The cardiovascular diseases

ANEURYSM OF THE ABDOMINAL AORTA

- Definition
- A few explanations
- The symptoms
- What does the physician notice?
- How to make the diagnosis?
- Once the diagnosis made, an operative check-up is required
- Complications
- The causes
- Clinical shape, Evolution, Prognosis
- Treatment, Conclusion

ONCE THE DIAGNOSIS MADE, AN OPERATIVE CHECK-UP IS REQUIRED

1 - The local check-up

X-ray of the aorta or arteriography.

It is aimed at specifying the extension of the bag of the aneurysm: up toward the renal arteries, and below toward the aortic bifurcation or even the iliac arteries. These 2 notions are fundamental for the therapeutic strategy.

The arteriography consists in achieving an x-ray of the aorta after having injected a contrast product impervious to x-rays. This exam requires the puncture of a palpable artery, as the artery of the fold of the groin (femoral artery), and the introduction of a hose permitting the injection of the product impervious to x-rays. During the injection of this product into the aorta, a few x-rays are made.

The limits of the exam are:

- The real size of the aneurysm, because of the frequent existence of a clot in the wall of the artery;

- The bad injection of the iliac arteries (arteries of the pelvis) because of the dilution of the product in the aneurismal volume.

2 - The general check-up: the check-up of the other vessels

The patient affected by an aneurysm of the abdominal aorta is a polyarterial patient: he is hypertensive in 40% of the cases, he is carrier of an attack of the heart arteries (coronary arteries) patent or latent in 50% of the cases, and finally, an atheroma of the neck arteries (carotid), an attack of the arteries of the lower members or a chronic renal insufficiency are frequently found.

The general check-up therefore includes:

- The achievement of a Doppler ultrasound of the supra aortic arteries (neck arteries), of the iliac arteries (pelvis arteries) and of the lower members;

- A renal check-up with a blood test including the dosage of the urea and the creatinine and a radiological exam called intravenous urography (IVU). Nevertheless, this exam is not always implemented;

- A variable cardiac check-up including, according to the case and the symptomatology presented by the patient: electrocardiogram, scintigraphy of the heart and sometimes displaying of the arteries of the heart (coronarography);

The exercise test involving an important effort is proscribed. In practice, if the Doppler ultrasound does not show an important diffusion of the illness, the questioning and the electrocardiogram are sufficient.

Previous     Next

File last modified on june 12, 2006