on the entire family as it was unexpected. To undergo an open incision or the Endovascular Aneurysm Repair (EVAR), which is a minimally invasive procedure, requires a lot of funds. This puts a financial strain on other family members, leading to a lot of stress and worrying, especially if the patient and the family members were not aware of that condition.

Conclusion

In conclusion, the growth rate and the risk od an AAA rapturing increases exponentially with the aneurysms diameter, with the serious risk of rapture being when the diameter of the aneurysm is at 5cm. AAA is asymptomatic , therefore making it hard to detect when it starts to develop. Most of the patients who experience AAA have never been previously diagonised, and when the rupturing happens, there are low chances of survival. AAA is hereditary, however other factors like smoking, hypertension, obesity, age and gender can also make one susceptible to AAA.

Reference

Golledge, J. (2019). Abdominal aortic aneurysm: update on pathogenesis and medical treatments. Nature Reviews Cardiology, 16(4), 225-242.

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