A ruptured aortic aneurysm can be fatal, but it’s often possible to treat an aneurysm before it tears open and causes a severe bleeding event.
An aortic aneurysm is a bulge that forms somewhere in the aorta, the large artery that carries blood from the heart to much of the body. When an aneurysm forms, it means the wall of the aorta is thinner, weaker, and at greater risk of rupturing.
A ruptured aortic aneurysm is a life-threatening emergency, as it can cause a massive bleeding event. With a healthy lifestyle and a focus on blood pressure management, the risk of a ruptured aortic aneurysm is diminished. But if an aneurysm appears likely to rupture or if it has ruptured, surgical interventions to repair the affected portion of the aorta may be an option.
Learn more about what it means to have a ruptured aortic aneurysm and why it’s critical to prevent one if at all possible.
The thick walls of the aorta can usually withstand normal blood pressure. However, if high blood pressure, atherosclerosis (narrowing of the arteries due to plaque buildup), injury, or other problems cause a portion of the aortic wall to weaken, an aneurysm can form.
An aneurysm is an outward bulge in the aorta. If it forms in the upper part of the aorta, it’s called a thoracic aortic aneurysm (TAA). If one develops below the chest and above the pelvis (where the aorta branches out into smaller arteries to supply blood to the legs), it’s called an abdominal aortic aneurysm (AAA).
As an aneurysm grows, the affected part of the artery’s wall thins. If it eventually breaks, the result is an aortic aneurysm rupture. A rupture interrupts blood flow to much of the body and causes internal bleeding. If the rupture isn’t treated quickly, the condition can be fatal.
The symptoms of a ruptured aortic aneurysm may include:
- rapid heart rate
- low blood pressure, which may cause lightheadedness, fainting, or an altered mental state
- pain in the chest, jaw, neck, or abdomen
- shortness of breath
- sudden, sharp pain in the back that descends toward the abdomen
- coughing up blood
In men, the pain may extend down to the scrotum.
Symptoms of a ruptured aortic aneurysm will not subside without treatment. Your symptoms may worsen the longer your normal circulation is interrupted.
If the aneurysm can be treated and healthy circulation restored in time, your symptoms should improve.
Sometimes, the rupture is initially contained and symptoms may be subtle at first before worsening.
An aortic aneurysm ruptures because the weakened aortic wall can no longer handle the stress of blood flowing inside it. The artery’s wall weakens as it’s stretched by the growing aneurysm. Larger aneurysms are significantly more likely to rupture than smaller ones.
An injury to the chest or abdomen may also cause an aneurysm to form or an existing aneurysm to burst.
The only effective treatment of a ruptured aortic aneurysm is to stop the bleeding by repairing the aneurysm itself. This can be done in two ways: open surgical repair or minimally invasive endovascular surgery. In the case of a rupture, emergency surgery would almost always be necessary.
Both procedures involve the placement of a special tube or graft around the affected portion of the aorta to stop the bleeding and stabilize the aorta, allowing healthy blood flow to resume.
The prognosis for a ruptured aortic aneurysm is usually grim. The American Heart Association reports that a ruptured abdominal aortic aneurysm is fatal about
However, a 2020 study found that for individuals who undergo open surgical repair of a ruptured abdominal aortic aneurysm, those who survive past 30 days have an encouraging prognosis. The study suggests a 5-year survival rate of about 64%.
A rupture is the worst-case scenario for an aortic aneurysm. It’s important to understand that many aneurysms don’t rupture and that you may be able to have elective repair surgery once an aneurysm has been diagnosed to prevent a rupture.
If you have been diagnosed with a TAA or AAA, but it’s still small and carries a low risk of rupture, be sure to work with your healthcare team, stay current with your scheduled check-ups and imaging, and maintain blood pressure goals.
Some people may require intervention sooner, depending on the underlying cause and rate of growth in the aneurysm. An aneurysm that approaches or exceeds
Also, if you’ve been diagnosed with a TAA or AAA, be sure you understand the symptoms of a rupture and that you know what to do if those symptoms come on suddenly. Be sure to let your loved ones and others around you know about the signs and symptoms of an aortic aneurysm and that they should always prompt a 911 call.