An aneurysm is a bulge in the wall of a vein or artery that collects blood. Over time, it can rupture and cause a medical emergency.
The vascular system of the human being is a true work of bioengineering. Thanks to blood flow, oxygen reaches each and every one of our cells (by the action of red blood cells), waste substances are collected and excreted in the urine, body homeostasis is maintained and immune cells are also transported aimed at ending a threat within the body. A human being has about 5 liters of blood inside, or what is the same, 8% of our body weight is this fluid.
Due to its importance, a failure in the circulatory system can be expensive. The World Health Organization (WHO) estimates that the leading cause of death worldwide is ischemic heart disease, an event in which there is a severe blockage of the coronary arteries that supply blood to the heart muscle. Stroke is the second cause, and it is also correlated with irregular blood flow.
There are many things that can go wrong in the cardiovascular system, especially in patients with congenital diseases and unhealthy habits. Today we come to tell you all about a condition of the circulatory system very little known but that, in certain situations, can be just as lethal as an ischemic stroke (or worse, in some cases). Know with us the 5 types of aneurysms that exist and their characteristics.
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What is an aneurysm and how are they classified?
An aneurysm is a dilation of an artery or vein. More specifically, it is a small balloon, grape, or blood-filled bunch-shaped bump that forms on the walls of a weakened or abnormal blood vessel. Aneurysms can be caused by a congenital condition, but it is also possible for them to appear for no apparent physiological reason.
Although the causes of these formations in the cardiovascular system are not fully known, it is believed that diabetes, obesity, hypertension, tobacco addiction, high cholesterol, copper deficiency and advanced age are some of the risk factors that could lead to their appearance. Next, we present the 5 types of aneurysms based on two very different criteria: morphology and location. Don’t miss it.
1. Aneurismas reales y pseudoaneurismas
Although it may not seem like it, not all cluster-shaped lumps attached to the wall of an artery have to be aneurysms to use. It is necessary to differentiate the real aneurysm from other clinical entities.
1.1 Real aneurysm
A real aneurysm is one that is formed by the three layers of the arterial wall (intimmate, middle and adventitia). This means that the lesion has not ruptured or there has been an outflow of blood, at least in the asymptomatic stages.
At this point, it should be noted that the real danger of an aneurysm is not its presence, but its rupture. Most aneurysms inside the patient’s body are asymptomatic, so the patient may never realize they have it. For example, the prevalence rate of a brain aneurysm is 2-3% of the world’s population, but this does not mean that all cases end with an intracranial hemorrhage.
1.2 Pseudoaneurysm
In pseudoaneurysm, a blood vessel is injured and blood leaks and pools in surrounding tissue. At the end, a hematoma is formed that is circumscribed and bounded by adjacent structures. Unlike the real aneurysm, in this case the bulge is not delimited by the vascular tissue itself (the arterial wall), but by the material that surrounds it.
2. Aneurysms according to their location
Aneurysms can form in both arteries and veins, but arterial aneurysms are much more common statistically. In addition, these can appear in arteries that flow into the brain, kidneys, areas of the chest, legs and superficial capillaries. However, at the clinical level, a distinction is made between 3 different types of aneurysms: cerebral, aortic, and thoracic. We tell you its particularities.
2.1 Brain aneurysm
Brain aneurysms are defined asdilations that appear in weak areas of arterial circulation that reaches the brain. They can vary in size (from 0.5 to more than 25 millimeters) and their location will be different in each case in the cerebral circulatory framework. It is estimated that the prevalence of this clinical event is 3.2% of the general population, especially from 50 years of age.
In any case, it should be noted that the rupture rate of the cerebral aneurysm is 10 per 1,000 patients, while in the rest of those affected it never manifests or generates problems. In the unfortunate event that the aneurysm ruptures, a clinical event known as hemorrhagic stroke occurs, which causes 20% of all strokes.
In this clinical picture, the aneurysm ruptures and floods the surrounding tissue of the brain, compressing vital structures and destroying neurons in a very short time, as they die due to lack of adequate blood supply and local waterlogging. The mortality rate of a ruptured brain aneurysm reaches 20% of patients, and up to 30% of those who survive are left with irreversible sequelae.
2.2 Thoracic aortic aneurysm
When the walls of the aorta are weakened, blood pushed through the duct can cause the walls to dilate and form an aneurysm of the thoracic aorta (the portion of the artery that runs through the chest). This imbalance in the blood system grows silently and in the early stages does not report symptoms, but as time passes, the patient may feel chest pain, hoarseness, cough and shortness of breath, among other nonspecific clinical signs.
In some regions, an incidence of 9 to 16 cases per 100,000 inhabitants is estimated at 9 to 16 inhabitants, respectively. Unfortunately, the scenario in this clinical picture is much bleaker than the previous one: the rupture of the thoracic aneurysm reports a mortality rate of 97%, and the survival rate of patients with untreated aneurysms (and without rupturing when detected) 5 years after diagnosis is 20%. This means that, unlike brain aneurysms, here they do end up rupturing almost always.
2.3 Abdominal aortic aneurysm
This case is very similar to the previous one, because the only difference between the two is the area in which the wall of the aorta has dilated. In the aneurysm of the thoracic aorta, the bulge occurs in the chest, while the abdominal aneurysm arises in the abdomen, as its name indicates.
In this case, when the aneurysm grows,symptoms usually occur in the side and lower back. In addition, a characteristic pulse near the navel can be detected. The prevalence is estimated at 4 to 7 per cent of the general population and the mortality rate is not negligible either: it ranges from 32 to 70 per cent. Although it is a very lethal type of aneurysm (the tenth cause of death in Caucasians over 60 years of age), it does not reach the levels of the thoracic aortic.
Summary
In summary, aneurysms are bulging of the walls of veins or arteries that cause blood to pool and pose some risk of rupturing. The brain aneurysm is the “mildest” of all, since it does not usually ruptureand, when it does, survival rates are a little more optimistic than in other cases. Not all hemorrhagic strokes lead to death, but it is normal for patients to be left with irreversible sequelae.
On the other hand, aortic aneurysms (thoracic or abdominal) are fulminant in almost all cases, with a practically zero survival prognosis. In these scenarios, the aneurysm can only be expected to be detected in a routine medical test (ultrasound, CT scan, etc.) and addressed in time before it ruptures.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
