Paging Dr. Frischer - Aneurysms

Our heart beats about 100,000 times every day. That comes to about three billion times in a lifetime. It will pump about 800 million pints of blood – enough to fill three super tankers. Each muscle contraction has enough strength that it takes only about 20 seconds to circulate blood throughout our entire vascular system, and in total, that comes to about 12,000 miles per day. Given the sheer immensity of our vascular system, and the force under which it operates, it’s remarkable that these blood vessels do their job for a lifetime, and with such amazing efficiency. While malfunctions are highly unusual, one of these rare complications is the aneurysm.

An aneurysm is a bulge resulting from a weakening of the wall of a blood vessel. As an aneurysm gets larger, the risk of a tear increases. If the aneurysm ruptures, the loss of blood can be deadly.

How is an aneurysm diagnosed? It might be from life-threatening complications from sudden major blood loss, or it might even be spotted on a routine x-ray. The danger depends on where it is, how big it is, and whether it has ruptured.

An aneurysm can occur in any blood vessel, but two common types can be particularly dangerous:

1.  Cerebral aneurysms

•A cerebral aneurysm causes symptoms when the bulge in the blood vessel pushes on a structure in the brain. It could result in fatigue, loss of perception or balance, speech problems or double vision. If it ruptures, there could be severe headaches, neck pain and stiffness.

•An estimated six million people in the United States have unruptured cerebral aneurysms. That represents about 1 in 50 people! Of these, about 30,000 rupture each year, and about 40% of them are deadly. Of those who survive, more than half have permanent brain damage.

•They’re most likely to occur in women between the ages of 35 to 60.

•Cerebral aneurisms can cause a subarachnoid hemorrhage (SAH). Its major symptom is a terrible headache. A subarachnoid hemorrhage is extremely rare, but is very high risk if missed.  It is detected by performing a CT scan, and early diagnosis is critical.

2. Abdominal, or aortic aneurysms

•Symptoms can include back pain, swelling, vomiting, and loss of circulation in the lower extremities.

•Every year, about 11,000 people in the United States die of a ruptured abdominal aneurysm.

•Abdominal aneurysms tend to occur after age 55, and affect more men than women.

What can we do to prevent an aneurysm? Some risk factors can’t be avoided – including genetics, age, and some infections. However, other major risk factors can be controlled or minimized, including diabetes, obesity, hypertension, smoking, alcoholism, high cholesterol, copper deficiency, kidney disease and syphilis.

Note that this is an extremely rare condition, but it often presents in a dramatic manner and can be deadly. Time is of the essence; get help fast.

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

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Published: Dec. 25, 2014 - Volume 13 - Issue 37