Aneurysm Chapter 6
Symptoms, Tests, and Diagnosis
Aneurysms usually have no symptoms and so may go undetected for years, especially if they lie within the body or brain. When the aneurysm is near the body surface, a swelling or throbbing mass may be seen. If the aneurysm compresses neighboring structures, like nerves, there may be weakness or numbness.
Because aneurysms are usually without symptoms, they're most likely to be discovered when the patient is having an exam done for another reason. Aortic aneurysms may be found during a routine medical exam, when the doctor may detect a whooshing sound (bruit) through the stethoscope. Aneurysms may also be detected if the patient has a chest X-ray or an ultrasound exam. A specialized test, like a computerized tomography (CT) scan, magnetic resonance imaging (MRI) scan, or angiogram may be needed to confirm the presence of the aneurysm. People who have risk factors for an aortic aneurysm should consider being screened regularly for the condition.
For aortic aneurysms, risk assessment is based on their width. Aortic aneurysms that are less than 2 inches (5 cm) in diameter rarely rupture, so the doctor will probably take a watch-and-wait approach, monitoring the aneurysm with ultrasound exams every 6-12 months. The patient will need to watch for, and report, abdominal tenderness or back pain, potential signs of a rupture. A beta-blocker, a high blood pressure medicine that slows the heart and decreases the force with which it contracts, may also be prescribed. If the aneurysm is wider than 2 to 2-1/4 inches (5 to 5.5 cm) the danger of rupture is significant, and surgery will probably be necessary.
Cerebral aneurysms are, in general, much smaller than aortic aneurysms. Aneurysms under a 1/2 inch (1.3 cm) are considered small, between a 1/2 and 1 inch (1.3-2.5 cm) are larger, and over 1 inch (2.5 cm) are considered to be giant. Cases of cerebral aneurysm are each considered individually to assess the wisdom of intervention. Factors such as the type, size, and location of the aneurysm, the patient's age, health, and family medical history, and the risk of rupture as well of treatment are all considered.
Popliteal aneurysms seldom rupture, so risk assessment is not based on their size, but on their potential to create clots that may block blood flow. Symptomatic popliteal aneurysms require treatment regardless of their size.
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Aneurysm and Stent, Angioplasty, Arrhythmia, Cardiovascular Continuum, Cholesterol and Atherosclerosis, Coronary Bypass Surgery, Heart Attack and Angina, Hypertension, Stroke, Thrombosis and Embolism, Women and Cardiovascular Health
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