Aortic Disease

The aorta is your largest artery. It carries oxygen-rich blood from your heart to the rest of your body. It travels from your heart down through your belly (abdomen) before splitting into smaller arteries that go to your legs. When the aorta is damaged or weakened, it can no longer function properly and may cause seriously complication.

An aneurysm is a weakened section of an artery. The pressure of blood flowing through the artery makes the weak section bulge out like a balloon. An aneurysm in the part of the aorta that goes through the belly is called an abdominal aortic aneurysm, or AAA.

Even if it doesn’t cause symptoms, an aortic aneurysm is very dangerous if it’s large or it’s growing. If it ruptures (bursts), it can cause bleeding. If an AAA ruptures, you can die within minutes. However, there are a variety of treatment options to help repair the aorta and save your life.

An aortic aneurysm, or aortic disease, rarely causes symptoms. In some cases, it can cause a pulsing sensation in the belly or pain in the belly, chest, or back.

If you have a family history of heart disease, you should regularly follow up with your doctor to ensure you maintain good heart health.

While we don’t know all of the causes for aortic disease, likelihood of developing an aneurysm may increase due to a few factors:

• Family history of aortic disease
• Smoking
• Overweight
• High cholesterol

Your provider may discover aortic disease through imaging tests including:

• X-ray
• Abdominal ultrasound
• Echocardiogram

If your AAA is large (over 2 inches across) or growing rapidly, it should be repaired. It can be repaired using a nonsurgical procedure called endovascular aneurysm repair (EVAR), or through open abdominal surgery.

In open abdominal surgery, a large incision (cut) is made in your belly. The weak area of the aorta is replaced with a graft. A graft is a tube of man-made surgical material.

EVAR is only recommended in certain cases. Your doctor may recommend an EVAR procedure if:

• You don’t have a section of artery long enough to hold a stent graft in place.
• You aren’t able or willing to have the follow-up tests needed every year after an EVAR procedure.
• Your surgery may be an emergency procedure. This is when the aneurysm has ruptured or is close to bursting.

How can I reduce my risk for developing aortic disease and managing my condition after treatment?

• If you smoke, quit. This is the single biggest difference you can make in your health. Ask your doctor or nurse for a copy of Intermountain’s booklet Quitting Tobacco: Your Journey to Freedom. Or, call 1-800-QUIT-NOW for the Utah Tobacco Quit Line, or go to waytoquit.org.
• If you have diabetes, control it. Keep your blood glucose (blood sugar) between 70 to 130 before a meal, and keep your HbA1c below 7%.
• Control your blood pressure. Aim to keep your blood pressure at less than 120/80mm Hg. Medicine, exercise, and weight loss can help you meet this goal.
• Control your cholesterol. Work with your healthcare providers to keep your total cholesterol under 200 and your LDL (“bad”) cholesterol under 100. If you have diabetes, you may need to take cholesterol medication, even if your cholesterol is normal.
• If you’re carrying extra weight, lose it — slowly and safely. Ask your healthcare provider for a referral to see a dietitian. You can also go to the Weigh to Health classes offered by Intermountain.
• Eat a “heart smart” diet. Choose foods that are low in saturated fats, cholesterol, and salt. Fill up on fresh fruits and vegetables and high-fiber grains. See the illustration below for some tips on how to make heart-healthy meals.
• Be more active. Physical activity will help you lower your cholesterol levels, lower your blood pressure, strengthen your heart, and help you feel better overall.
• Follow your doctor’s instructions for taking medicines. Certain medicines are especially helpful for PVD. They include aspirin and other antiplatelet (anti-clot) medicines, cholesterol lowering medicine, and blood pressure medicine.
• Check with your doctor before taking supplements. While it is usually a good idea to take a multivitamin, some supplements can interact with other medicines and cause side effects. Talk to your doctor first before you start taking any vitamin or herbal supplement.