The symptom of aneurysm?

summary

Aortic aneurysm refers to the local or diffuse abnormal expansion of the aortic wall, which oppresses the surrounding organs and causes symptoms. It often occurs in ascending aorta, aortic arch, descending thoracic aorta, thoracoabdominal aorta and abdominal aorta. The symptom of aneurysm? Let's talk about it

The symptom of aneurysm?

X-ray examination is helpful. Enlargement of aortic shadow can be found on anteroposterior and lateral films. The size, location and shape of the lesion can be estimated from the shadow. The expansive pulsation of aneurysm can be seen under fluoroscopy, but the pulsation may not be obvious when there is thrombosis in the aneurysm. Aortic aneurysm should be distinguished from the solid mass attached to the aorta, which causes conductive pulsation and can be differentiated by aortography. Echocardiography can find aortic aneurysm of ascending aorta, and the lesion is enlarged. X-ray computed tomography (CT) is also useful for diagnosis.

However, abdominal palpation of arterial pulsation is not necessarily an aneurysm, and normal abdominal aorta is often palpable in patients with emaciation and lordosis. If you hear systolic vascular murmur in abdomen, it may be due to mild stenosis of kidney, spleen, mesentery and other arteries, and may not come from aortic aneurysm. Ultrasound examination is very important for the diagnosis. At present, many cases are found in routine ultrasound examination, so the detection rate of this disease is much higher than in the past. The diameter of aorta was widened, and the width of the liquid flat segment between the anterior and posterior walls of the artery was increased. If there was thrombosis, the widened flat segment was not obvious, but the synchronous pulsation between the anterior and posterior walls of the aneurysm and the heart beat existed, and the external diameter of the artery was still increased. Ultrasound examination could determine the size of the lesion, with an accuracy of 2-3mm, its scope and shape, as well as intraluminal thrombosis. X-ray computed tomography is also useful, especially for the detection of intraluminal thrombus and wall calcification. The relationship between aneurysms and adjacent structures such as renal artery, retroperitoneal cavity and spine can be shown. MRI has the same value as CT and abdominal ultrasound in judging the size of tumor and its relationship with renal artery and iliac artery. The main disadvantage of MRI is that image analysis is time-consuming and expensive. Aortography is also helpful for localization diagnosis, but endovascular thrombosis may affect the assessment of the extent of the lesion. However, aortography is still recommended for patients with unclear diagnosis, hypertensive patients with renal artery disease, patients with suspected obstruction or aneurysm like lesions, and patients preparing for surgery.

① True aortic aneurysm: the aneurysm sac consists of one or more layers of the arterial wall; ② Pseudoaortic aneurysm: due to trauma, infection and other reasons, blood overflows from the artery to the surrounding tissue, blood clots and their organizations, fibrous tissue together with the arterial wall constitute the wall of the aneurysm. ③ Dissecting aneurysm. After the rupture of intima or middle layer of artery, the middle layer is gradually separated into a dissection by the impact of blood flow, and blood accumulates and bulges in the separation cavity. It can also form a double lumen structure with the arterial cavity.

matters needing attention

1. At least 6 months to 1 year of regular follow-up is necessary, through CT to determine the changes of aorta. 2. Patients with hypertension should control their blood pressure. Some activities that can make blood pressure rise suddenly (such as strenuous activities, mental stress, going to the bathroom, being in the cold) should be avoided as far as possible. 3. It is impossible to prevent rupture of large aneurysm completely. When the tumor is large enough, surgical treatment should be selected as soon as possible. 4. Elderly, hypertension, diabetes, or other circulatory diseases, with a family history of aneurysms, are high-risk groups. 5. We should also pay attention to develop good living habits to prevent the formation of atherosclerosis.