ReMar Nurse logo
ReMar Nurse logo

All articles

AneurysmUpdated 2 years ago

What is Aneurysm?

  • An aneurysm is a dilatation formed at a weak form on the wall of the artery. 
  • Classified according to their shape, morphology, and location.
  • At least 50% increase in diameter



  • False aneurysm or pseudoaneurysm: collection of blood and connective tissue outside the aortic wall.




ETIOLOGY

  • Atherosclerosis
  • Vasculopathy
  • Vascular injury
  • Hypertension
  • Hyperlipidemia
  • Trauma
  • Infection-bacterial
  • Neoplasm
  • Smoking


TYPES OF ANEURYSM


                             

Abdominal Aortic Aneurysm

  • Sometimes known as “Triple A,” are the most common aneurysms of the aorta — the large blood vessel that carries blood away from your heart and through your body.
  • Given the aortas reach and size (it’s almost an inch wide in places), substantial internal bleeding occurs when blood pressure increases against the aortas walls, causing it to rupture.
  • Sometimes mistaken for a heart attack, an abdominal aortic rupture can be characterized by pulsating mass, chest and jaw pain, stabbing abdominal or back pain, fainting, difficulty breathing, and weakness on one side of the body.


Thoracic Aortic Aneurysm

  • Thoracic aortic aneurysms develop in the portion of the aorta that passes through the chest. Also like abdominal aortic aneurysms, thoracic aortic aneurysms are largely asymptomatic — so you’re unlikely to know that it’s lurking.
  • However, some symptoms to look out for are back pain, hoarseness, shortness of breath, or tenderness or pain in the chest prior to a thoracic aneurysm rupture.



Cerebral Aneurysm

  • Cerebral aneurysms, also known as brain aneurysms, are weakened, bulging vessels above the aorta, in the brain. 
  • These are most common in people from ages 30 to 60. While cerebral aneurysms can be tiny and not cause any problems, larger ones can rupture causing bleeding in the brain and potentially becoming fatal.


CLINICAL MANIFESTATIONS

(UNRUPTURED)

Abdominal Aortic Aneurysm

  • Femoral bruit
  • Gnawing abdominal 
  • Flank and back pain 
  • Prominent pulsation of a mass

Thoracic Aortic Aneurysm

  • Back pain
  • Shortness of breath
  • Hoarseness
  • Dysphagia
  • Visible mass above the suprasternal notch

Cerebral  Aneurysm

  • Headache
  • Visual acuity loss
  • Cranial neuropathies
  • Pyramidal tract dysfunction
  • Facial pain


CLINICAL MANIFESTATIONS

(RUPTURED)

Abdominal Aortic Aneurysm

  • sudden and severe pain in the abdomen or lower back
  • rapid heart rate
  • abdominal distention
  • dizziness or lightheadedness
  • shortness of breath
  • cold sweat

Thoracic Aortic Aneurysm

  • sudden and severe chest pain
  • shortness of breath
  • sudden back pain
  • significant drop in blood pressure
  • numbness in the limbs

Cerebral  Aneurysm

  • Subarachnoid Hemorrhage (SAH)


DIAGNOSTIC TESTS

Abdominal Aortic Aneurysm

  • Abdominal ultrasound

Thoracic Aortic Aneurysm


  • Magnetic resonance imaging
  • Computed tomography imaging
  • Chest X-ray

Cerebral  Aneurysm

  • Magnetic resonance angiography (MRA) or
  • Computed tomography angiography (CTA)


MANAGEMENT

Non Surgical

 Medication: Antihypertensives
 Lifestyle
  • Avoid lifting and straining activities.
  • Smoking cessation.
  • Aneurysm precaution.

Surgical

 Abdominal & Thoracic: Open repair and Endovascular repair (stent placement)
 Cerebral/Brain: Surgical clipping and Coiling of aneurysm

Surveillance

 Imaging studies to determine increased diameter.
 Regular assessment of clinical manifestations.

Adjuvant therapies

(pre-surgery)

Indicated for cerebral aneurysm
  • Induced hypotension,
  • Cerebrospinal Fluid (CSF) drainage
  • Diuretics
  • Hyperventilation


NURSING PRIORITIES

Health teaching

  • Avoid activities involving lifting, straining, contact sports, pushing and pulling activities. 
  • Smoking cessation.
  • Importance of controlling blood pressure and surveillance.

Monitoring

  • Mean arterial pressure, early signs of hypotension, respiratory distress , paralytic ileus.
  • Post - Op: Signs of bleeding, severe pain, cyanosis, abdominal distention, oliguria and paralysis.

Management

  • Pain
  • Nausea  and vomiting




Was this article helpful?
Yes
No