ANEURYSM
Aneurysm is a degenerative disease of the blood vessels that is irreversible. It develops due to destruction or weakening of the walls of the arteries caused by the constant pressure from blood flowing in the arteries, medical conditions, trauma or, genetic factors. This however, leads to widening or budging out of the arteries as compared to the original size. The budged arteries can lead to complications due to its compression of surrounding organs and tissues, their eventual rapture and, even bleeding. An Aneurysm may not show any symptoms but can be fatal. It may affect any artery especially, at the branching site but, the two most affected arteries are; the abdominal artery which transports blood from the heart to the rest of the body and, the thoracic artery which takes to the brain. An Aneurysm can take two forms; either fusiform which, bulges all-round the vessel or saccular which bulges on only one side of the blood vessel (Erbel, Boileau and Aboyans, 2014).
1. Description of the pathology
Although the real cause of aneurysm may not be known, there are many risk factors that may lead to its development. An Aneurysm can result from trauma, especially severe head injury. Arteriosclerosis and infections such as syphilis can also cause it. Factors such as age beyond 40yrs too put one at risk of developing aneurysm since as age advances, the arteries weakens due to the constant pressure from the blood (Erbel, Boileau and Aboyans, 2014). Women in menopause are at a higher risk too. This is because, after menopause, estrogen hormone, which is thought to maintain the elasticity of the blood vessels, reduces significantly. Having a close family member, for instance, a parent or a brother, also places one at risk of developing, unlike one with no family history of aneurysm. A person with hypertension similarly can develop an aneurysm. High blood pressure increases the pressure on the walls of the blood vessels, therefore, weakening them. Lifestyle practices like smoking tobacco and the use of cocaine are known to lead to the development of aneurysm (Norman and Curci, 2013). These substances tend to inflame the blood vessels thus increasing blood pressure which ultimately weakens blood vessels
2. The normal anatomy of significant body systems affected
Aneurysm usually affects the circulatory system. It can affect both the veins and arteries, but it mostly affects the arteries, mainly the aorta. The origin of the aorta is the left ventricle. It usually starts immediately after the aortic valve. It then travels upwards and first branches forming the brachiocephalic artery, from there is goes behind the heart forming the aortic arch. It then moves downwards, creating the descending aorta, which then divides one through the thorax forming the thoracic aorta and the other down to the abdomen creating the abdominal aorta. The abdominal aortal further divides into the left and right iliac arteries. The inner walls of these arteries are made of 3 three layers; intima, media, and adventitia. Intima is the inner thinnest layer that is lined with endothelium. Media is the middle thick layer made of elastic fibers which are spirally arranged. Finally is the outermost layer (adventitia), which is very fibrous and contains the media’s nutrients. The average diameter of a healthy artery is approximately 2cm.
3. Normal physiology of body system affected
The left ventricle pumps blood to the other parts of the body through the aorta. The aorta then divides into the thoracic and abdominal aortas that supply blood to the head and the rest of the body, respectively. Aortic blood is usually highly oxygenated and flows at a moderate speed through the full lumen of the artery. The full lumen makes the blood flow at a higher pressure. Very high pressure beyond 100 diastolic and 140 systolic applies too much pressure on the walls of the vessels hence weakening them.
4. Mechanism of pathophysiology
Aneurysm can either be true or false. When all the three layers of the wall of the artery are affected, it is known as true aneurysm. In contrast, false aneurysm occurs when either the innermost or both the intima and the media are affected, leading to intermural hemorrhage. Factors such as smoking, family history, hypertension, and the risk factors that cause aneurysm apply a lot of pressure on the smooth muscle tone hence making it drop out. This leads to the degeneration of the elastic fibers in the medial. This degeneration weakens the blood vessel wall and leads to the formation of an aneurysm. If not early treated, it progresses and eventually ruptures, causing more complications and may even lead to death (Sadasivan, Fiorella, Woo and Lieber, 2013).
5. Prevention
An aneurysm can be prevented by avoiding factors that place one at risk of developing it. For instance, healthy living practices that lower high blood pressure, such as eating a healthy diet, exercising regularly, and maintaining a healthy weight, should be encouraged. Also, cocaine users and tobacco smokers should significantly reduce the use of those substances. Complications of an aneurysm can be prevented by early diagnosis and treatment (Erbel, Boileau, and Aboyans, 2014).
6. Treatment
Treatment of aneurysm depends on the cause, the risk factors, size, and location. Healthy lifestyle sand medications may be used to manage smaller aneurysms. The main goal of treatment is usually to slow down the growth of the aneurysm and prevent it from rupturing or dissecting. Medications like antibiotics and beta-blockers can be used to slow the growth of the aneurysm. Antibiotic therapy is employed when chronic inflammation is the cause. Beta-blockers, on the other hand, are often used in the management of patients with hypertension. It lowers blood pressure and reduces the expansion of the aneurysm. Surgical repair is recommended for more giant aneurysms that are at risk of rupturing. However, this method is associated with high perioperative risks that could lead to death. Endovascular repair is an alternative method for surgery since it’s less invasive and cheaper. An endograft is inserted into the lumen, excluding the aneurysm from blood flow, thus reducing the risk of rapturing (Erbel, Boileau, and Aboyans, 2014.
Conclusion
In conclusion, even though the symptoms of aneurysm are not readily noted, the cases can still be fatal. Ruptured aneurysms cause an estimated 40 percent of most deaths within 24hrs. This, therefore, means that preventive measures need to be employed to reduce such cases. Risk factors for developing aneurysm should be significantly reduced. Practicing a healthy lifestyle greatly reduces the risk and progress of aneurysm. Early detection and management of aneurysm also slows its growth and minimizes ruptures.
References
Erbel,., Boileau, C. and Aboyans, V., 2014. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases. European Heart Journal, 35(41), pp.2873-2926
Norman, P., and Curci, J., 2013. Understanding the Effects of Tobacco Smoke on the Pathogenesis of Aortic Aneurysm. Arteriosclerosis, Thrombosis, and Vascular Biology, 33(7), pp.1473-1477.
Sadasivan, C., Fiorella, D., Woo, H., and Lieber, B., 2013. Physical Factors Affecting Cerebral Aneurysm Pathophysiology. Annals of Biomedical Engineering, 41(7), pp.1347-1365.