Aortic Aneurysms – Frequently Asked Questions

An aortic aneurysm is a bulge or swelling in the wall of the aorta, the body’s largest blood vessel. If it grows too large or ruptures, it can cause life-threatening internal bleeding, requiring emergency surgery.

There are two main types, depending on their location:

• Abdominal Aortic Aneurysm (AAA). Occurs in the part of the aorta that runs through the abdomen.
• Thoracic Aortic Aneurysm (TAA). Develops in the chest portion of the aorta.

Aneurysms develop when the aortic wall weakens over time due to:

✔ High blood pressure (hypertension) – Puts extra stress on artery walls.
✔ Atherosclerosis – Hardening of arteries due to plaque buildup.
✔ Genetic conditions – Such as Marfan syndrome or Ehlers-Danlos syndrome.
✔ Smoking – A major risk factor that weakens artery walls.
✔ Aging – More common in people over 60.
✔ Trauma or injury – Can damage the aorta.

You may be at higher risk if you:

🔹 Are male and over 60, especially if you have smoked.
🔹 Have a family history of aneurysms.
🔹 Have high blood pressure or high cholesterol.
🔹 Have a connective tissue disorder affecting blood vessels.

Most aortic aneurysms have no symptoms until they become large or rupture. When symptoms do occur, they depend on the aneurysm’s location:

🔹 Abdominal Aortic Aneurysm (AAA):
✔ Deep pain in the back or abdomen.
✔ A pulsating mass in the abdomen.
✔ Sudden, severe abdominal or lower back pain (a warning sign of rupture).

🔹 Thoracic Aortic Aneurysm (TAA):
✔ Chest or upper back pain.
✔ Shortness of breath or difficulty swallowing.
✔ Hoarseness (due to pressure on the vocal cords).

🚨 A ruptured aneurysm is a medical emergency and causes:
⚠ Severe pain (in the back/chest/abdomen)
⚠ Dizziness or fainting.
⚠ Rapid heart rate and low blood pressure (signs of internal bleeding).

The large majority of aneurysms are asymptomatic, and are often found incidentally when undergoing imaging tests for other unrelated conditions. More detailed diagnostic tests may involve:

• CT Aortogram- provides detailed images of the aneurysm’s size and location
• Ultrasound Scan- more useful for abdominal aortic aneurysms

Treatment depends on the presence of symptoms, size, shape. Intuitively, the larger the aneurysm size, the higher its risk of rupture:

• All aneurysms associated with symptoms (eg. chest/back pain) require treatment
• In the absence of symptoms, the indication for surgery depends on the size of the aneurysm.

🔹 Small Aneurysms (<5 cm):
✔ Regular monitoring with imaging scans 6 to 12 monthly
✔ Lifestyle changes – Quit smoking, control blood pressure, and eat a heart-healthy diet.
✔ Medications – To lower blood pressure and cholesterol.

🔹 Large (>5cm) or Rapidly Growing Aneurysms:
✔ Endovascular Aneurysm Repair (EVAR) – A minimally invasive procedure where a stent graft is inserted through small incisions in the groin. This reinforces the aortic wall and creates a new channel for blood flow, effectively bypassing the aneurysm.

✔ Open Surgical repair  – The aneurysmal part of the aorta is replaced with a graft.

• Some aneurysms with atypical shapes (ie fusiform shaped) require surgery despite being <5cm in size, as they are regarded to have an inherently higher risk of rupture.

While not preventable, you can lower your risk by:

✔ Quitting smoking – One of the biggest risk factors for aneurysm formation.
✔ Managing blood pressure and cholesterol – Reducing strain on artery walls.
✔ Eating a heart-healthy diet – To prevent atherosclerosis.
✔ Exercising regularly
✔ Getting screened – If you have risk factors

If left untreated, an aortic aneurysm can continue to enlarge and may eventually rupture, leading to:

⚠ Severe internal bleeding.
⚠ Shock and organ failure.
⚠ A high risk of death if not treated immediately.

If you’re at risk for an aortic aneurysm or need expert evaluation, we’re here to help.

📍 Visit: Novena Vascular & Varicose Vein Centre. 38 Irrawaddy Rd, #08-48, Singapore 329563
📞 Call or drop a message on WhatsApp: (+65) 9727-0788
📧 Email: contact@drdarryllim.com
🌐 Website: https://drdarryllim.com