Aneurysm Health Dictionary

A local widening (dilatation) in the wall of an artery usually the aorta or a major artery. May grow into a pulsating tumour and finally burst. Situation is important; aneurysm in chest, abdomen or head being most at risk. Where not due to excessive athletic performance, it is a sign that arteries are already diseased. Excessive athletic exercise and high living predispose.

Usually painless, it is recognised by touch as a round swelling about the size of a plum and visibly expands and contracts with each heart beat. A difference in the pulse on both sides of the body or inequality of pupils of the eyes may determine diagnosis. Tendency for blood to clot, indicating need for large doses of Vitamin E to prevent formation of a solid mass.

Symptoms: breathlessness, difficult swallowing, cough, change in tone of voice.

Treatment: Directed towards reduction of volume of blood and blood pressure. Rest in bed.

Teas: Single or in combination. Yarrow, Cactus flowers, Motherwort.

Tinctures: Lily of the Valley 1; Pulsatilla 1; Hawthorn 2. Dose: 10-30 drops in water thrice daily. Practitioner: Tincture Selenicereus grand, 10ml . . . Tincture Crataegus Oxy., 20ml . . . Tincture Pulsatilla, 10ml . . . Tincture Scutellaria lat., 10ml. Aqua to 100ml. Dose: 5ml (3i) tds aq. cal. pc.

Diet. See: DIET – HEART AND CIRCULATION. 

Abnormal dilation (ballooning) of an artery caused by the pressure of blood flowing through a weakened area. Aneurysms most commonly affect the aorta and arteries supplying the brain. The most common cause of an aneurysm is atherosclerosis, a condition in which fatty deposits weaken the artery wall. The aorta is the usual site of atherosclerotic aneurysms.

Less commonly, aneurysms may be due to a congenital weakness of the artery walls. Most cerebral aneurysms, known as berry aneurysms because of their appearance, are congenital. Marfan’s syndrome, an inherited disorder in which the muscular layer of the aorta is defective, is often associated with aneurysms just above the heart. The as occurs in poly- artery wall arteritis nodosa.

Most aneurysms are symptomless and remain undetected, but if the aneurysm expands rapidly and causes pain, or it is very large, the symptoms are due to pressure on nearby structures. Aneurysms may eventually rupture, cause fatal blood loss, or, in the case of a cerebral aneurysm, loss of consciousness (see subarachnoid haemorrhage).

In some cases, only the inner layer of the artery wall ruptures, which allows blood to track along the length of the artery and block any branching arteries. There is usually severe pain and high risk of rupture occurring.

Aneurysms sometimes develop in the heart wall due to weakening of an area of heart muscle as a result of myocardial infarction. Such aneurysms seldom rupture but interfere with the pumping action of the heart.

Aneurysms of the aorta may be detected by ultrasound scanning, and cerebral aneurysms by CT scanning or MRI. Angiography provides information on all types of aneurysm. Ruptured or enlarged aneurysms require immediate surgery (see arterial reconstructive surgery).

A localised swelling or dilatation of an artery (see ARTERIES) due to weakening of its wall. The most common sites are the AORTA, the arteries of the legs, the carotids and the subclavian arteries. The aorta is the largest artery in the body and an aneurysm may develop anywhere in it. A dissecting aneurysm usually occurs in the ?rst part of the aorta: it is the result of degeneration in the vessel’s muscular coat leading to a tear in the lining; blood then enters the wall and tracks along (dissects) the muscular coat. The aneurysm may rupture or compress the blood vessels originating from the aorta: the outcome is an INFARCTION in the organs supplied by the affected vessel(s). Aneurysms may also form in the arteries at the base of the brain, usually due to an inherited defect of the arterial wall.

Aneurysms generally arise in the elderly, with men affected more commonly than women. The most common cause is degenerative atheromatous disease, but other rarer causes include trauma, inherited conditions such as MARFAN’S SYNDROME, or acquired conditions such as SYPHILIS or POLYARTERITIS NODOSA. Once formed, the pressure of the circulating blood within the aneurysm causes it to increase in size. At ?rst, there may be no symptoms or signs, but as the aneurysm enlarges it becomes detectable as a swelling which pulsates with each heartbeat. It may also cause pain due to pressure on local nerves or bones. Rupture of the aneurysm may occur at any time, but is much more likely when the aneurysm is large. Rupture is usually a surgical emergency, because the bleeding is arterial and therefore considerable amounts of blood may be lost very rapidly, leading to collapse, shock and even death. Rupture of an aneurysm in the circle of Willis causes subarachnoid haemorrhage, a life-threatening event. Rupture of an aneurysm in the abdominal aorta is also life-threatening.

Treatment Treatment is usually surgical. Once an aneurysm has formed, the tendency is for it to enlarge progressively regardless of any medical therapy. The surgery is often demanding and is therefore usually undertaken only when the aneurysm is large and the risk of rupture is therefore increased. The patient’s general ?tness for surgery is also an important consideration. The surgery usually involves either bypassing or replacing the affected part of the artery using a conduit made either of vein or of a man-made ?bre which has been woven or knitted into a tube. Routine X-ray scanning of the abdominal aorta is a valuable preventive procedure, enabling ‘cold’ surgery to be performed on identi?ed aneurysms.

n. an abnormal balloon-like swelling in the wall of an artery. This may be due to degenerative disease or infection, which damages the muscular coats of the vessel, or it may be the result of congenital deficiency in the muscular wall. An aortic aneurysm most frequently occurs in the abdominal aorta, below the level of the renal arteries. Beyond a certain size it is prone to rupture, presenting as an acute surgical emergency with abdominal and back pain and haemorrhagic shock. A dissecting aneurysm usually affects the thoracic aorta and results from a degenerative condition of its muscular coat. This weakness predisposes to a tear in the lining of the aorta, which allows blood to enter the wall and track along (dissect) the muscular coat. A dissecting aneurysm may rupture or it may compress the blood vessels arising from the aorta and produce infarction (localized necrosis) in the organs they supply. The patient complains of severe chest pain that has a tearing quality and often spreads to the back, shoulder, or abdomen. Emergency surgical repair is indicated (see endovascular aneurysm repair). A ventricular aneurysm may develop in the wall of the left ventricle after myocardial infarction. A segment of myocardium becomes replaced by scar tissue, which expands to form an aneurysmal sac. Heart failure may result or thrombosis within the aneurysm may act as a source of *embolism. See also arteriovenous aneurysm.

Most aneurysms within the brain are congenital: there is a risk that they may burst, causing a *subarachnoid haemorrhage. Berry aneurysms are small saccular aneurysms most commonly occurring in the branches of the *circle of Willis. Usually associated with congenital weakness of the vessels, these aneurysms are a cause of fatal intracranial haemorrhage in young adults. Charcot–Bouchard aneurysms are small aneurysms found on tiny arteries within the brain of elderly and hypertensive subjects. These aneurysms may rupture, causing cerebral haemorrhage. Options for treatment of cerebral aneurysms include surgical clipping of the aneurysm and placing metallic coils within the aneurysm to establish a clot within it (endovascular *coiling).

In a pseudoaneurysm (or false aneurysm) the swelling of the artery is contained by clotted blood rather than the wall of the artery. —aneurysmal adj.