An aneurysm is a pathological enlargement of a blood vessel. The aneurysm is localized and spindle- or sac-shaped. It is caused by congenital or acquired weaknesses or changes in the vessel wall.
A cardiac aneurysm is a bulge in the heart wall. If an aneurysm is suspected, you should consult a heart aneurysm specialist as soon as possible.
The term "aneurysm" is derived from the ancient Greek word "aneúrysma", which literally means "dilation". All blood vessels can be affected by an aneurysm.
In most cases, however, such a vascular dilatation forms along the arteries. Arteries are blood vessels that transport oxygenated blood from the heart to organs, muscles and tissues. An aneurysm is therefore also referred to as an arterial dilatation or arterial protrusion.
Aneurysms rarely occur in the veins, i.e. the blood vessels that carry the deoxygenated blood to the heart.
Aneurysms most frequently occur in the main artery, also known as the aorta. This type of aneurysm is also known as an aortic aneurysm.
An aneurysm on the lower main artery in the abdominal cavity, on the abdominal aorta, is known as an abdominal aortic aneurysm. This is the most common aneurysm, accounting for over 90 percent of all aneurysms.
An aortic aneurysm on the upper aorta, which runs in the chest and is therefore called the thoracic aorta, is known as a thoracic aneurysm. This type of vascular dilatation of the upper aorta in the chest occurs much less frequently. It accounts for only around 3 percent of all aortic aneurysms.
In addition to the upper and lower aorta, other vessels can also be affected by pathological vasodilation in rare cases:
A heart aneurysm or heart wall aneurysm can develop in the left ventricle after a heart attack.
Depending on the type of vascular dilatation, we distinguish between three different types of aneurysm:
The aneurysm verum is the aneurysm in the true sense of the word. All three layers of the blood vessel wall are intact. They protrude outwards like a sac and form a sac-shaped widening of the vessel.
In aneurysm dissecans, one layer of the blood vessel wall is torn. As a result, blood flows between the different layers of the vessel wall and forms an expanded cavity.
The aneurysm spurium or falsum is also known as a false aneurysm. It is not an arterial sac in the true sense of the word. It occurs when a haematoma forms around the blood vessel after an injury to the vessel wall. After some time, this is covered by a connective tissue capsule and blood flows through it.
Aneurysms usually develop in places where the vessel wall is weakened. These weaknesses can be either congenital or acquired.
Congenital causes:
Acquired weaknesses and changes in the vascular wall can result from vascular injuries caused by a cardiac catheterization, for example.
Some risk factors favor the formation of an aneurysm. These include in particular
An aneurysm often causes no symptoms for a long time. Symptoms often only occur when the diameter of the dilated vessel is so large that it puts pressure on the surrounding structures. The exact symptoms caused by an aneurysm then depend on its location.
For example, an abdominal aortic aneurysm usually causes symptoms such as
occur.
Abdominal pain in the lower abdomen can be a sign of an abdominal aortic aneurysm
If an abdominal aortic aneurysm ruptures, life-threatening internal bleeding can occur in the worst case. This manifests itself as sudden, very severe, stabbing and persistent pain in the flanks.
A thoracic aortic aneurysm, i.e. an aneurysm on the main artery in the chest area, is characterized by symptoms such as
If a thoracic aortic aneurysm ruptures, severe chest pain usually occurs, which is similar to the symptoms of a heart attack.
Bleeding from an aneurysm of the cerebral arteries, medically known as an intracranial or cerebral aneurysm, can cause symptoms such as
can occur.
Heart wall aneurysms and aneurysms of the aorta close to the heart can cause
life-threatening heart failure.
An aneurysm is usually diagnosed as part of a physical examination, during which the attending physician palpates the abdominal or pelvic arteries, as well as with the help of further imaging examinations. The imaging examinations that are suitable for diagnosing an aneurysm include
Whether an aneurysm needs to be treated and what exactly the therapy looks like depends, among other things, on the location and size of the vascular dilatation and the increase in the transverse diameter of the aneurysm. In principle, both conservative and surgical treatment options are available.
Conservative treatment is mainly used for smaller aneurysms that do not cause any symptoms. It aims to treat and avoid the underlying causes and risk factors. These risk factors include
This is to prevent the aneurysm from enlarging or rupturing.
The larger an aneurysm is, the greater the risk that it will rupture. In these cases, doctors usually recommend an operation to remove the aneurysm. There are various surgical methods to choose from, including the insertion of a so-called vascular prosthesis or a stent in the affected blood vessel. In the case of an aneurysm of the cerebral arteries, there are basically two possible surgical procedures, known as clipping or coiling.
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