Ask Dr Trisha: Abdominal aortic aneurysm

Ask Dr Trisha: Abdominal aortic aneurysm
abdomen.jpg

Your aorta is the main artery carrying blood away from your heart. It’s a strong pipe about 2cm in diameter that passes down from your chest and through your abdomen before dividing into two large arteries taking blood to your legs.

Your abdominal aorta tends to develop arterial disease or atherosclerosis just as other arteries do. In atherosclerosis, thick layers or plaques of cholesterol-based material build up on the inner walls of the artery, leaving it stiffer and making it harder for blood to flow.

The pressure of blood being forced out of your heart as it beats is very high. When the aorta is diseased, this high pressure may cause the walls to dilate and balloon out. This ballooning is known as an aneurysm, and as it grows there is a risk that the thinned stretched walls may burst, sometimes with dangerous internal bleeding. 

The risk of rupture is low and an Abdominal Aortic Aneurysm (a triple A or AAA) is small, but as it expands past 5.5cm in diameter the risk becomes more serious. Many people with an AAA have no idea that they have a problem. You may notice a swelling in the centre of your abdomen, especially if you’re thin, and it may be possible to feel this swelling pulsate with each heart beat. Sometimes the AAA causes back or abdominal pain.

If the AAA starts to leak, there may be more severe pain, and if it ruptures you may suddenly collapse because you’ll quickly lose blood and your blood pressure will drop. Leaking or ruptured AAAs need urgent surgery to stop the bleeding and to replace the ballooned diseased artery with an artificial tube. Sadly 80 per cent of people don’t survive so it’s important to reduce your risk of it happening.

Men over 65 are particularly at risk of AAA, and it is estimated that the condition accounts for the death of at least one in 50 older men each year. Smoking, high cholesterol and high blood pressure increase the risk that an aortic aneurysm will develop and rupture. So try to stop smoking and get your blood pressure and cholesterol checked regularly.

Because an AAA can be so dangerous, the NHS in England now invites all men over 65 for a screening test.

This simply involves having an ultrasound scan to measure the width of your aorta and the condition of its walls. If the test is normal, the scan doesn’t need to be repeated but if an aneurysm is found it will need to be regularly monitored with more scans. If you’re worried about a possible aneurysm in yourself or your partner, talk to your GP as soon as possible.

Q. Apparently I have floaters in my eyes, but what does that mean?

Dr Trisha says: Floaters are little black spots, shadows or cob-webby threads that move around in your field of vision. They are shadows cast onto your retina by microscopic bits of debris floating around in the main chamber of your eye. Floaters are often more obvious when you look at something pale or bright, such as a white-painted wall or a clear sky.

In most cases floaters are harmless. They can be very distracting but they don’t actually affect your vision and don’t usually need any treatment. Your brain may learn to ignore them or they may just stay there with you for years. If you notice a sudden increase or change in them, or have white flashes or loss of vision, make an urgent appointment with your optician to get your eyes checked.

  • Dr Trisha writes a column every fortnight in Yours magazine. Ask Dr Trisha about your health problems by emailing yours@bauermedia.co.uk.