GP Alice Fitzgibbon explores the issue of Abdominal Aortic Aneurysms.
This month I thought I would write about Abdominal Aortic Aneurysms (also known as AAAs). Many people will not have heard of these, however, every man in the UK will be invited for an ultrasound scan once they turn 65 years old in order to check for this condition. So, what is an AAA?
An abdominal aortic aneurysm is a swelling of a major blood vessel. The aorta is the biggest blood vessel in the human body. Every time the heart beats, blood is pumped at high pressure into the aorta – it travels through the chest and down through the abdomen – and is essential for blood to travel around the body. When there is an AAA, there is a weakness in the wall of the aorta which causes a swelling (known as an aneurysm). As blood continues to be pumped at high pressure from the heart, over time this swelling can get bigger and bigger. In some cases, the aorta may burst due to the swelling. If this happens, it is immediately life threatening and often fatal; this is why early detection of this condition is important. If the presence of an AAA is detected early, it can be monitored by ultrasound scans to monitor the size of the swelling. If, and when, the swelling reaches a certain size, an operation to repair the swollen piece of aorta might be offered. This operation is major surgery, with a risk of death, and only people who are fit enough to survive the operation may be even be offered it.
So, who is at risk of developing an AAA? Well, men over the age of 65 (that’s why they are offered a screening ultrasound to check) and some women over the age of 70 if they have risk factors. Risk factors include high blood pressure, a family history of AAA, smoking, chronic obstructive pulmonary disease and cardiovascular disease. Having a AAA may give no symptoms or signs. In some people who are slim, a pulsing sensation may be felt in the tummy area. In others, there may be abdominal or low back pain that starts and does not settle down. If the aorta bursts, it can cause sudden onset severe abdominal or back pain, collapse, a fast heartbeat, shortness of breath and sweaty, pale and clammy skin. This is because so much blood is lost very quickly. Any symptoms of a ruptured (burst) AAA need immediate medical attention and a 999 ambulance should be called if these develop. In many people who have an AAA, it does not cause any symptoms and does not impact their life. Most people who have an AAA will die of an unrelated cause, and not because of their aneurysm bursting.
If you are diagnosed with an AAA, there are several things you can do to reduce the chances of it getting bigger. These include, stopping smoking, reducing alcohol intake, eating a balanced and healthy diet with reduced fatty foods, maintaining a healthy weight and exercising regularly for 150 minutes per week as recommended by the NHS. These steps to a healthy lifestyle also reduce the risk of developing an AAA in the first place.
So, if you are called for your screening appointment, please attend for the ultrasound scan. It is painless and it won’t take long to do. If your aorta appears healthy then it is reassuring. If there is any swelling detected then the next steps will depend on the size of the aneurysm. If you have a diagnosis of an AAA it is important that your close friends and family are aware of the signs to look out for just in case you become unwell.
For further information on Abdominal Aortic Aneurysms from the NHS visit https://www.nhs.uk/conditions/abdominal-aortic-aneurysm/
