Aortic Anenurysm : Silent Killer

What is aneurysm, it is the bulging or ballooning or weakened area of a blood vessel.

What is aorta; it is the main trunk of the arterial system of the body

Aortic aneurysm is the bulging or ballooning of a weakened area of the abdominal aorta.

The country’s experts come together for a symposium on Aortic Aneurysms, and emphasize the urgency for screening among at-risk patients

I for one, is familiar with aneurysm is when a vessel in your head ruptures. But last week, I found out that there are different kinds of aneurysm and this is also crucial since they are considered silent killers. Apart from the more commonly discussed illnesses like rheumatic and congenital heart diseases that cause conditions such as heart attack and failure, aortic aneurysms is one another cardiovascular killers that people do not know about until it is too late.

I was lucky that I was able to have my self-check-up during the event. I am surprise that there is this kind of disease and not all knew about it. It is better for us to prevent diseases like this that spent thousands of pesos to cure it and the sad part is; there’s no cure. The least we can do is having our self-check and if ever we find about it at an early stage; at least we can do something to prevent is from advancing in a more critical stage.

The procedure is so easy since they are using ultrasound equipment just like the one that we use when we are pregnant and from there, they could measure your aorta and find out its size. 

In the Philippines, more and more people are at risk for aortic aneurysms even as awareness on it remains low.  Many Filipinos who suffer from this disease are unaware until it’s too late to remedy. Aneurysms can develop quietly and slowly over many years, usually without symptoms, until it begins to leak or expand, and without warning, can rupture with deadly consequences.

In line with its commitment to advancing hearthealth, the experts of the Aortic Endovascular Unit at the Heart Institute of the Chinese General Hospital and Medical Center (CGHMC) hosted one of the first media symposiums designed to help create awareness on aortic aneurysms, to better prepare and equip Filipino families to detect and effectively treat the condition. 

Hosted by Dr. Timothy Dy, Interventional Cardiologist and Head of theAortic Endovascular Unit at the Heart Institute of the CGHMC together with Dr. Nelson Lee, Thoracic and Cardiovascular Surgeon, Head of Cardiovascular Surgery Divisions of CGHMC and Metropolitan Medical Center, Head of Aortic Surgery Philippine Heart Center and Dr. Melissa Co-Sia, Interventional Cardiologist of CGHMC who is also the Head of the Cath lab of the Metropolitan Medical Center, the symposium discussed Abdominal Aortic Aneurysms (AAA) focusing on their pathophysiology, diagnosis and treatments.

The danger of aortic aneurysms and the risk factors

Aortic aneurysms develop when the wall of the aorta deteriorates and weakens due to deposits of cholesterol. It then enlarges and becomes thinner making it more vulnerable to rupture. There are two kinds –AAA, which occurs in the abdominal area, and a TAA, which occurs in the chest area. The symposium focused mainly on the more commonly encountered AAA. Not to be mistaken for vascular conditions such as heart failure or heart attacks, aortic aneurysms have a near 50% fatality rate upon rupture. If the aneurysm grows to 6cm in diameter, there is a high risk that the aneurysm could rupture. The effects are often fatal.

Factors that one should seriously take into consideration are high blood pressure (hypertension), high level of cholesterol (hypercholesteremia), existing clogged arteries (atherosclerosis), and the health history of one’s family. Smoking or a history of smoking along with a sedentary lifestyle and obesity, are also major risk factors. “If one has any of these risk factors, he or she is a candidate and is advised to get a diagnosis through vascular screening. This is the first step and can spell the difference between life and death," urges Dr. Timothy Dy.

Screening for aneurysms and the best treatments available

While aortic aneurysms are generally asymptomatic (without symptoms), there are signs that may hint this such as: hoarseness, difficulty swallowing, pain in the chest, back, side for Thoracic Aortic Aneurysm or stomach with pain ranging from mild to severe for Abdominal Aortic Aneurysm. Fortunately, it can often be diagnosed with a simple screening test done through anultrasound for AAA. “Given the reputation of the aortic aneurysms to go almost undetected, we advise those who fit the profile or experience any of the possible signs to get screened immediately,” shares Dr. Nelson Lee.

“We are very fortunate that we have made great advances in medical science and are more than capable to treat such aneurysms through minimally invasive procedures,” adds Dr. Melissa Co-Sia. There are two common treatments for aortic aneurysms: open surgical repair and the minimally invasive option. The CGHMC is one of the few hospitals capable of treating aortic aneurysms through both approaches including the lesser invasive Endovascular Aneurysm Repair (EVAR) for abdominal aneurysms, and Thoracic Endovascular Aortic Repair (TEVAR).

Both procedures make use of a stent graft - a fabric tube lined with a metal frame - that serves as the new pathway for blood to flow in the afflicted area. For these procedures, patients are discharged quickly and would have up to 4-6 weeks to recover, over open surgical repair, which presents an increased chance of complications and a longer recovery period of up to 12-24 weeks.

The experts nonetheless share that no two cases are alike and stress the need for proper screening. “There are cases where the aneurysm is small and can be addressed with monitoring, medication, and with the patient choosing an overall healthy lifestyle. Then there are the more severe cases where EVAR is the best course of treatment. Earlier diagnosis is still the optimal course of action to determine the proper course of action for each patient,” explains Dr. Dy. “It can be easy to mistake certain signs or symptoms for other afflictions but if your profile fits that of Aortic Aneurysm, it is advised that one undergo screening to catch aneurysms at its earlier stages and prevent complications much later on.”

For more information on EVAR, you may call the Aortic Endovascular Unit of Chinese General Hospital at (+632)742-3748.

Have yourself check; it better to prevent it than cure it.

Just saying……………….