Aortic Aneurysm

Causes

Causes

One major cause of aortic aneurysms are the breakdown of the muscular layer and the elastic fibers of the aorta caused by atherosclerosis (hardening of the arteries) or, more commonly, high blood pressure and tobacco abuse. As the tissues break down, the wall weakens and the pressure within the aorta causes the wall to stretch. As the aorta enlarges, it forms an aneurysm.

Other causes of aortic aneurysms include inherited conditions such as Marfan syndrome which results in a weakness of the aorta. There are also occasional infections of the aorta called mycotic aneurysms. Post-traumatic pseudoaneurysms occur after sudden deceleration injuries such as a car accident. The wall of the aorta is torn and the aneurysm forms suddenly. Pseudoaneurysms also can occur as a consequence of penetrating atherosclerosis.

Risk Factors

Age and hypertension are the principal risk factors for aneurysms, although smoking has a definite impact. The vast majority of patients with aortic dissections have a history of high blood pressure that often has not been well controlled.

Abdominal aneurysms and thoracic aneurysms can run in families, so it is important to inform the physician if other family members have had aneurysms.

Prevention

The best prevention for an aneurysm is controlling blood pressure and not smoking. In addition, medications that slow the heart rate such as beta-blockers can have an impact on aneurysm formation and aneurysm expansion

Using tetracyclines to inhibit the growth of small aneurysms is currently being studied. It is too early to know if these medications will be effective. The most important aspect of care is to identify aneurysms early and then monitor them closely.