Aortic Aneurysm

To begin with, the word aneurysm derives from the Latin word “aneurysma.” In Latin “aneurysma” means dilation and dilation means that act of expanding. From this, it is easier to figure out what an aneurysm really is. The definition of the English word aneurysm means, blood-filled dilation of a blood vessel. There are several different types of aneurysm, but this report will only cover a cerebral one.

Nevertheless, there is an understandable and noticeable link between circulatory related diseases and lifestyle diseases, such as Coronary Heart Disease. Coronary heart disease can occur when fatty acids, such as cholesterol in an inadequate diet, build up in the walls of the coronary artery. These fatty deposits collect minerals and harden to become a plaque. Eventually, this plaque grows and can swells up, forming an aneurism. In some cases, this aneurism may burst leading to instant death. As it continues to grow and swell up, it finally blocks the artery completely and forms blood clots. This is known as coronary thrombosis. A myocardial infarction, or in other words as heart attack, occurs when no oxygen is able to reach the coronary artery and thus it is unable to fulfil its role in providing the heart muscle with a sufficient supply of blood. Heart attacks are very common in the society nowadays, especially occurring in smokers or obesity related diseases (Millar, June 2014)

The pathophysiology of ACS includes the stable plaque forms get converted into unstable plaque forms.2 These unstable plaque forms have numerous thin fibrous cap cells, inflammatory cells, activated macrophages, and smooth muscle cells. Sympathetic activity increases myocardial contractility, pulse rate, blood pressure, and coronary blood flow which leads to plaque rupture or fissure. As the artery ruptures, it causes thrombus formation and ischemia in this particular artery. Depending on the condition, different thrombi could form. The unstable angina forms a small thrombus formation, NSTEMI forms a partial thrombus formation, and STEMI forms a complete and persistent thrombus. The risk factors involved in ACS are age, physical inactivity, and history of hypertension, diabetes, or angina. The signs of acute coronary syndromes are an acute heart failure, tachycardia, bradycardia, or heart blockage, and the symptoms of ACS consist of chest pain, pain in the extremities, nausea, shortness of breath, heavy

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An aneurysm is a life-threatening arterial disease in which the wall of arteries dilates permanently. The aortic aneurysm mainly occurs in the thoracic and abdominal regions of the aorta and can lead to the aortic dissection or rupture resulting in mortality and morbidity of patients. It is believed that multiple factors play roles in the initiation and progression of this disease. However, the underlying causes of the aortic aneurysm and its failure have not been fully understood yet. The current work aims to investigate the failure mechanisms of Ascending Thoracic Aortic Aneurysms (ATAAs) from a biomechanical perspective by considering the histological and morphological changes of the ATAAs.\\

Surgical intervention is presently the only effective method of treating AAAs. The risk of surgical repair is outweighed by the risk of aneurysm rupture or aneurysm related death. Patients

Magnetic resonance angiography (MRA)-An MRA is a painless imaging test that may be used to diagnose an aneurysm and determine its size and location. In this test, you lie on a movable table that slides into the tunnel.

Another hypothesis is that these associations can accidentally exist together.20 Among these hypothesis, the hemodynamic stress secondary to the increased blood flow of AVM plays a significant role to provoke this coexistence of lesion.1,21 This hypothesis is supported by a report showing that the associated aneurysms tend to be concentrated in feeding arteries which supply AVM and the associated aneurysms may shrink in proportion to the occlusion of the AVM. 3

The most common cause is hypertension, or high blood pressure. Stress, smoking, high cholesterol, and obesity can also lead to stress of the heart and aorta, which can lead to the aneurysm. A family history of heart problems, high blood pressure or aneurysms may raise a patient’s risk of having their own aneurysm. Other than the health reasons above, there are also some medical disorders that can weaken the aorta, thus increasing the chance of aneurysm. These disorders are: Marfan Syndrome (a genetic disorder that affects the connective tissue), Ehlers-Danlos syndrome (another inherited connective tissue disorder), syphilis and

Atherosclerosis, the underlying cause of coronary heart disease which can affect any artery in the body, is essentially the narrowing of arteries due to excessive build up of cholesterol-rich lipids known as plaque (Insull 2009). Once the arteries become narrow, the flow of blood will be constricted, and the amount of blood, nutrients and oxygen that are able to reach the heart are reduced. As a consequence, the heart becomes increasingly hypoxic resulting in ineffective contraction. The aftermath of narrow arteries often poses serious consequences as it has a high probability of causing heart attack, angina, or even stroke (Marieb & Hoehn 2010; Insull 2009). Despite the fact that arteries will harden naturally as people age, the rate of plaque development is determined by the number of risk factors (Insull 2009). This essay will discuss and review the procedure in which the risk factors: hypertension, abnormal level of blood lipids, and smoking took to assist in the development of atherosclerosis.

Calcific or degenerative aortic valve disease is considered one of the most, if not the most, common valvular lesion encountered among elderly patients.( Iung B, Baron G, Butchart EG, et al.) In fact, as shown in the Helsinki Aging Study, 501 randomly selected people, men and women, in an age range from 75 to 86 underwent echocardiography. (Iivanainen AM, Lindroos M, Tilvis R, et al) The outcome of the research was that, the prevalence of critical aortic stenosis increased with age from 1 to 2 percent in those patients aged between 75 and 76, up to almost 6 percent in those 86 years of age (Lindroos M, Kupari M, Heikkilä J, Tilvis R.)

Causes are regurgitation, stenosis, artesia. Regurgitation is when a valve flaps and blood leaks backwards. Stenosis is when the valve becomes thick and stiff. Results are narrow openings and reduced blood flow. Artesia is when the valve isn’t fully formed and it is a sheet of solid tissue that blocks the blood flow. People don’t usually feel the symptoms of this disease for a long time. There is a infection of the inner lining of the heart muscle and heart valves called Bacterial Endocarditis. Things that can damage the aortic valve are high blood pressure and atherosclerosis. Now also one or more valves can get damaged from other disorders for example carcinoid tumors, rheumatoid arthritis, systemic lupus erythematosus, syphilis. Also there are drugs that can promote heart valve disease for example, Methysergide which is a medication that helps treat migraine headaches. Some common symptoms are irregular heartbeat, swelling of ankles and feet, dizziness, fainting. Now some symptoms that aren’t really common are a heart murmur which can be determined when a doctor listens to the heart and shortness of breath when lying down or being very

It is mainly as a result of one of these three problems: ST elevation myocardial infarction, unstable angina and lastly non ST elevation myocardial infarction with chest pain being the main symptom (Linton, 2012). There are five main pathophysiologic processes that contribute to the development of ACS: thrombus on pre-existing plaque, active obstruction from coronary spasm, progressive mechanical obstruction, infection and unstable angina due to oxygen supply to myocardial (Linton, 2012). ACS is mainly caused by thrombus formation on a pre-existing plaque and it can be demonstrated through angiography or autopsies (Marshall, 2010). A thrombus is formed from plasma coagulation and platelets. There are risk factors that contribute to ACS such as cigarette smoking, diabetes, hypertension and high blood cholesterol (Linton, 2012). Both men and women are at a risk of having a heart attack. However it is more common in men especially when having a family background of heart attack, being overweight and inactive (Scruth, Carter, Cheng, Rolley, & Page, 2012). Modifying and identifying the risk factors is important as it can prevent further heart problems.

An aneurysm is permanent, excessive dilation of a blood vessel. It can occur in the aorta and other blood vessels; the most common location for an aneurysm is in the abdominal section of the aorta (Humphrey and Taylor [88] from ITL biomechanics thesis). There are a couple of definitions of an abdominal aortic aneurysm (AAA): one is a local dilation in the aorta whereby the diameter of a dilated artery is more than 50% larger than the original diameter [1]. Another definition is when the external AAA diameter exceeds 30mm [3].

specific changes in the geometry of the vessel (length, diameter, and wall structure/sti ness) resulting from the natural aging process combined with changes they induce in the hemo- dynamics, are the primary cause of aneurysm formation. This assumption postulates, that the mentioned coupling induces a segment of the aortic wall to degrade and simultaneously leads to a gradually increase of its diameter.