Aunerisma de Aorta

““To return

If there is a disease that is deletérea is the aortic aneurysm, because this artery is greatest of the organism and that it has a direct connection with the heart reason why to be damaged inflicts the casualty of the blood pumped from the heart through its light.

It is considered that the presence of aneurism when an expansion of 3cm is observed or compared with the normal caliber of the artery exists more aorta in anyone of its passages.

The complications of the aortic aneurysm are to the rupture, tromboembolia and/or the occlusion with production of infarct and in best of the cases the erosion of annexed structures to the aneurism by their expansion.

The artery aorta has several passages, the one that corresponds to the been silent one that it is what gives the return from the left cavity of the heart by above of him, soon lowers by the thorax constituting the thoracic passage, and later has an abdominal passage that is more frequently affected in the patients.

The aortic aneurysm is a disease that is associated to the age outpost, overweight, coronary disease, atherosclerosis (fat deposit in the arteries), dislipidemias (fat elevation in blood) tobacco addiction, to the arterial hypertension, genetic antecedents of this disease, antecedents of EPOC (pulmonary disease obstructiva chronicle or pulmonary emphysema) and to the fact to belong to masculine sex.

An aortic aneurysm is 7 times more frequent in patient smokings who nonsmokings, are related in addition to a duraciónno with the amount to tobacco consumed per day.

It was observed in realised investigations that a 15% of patients who suffered of aneurism had familiar antecedents of this disease. The EPOC is associated to abdominal aortic aneurysm and if badly the association is controlled is greater, 7-11% of the patients presents aortic aneurysm. More the frequently affected zone is the abdominal one, of these the zone below the kidney is the one that appears more occupying a percentage of 90-95% of all the cases of abdominal aneurisms. The aneurisms do not give symptoms, are detected as findings investigating other abdominal pathologies, the third part of the abdominal aneurisms detect when the abdomen in the exploration by other reasons is felt. The presence of an abdominal blowing can make suspect the aneurism. The best way to evaluate to a patient with antecedents or factors of risk for aneurism is doing an abdominal ultrasound to him that has a sensitivity of 92% and specificity of 98%, nevertheless the computed axial tomography of abdomen with three-dimensional reconstruction is 100% effective although much more expensive one to be used as study to track aortic disease by aneurism although is the best study for obese patients.

The magnetic resonance with angioresonancia is a study very exact although more expensive than the tomography. The aneurism is in risk of breaking itself enters greater is, already exist tables that mark the percentage of risk for the rupture possibility.

>4 to 4,9 cm                      0.5-5.0% of risk
5 to 5,9 cm                      3,0-15%
6.0 To 6.9cm                   10 to 20%
7.0 to 9,0 cm                  20 to 40%
8.0 or more cm                50% of risk

The acute manifestations of the disease are abdominal pain or intense back, intense pain to the abdominal palpation or the exploration lumbar region, pain in members inferiors and glutei, when there are embolisms that cover the arteries of the legs. Detection of tumoración that beats in the abdomen.

If an aneurism gives manifestations without mattering its size is due to repair.

The aneurisms are broken more easily in women than in men by the smaller caliber of the feminine aorta.

The form to repair the aneurisms is by surgery with grafts or patches that replace the defect in the artery. Also they are possible to be repaired introducing a catheter by an artery in the groin and then, placing a endoprótesis on the inside of the aorta that seals and reforms the light of the artery leaving sealed to the defect with much better recovery and success.

To detect the aneurisms with a study of ultrasound in people with risk factor is very easy, later to program its treatment knowing its dimensions is the step to follow.

If you have risk factors ask to your medical internist that studies to you.

Bibliography
Mexican guides of Clinical Practice. CENETEC.
Montoya JE. Abdominal aortic aneurysm. Repert. Med.cir. 2009: 18(1): 21-22.
Copper M. Abdominal Aortic aneurysm. MedLine. 2013.

Dr. Alejandro Cárdenas Cejudo
Medical internist