Causes, symptoms, diagnosis and treatmentaortic aneurysm

Аневризма что этоIrreversible expansion of the site itself
large blood vessel in the human body due to
weakness of its walls, called aortic aneurysm. Running forms
this pathology can be fatal. Therefore disease
requires timely and comprehensive treatment in inpatient
conditions under the control of several medical

Causes of disease

Depending on the origin, all aneurysms are divided into congenital
and acquired. The first group includes those forms of the disease
the occurrence of which is associated with hereditary diseases
aortic walls: fibrous dysplasia, imperfect desmogenesis
Rusakov, Marfan syndrome, elastin deficiency, etc.
Acquired aneurysms develop in the background:

  • arterial inflammation caused by pathogenic
    or opportunistic fungal microflora;
  • Причины аневризмыsyphilis;
  • postoperative complications (infectious or related
    defects of dentures, suture materials);
  • atherosclerosis – a pathology characterized by deposition
    cholesterol and certain lipoprotein fractions on the vascular
  • mechanical damage;
  • aortic medionecrosis – a disease manifested by decay
    elastin and collagen in the walls of the main artery, its death
    cells with the subsequent formation in their place of cysts filled
    mucous mass.

Among the indirect causes of aneurysms include elevated
blood pressure, alcohol abuse,
low mobility, high physical exertion, tobacco smoking,
unfavorable heredity and old age. In men
the disease is diagnosed much more often than in women.

Что такое аневризма

In addition to the defectiveness of the aortic walls, in the pathogenesis of aneurysm
hemodynamic and mechanical factors play an important role. More often
the entire aorta expands in functionally tight areas,
subject to excessive loads due to the steepness of the increase
pulse wave and increased blood flow velocity. Permanent
artery injury with hyperactivity
proteolytic enzymes, leading to the destruction of elastic
vessel framework and the appearance of degenerative changes in its

In most cases, aneurysm quickly grows in size.
This is due to the fact that the pressure on the walls of the aorta increases right
proportional to the expansion of the diameter of the vessel. Blood flow in
the aneurysmal cavity slows down and becomes turbulent.
Because of this, only a small part of the vascular bed gets into the distal channel.
the volume of blood that is in the extended area

Types of pathology

In modern vascular surgery, aneurysms are classified by
morphological structure, segmental localization, form and
clinical course. The first base allows you to select the true
and the false form of the disease. Differentiating feature with this
there are features of pathological changes in aortic

ATиды аневризмыWith a true aneurysm that develops on the background
atherosclerosis or syphilis, thin and bulge out all
layers of the main artery. False aneurysmal bag
formed from connective tissue formed in the area
pulsating hematoma after surgery or injury. Wherein
own walls of the aorta in the pathological process is not
are involved.

Segmental classification allows differentiation of aneurysms.
ascending, abdominal, thoracoabdominal and descending section
arterial trunk, sinus valsalva and aortic arch. AT
зависимости от формы аневризматического утолщения выделяют
The following types of pathology:

  • saccular – the vascular wall bulges only on
    limited area;
  • spindle-shaped – diffuse expansion of the whole is observed
    diameter of the main artery.

According to the clinical course, aneurysms are classified into
exfoliated, complicated and uncomplicated. For the first group
a rupture of the aortic inner membrane and penetration of blood into the
the gaps formed by layers of the arterial wall.

Complicated aneurysmal disease may develop on the background
violation of the integrity of the main vessel, accompanied by
the formation of hematomas and profuse internal bleeding. Besides
This, as specific complications, may be arterial
thromboembolism, thrombosis and cellulitis of tissues surrounding the hearth

Clinical picture

Symptomatic manifestations of aneurysm are very diverse.
The differences between them may be due to localization,
the length and size of the aneurysmal bag, as well as
factors that trigger the development of pathology. Так, для
abdominal aneurysms are characterized by the following

  • Отрыжка при аневризмеabdominal pain
    (permanent or periodic);
  • belching;
  • constant feeling of fullness in the stomach;
  • heaviness in the epigastric zone;
  • drastic weight loss;
  • intestinal dysfunction;
  • vomiting, nausea.

Very often, patients complain of increased pulsation in
lower abdomen. Palpation reveals intense and
painful education with a dense texture.

Typical symptom aneurysm of the ascending aorta are
pain in the sternum or in the region of the heart arising on the background of stenosis
or compression of the coronary vessels.


Помимо этого, пациентов беспокоят:

  • swelling of the upper torso and face;
  • dyspnea;
  • dizziness and migraine;
  • tachycardia.

In the formation of the aneurysm of the descending aorta in patients
there are pains in the scapula and left arm. AT тех случаях, когда в
pathological process involves intercostal arteries in patients
paralysis of both upper or lower extremities develop,
paraparesis and ischemia of the spinal cord. Spinal compression
accompanied by the displacement of its constituent elements, leading to
kyphosis formation. Against the background of compression of the nerves and blood vessels in a patient
intercostal and radicular neuralgia develop.

Кашель при аневризме


The first sign of aortic arch aneurysm, accompanied by
compression of the esophageal tube, local pains and
swallowing disorders. AT дальнейшем клиническая картина
Disease supplemented by:

  • dysphonia (hoarseness);
  • increased salivation;
  • unproductive cough;
  • disorders of sinus rhythm;
  • shortness of breath;
  • congestion in the lungs;
  • noisy wheezing;
  • frequent pneumonia.

AT клинической практике часто встречаются бессимптомные
aneurysm. The disease, which is characterized by a hidden course,
detected by chance (during routine inspection or during
appeal to doctors on other issues).

Diagnostic measures

Differential diagnosis of aneurysm begins with analysis
complaints, personal and family history of the patient. AT дальнейшем врач
conducts inspection to identify systolic murmurs in the projection
thickening of the aorta and wheezing in the lungs, detect signs of hypertension and
atherosclerosis. Besides этого, специалист направляет больного на
a series of additional studies, among which may

  • Биохимический анализ кровиblood chemistry,
    allowing to determine the concentration of “harmful” cholesterol,
    triglycerides, glucose in the body;
  • Ultrasound, thanks to which physicians have the opportunity to examine
    aneurysmal bag and estimate its size;
  • Doppler ultrasound, which allows to assess the nature and
    blood flow velocity in the affected area of ​​the aorta;
  • echocardiography, the results of which allow
    diagnose the aneurysm of the ascending mainline
  • complete blood count to establish the causes of the disease,
    factors contributing to its development, and timely identify
    complications of the pathological process;
  • Ультразвуковая допплерографияmagnetic resonance and
    computed tomography providing physicians with information about
    cross and longitudinal size of the aneurysmal bag,
    localization of the focus of the disease;
  • X-ray of the chest, abdominal organs, stomach
    and esophagus, which allows to identify large aneurysms;
  • ultrasound color doppler scanning using
    which doctors get information about the type, location and size
    aneurysmal bag, measure the speed of blood flow on the affected
  • computed tomography angiography to detect
    parietal thrombi.

If necessary, the doctor offers the patient to consult
adjacent specialists (vascular surgeon, infectious diseases specialist and

Компьютерно-томографическая ангиография

Treatment methods

With aneurysms occurring in slowly progressive
asymptomatic forms, treatment is limited to dynamic medical
observation and regular radiological control. To persons
those at risk of developing complications are prescribed
blood pressure lowering drugs
�”Harmful” cholesterol, inhibiting the activity of the coagulation system
blood and preventing the formation of blood clots.

Surgical intervention is carried out only when identifying
absolute testimony. These include:

  • Хирургическое вмешательствоincrease in aortic diameter up to 40
    mm in the abdominal region or up to 55 mm in the chest area;
  • expansion of the aneurysm by 5 mm or more within 6 months;
  • persistent pain;
  • rupture of aneurysmal bag.

ATо время операции врач иссекает расширенный участок
arteries, suture defect or replace it with prosthetic
construction (synthetic graft). If necessary
The described manipulations are combined with aortic prosthetics.
valve. An alternative to open surgery may be
serve the installation of an endovascular stent – an operation that allows
strengthen the walls of the aorta and create a reliable framework that protects them from

Diet therapy for aneurysm

To persons у которых было диагностировано патологическое расширение
aorta, it is very important to follow a sparing diet. AT перечень продуктов,
рекомендованных при этой патологии, входят:

  • light avocado-based vegetable salads;
  • grapefruits, apples, pomegranates;
  • linseed oil;
  • Питание при аневризмеcereals;
  • broccoli, pumpkin, garlic;
  • beans, beans, peanuts;
  • wild strawberries and raspberries;
  • sweet cherry, cherry, black and red currants;
  • salmon, mackerel, trout, salmon, sardine, tuna;
  • poultry dishes;
  • lean meat (steamed or boiled);
  • mushrooms;
  • chocolate with a cocoa content of at least 70%;
  • almond and walnuts;
  • fermented milk products with a low fat content.

Миндальные и грецкие орехи

Negative effects on the condition of patients with aneurysm have
products containing GMOs, preservatives and growth hormones. Besides них,
from the diet of a sick person is very important

  • milk and white chocolate;
  • Шоколад при аневризмеsynthetic food additives;
  • meals containing large amounts of animal fat;
  • hot spices;
  • mayonnaise and other fat sauces;
  • deep-fried foods;
  • ketchup;
  • meat semi-finished products;
  • smoked meat;
  • canned products;
  • margarine.

Нельзя кетчуп

To persons проходящим курс лечения от аневризмы, необходимо
give up drinking alcohol and low alcohol

Folk remedies

There is a whole range of folk techniques that allow
slow the progression of the aneurysm and significantly improve
patient status. So, experts in the field of unconventional
Medicine recommended to persons who have identified an extension
аорты, использовать следующие рецепты:

  1. Cover a handful of crushed Levkoy grass in a thermos
    jaundice and pour boiling water over it (400 ml). The resulting mixture insist
    within 2−2.5 hours. Strained infusion take 5 tbsp. spoons
    per day.
  2. Folk remediesPrepare a collection of grass horsetail,
    bird mountaineer and hawthorn flowers (2: 3: 5). Boil 2 tbsp. spoons
    the resulting mass in 2 cups of water for 15 minutes, insist 2
    hours and strain. ATыпивать по ½ стакана отвара в день.
  3. Crush in a mortar 3 handfuls of ripe fruit of viburnum. Pour
    berry puree 2 cups boiling water and put in a warm place. Through
    1.5 hours, drain the liquid and add honey to taste.
    The resulting juice to drink during the day.
  4. Pour стакан сухих семян льна литром кипятка и настоять в
    for an hour. Ready infusion taken orally for 3 sips
  5. Prepare a collection of seeds and chopped dill (1: 1).
    Pour столовую ложку смеси кипятком (350 мл) и оставить в тепле на
    2 hours. Strain the infusion and drink it during the day.
  6. Боярышник при аневризмеGrind in a mortar 2 tbsp. spoons сухих
    hawthorn fruit. Pour полученный порошок кипятком (1,5 стакана)
    and insist at least 2 hours. Ready to drink a drink for the day
    dividing the daily dose into 3 doses.
  7. Grind in a coffee grinder dried Siberian elderberry.
    Pour into a pot 1 tbsp. spoonful of powder, pour a glass of boiling water and
    put on fire When the mass boils, pour it into a thermos and
    let it brew for 6 hours. Ready medicine to take 1 sip.
    трижды per day.
  8. Prepare a collection of crushed holey grass
    St. John’s wort, yarrow and flowers of mountain barannik (4: 5: 1).
    Pour горсть растительного сырья литром ледяной воды, настоять 3
    hour, then put on the fire, bring to a boil and cool.
    ATыпивать в день по 1 стакану процеженной жидкости.

Unfortunately, folk techniques are not able to replace
drug therapy and surgery for
aneurysm. Therefore, they can only be used as a supplement to
The main treatment prescribed by the doctor.

Prevention and prognosis

Developed a whole range of measures aimed at prevention
aneurysm. In order to reduce the risk of developing this disease,
it is necessary:

  • Мерять давлениеregularly undergo preventive examinations
    screening ultrasound and angiosurgeon and cardiologist
  • timely treat fungal infections, syphilis, aortic
    medionecrosis, atherosclerosis;
  • constantly monitor blood pressure;
  • eat right;
  • lead a healthy lifestyle;
  • avoid stressful situations.

Правильное питание

The prognosis for the natural course of the disease is unfavorable.
Patients who refuse treatment die from thromboembolic
осложнений или разрыва aneurysm. ATместе с тем раннее обнаружение
pathology and compliance with all medical recommendations allows
patients not only to avoid death, but also for
few weeks back to normal life.

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