Aneurysm Chapter 7

Aneurysm Complications

The main complications of aneurysm are rupture and dissection, infection, and clotting.

Rupture: Aortic Aneurysm

Rupture is the most dangerous complication of an aortic aneurysm. When an aneurysm ruptures, blood pressure may plummet, heart rate may increase, and the patient may feel dizzy and weak. If the bleeding is severe, he or she may go into shock.

Symptoms of an aortic rupture include:

  • Sudden, persistent abdominal, chest, or back pain
  • Pain that radiates to the back or legs
  • Sweatiness, clamminess
  • Dizziness
  • Low blood pressure
  • Rapid heart beat
  • Shortness of breath
  • Loss of consciousness

Ruptured aortic aneurysms are the mostly deadly because there may be massive, often fatal, bleeding. In fact, more than 80% of people who have a ruptured abdominal aneurysm die; most die before they even reach the hospital. In the US, about 15,000 people die of abdominal aortic aneurysms each year.

Aortic Dissection

Aortic dissection, another complication of aortic aneurysm, is a relatively uncommon but potentially fatal condition. In aortic dissection, a tear develops in the inner layer of the aorta's arterial wall, usually where pressure from the surging blood is high. Blood pulses through this tear and causes the inner and middle layers of the arterial wall to dissect (separate). The tear usually continues down the descending aorta and into the arterial branches. If the outside wall of the aorta ruptures, the results are usually fatal.

Aortic dissections are classified according to where they begin. Type A dissections originate in the ascending aorta and often move to the aortic arch and beyond, away from the heart. Type B dissections begin in the descending aorta.

Symptoms of aortic dissection include sudden, severe chest pain, tearing sensations, and cold sweat. Pain may be felt in the front or the back of the chest, and it moves as the dissection propagates.

Rupture: Cerebral Aneurysm

When a cerebral aneurysm ruptures, there may be a change in awareness and the patient may have light sensitivity or double vision, a sudden severe headache, or nausea. He or she might lose consciousness altogether.

A ruptured cerebral aneurysm can bleed into the brain and cause stroke, permanent nerve damage, or death. There may be damage due to subarachnoid hemorrhage, bleeding into the space between the skull bone and the brain. This can cause hydrocephalus, in which cerebrospinal fluid in the brain builds up and presses on the brain. Another possible complication after a cerebral rupture is vasospasm, when other blood vessels in the brain contract and limit blood flow to vital areas of the brain, causing stroke or brain tissue damage. Vasospasm is the leading cause of disability or death following a rupture.

Up to 40% of patients who have ruptured cerebral aneurysms die within 1 day, and another 25% die within 6 months. Of those who survive, more than half will have some sort of permanent disability.

Other Complications

Infection: Aneurysms can become infected due to infections at other sites in the body. This can lead to systemic illness and rupture.

Clotting: A blood clot, or thrombus, will often develop inside the aneurysm because the blood flow is sluggish. If it breaks loose as an embolus and travels elsewhere in the body, it can cause pain or even life-threatening blood flow obstruction in the legs, toes, or abdomen. If the aneurysm is in the ascending aorta, emboli or debris travelling to the brain may cause a stroke.

More on this topic

What is an Aneurysm? (VIDEO)

Aneurysms Explained

Where Aneurysms Happen

Head & Neck Aneurysms

Risk Factors

Symptoms, Tests, and Diagnosis

Aneurysm Complications

Abdominal Aortic Aneurysm Surgery

Cerebral Aneurysm Surgery


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