An aneurysm (AN-yer-iz-im) is a bulge in a blood vessel. It happens
because there's a weak spot in the blood vessel wall. An aortic aneurysm
is in the large artery that carries blood from the heart to the body. This artery
is called the aorta(ay-OR-tuh).
What Happens in an Aortic Aneurysm?
When a child has an aortic aneurysm, blood flowing through the aorta pushes on
the weak spot in the wall. This makes the aorta bulge out. Sometimes the weak spot
bulges out so much it gets very fragile. Like a balloon that's blown up too much,
the aorta can burst.
What Problems Can Happen?
When doctors know that a child has an aortic aneurysm, they set up regular checkups
and tests. If there's a chance an aneurysm might burst, surgeons step in to repair
the blood vessel. Checkups and surgery can help stop problems like these before they
start:
Internal bleeding. The aorta is the largest blood vessel in the
body. It carries a lot of blood. If it bursts, blood floods into the chest or belly.
A burst aneurysm is an emergency. Children need surgery fast.
Blood clots. Sometimes blood clots form inside an aneurysm. If
they break free, they can clog branches of the aorta farther down the body. This is
called an embolism (EM-buh-lizm). It can block blood flow to the
kidneys, legs,
or other body parts.
What Are the Signs & Symptoms of an Aortic Aneurysm?
There may be no signs that a child has an aortic aneurysm. That's why doctors keep
a close watch on children who might get one.
Aortic aneurysms can happen in the chest or belly. They have different symptoms.
Aneurysms in the belly are called abdominal aortic aneurysms (AAAs).
A child with an AAA may have:
pain anywhere from the upper belly to the hips
a pulsing lump in the belly that can be felt through the skin
belly tenderness (pain with touching or pushing on the belly)
Aneurysms in the chest are called thoracic (thuh-RAS-sik) aortic
aneurysms (TAAs). They can't be felt from the outside. Most show up when
doctors do tests for a heart problem.
Who Gets an Aortic Aneurysm?
Some kids have a bigger chance of getting an aortic aneurysm:
their aorta was injured when a
was put into their belly button shortly after birth
they had an infection like endocarditis (an infection of the heart's lining)
they had chest or belly surgery
they had a whole-body injury, such as a car accident or a fall from a tree or
roof
they had a wound in the chest or belly
How Is an Aortic Aneurysm Diagnosed?
There are lots of ways doctors might find an aneurysm:
It might show up on an ultrasound
scan before a baby is born.
If a child shows signs of heart or artery problems, doctors will do tests to see
what's going on. A thoracic aortic aneurysm might show up when doctors do an ultrasound
scan of the heart (called an echocardiogram).
If a child has an abdominal aneurysm, doctors and nurses might notice it during
a physical exam. They will then confirm the problem by doing an ultrasound
scan.
Aneurysms can run in families. If your family has a genetic
condition that causes them, doctors might test your child for aneurysms.
How Is an Aortic Aneurysm Treated?
After diagnosing an aneurysm, doctors often order tests to get detailed images.
These help them know what treatment to give.
Doctors treat aortic aneurysms based on:
the child's age
the size and location of the aneurysm
other health issues the child may have
the cause of the aneurysm, such as a genetic condition
Medicines and Monitoring
When aneurysms are small, children usually don't need treatment right away. Doctors
watch to see if the aneurysm gets larger. If the aneurysm causes high blood pressure,
doctors prescribe medicines to keep it in check.
Surgery
When the time is right, surgeons might repair the aorta. To do that, they might:
open the aorta and cut out the stretched part, then close the aorta
remove the piece of the aorta with the aneurysm and replace it with special medical
tubing or a blood vessel
repair the aneurysm from inside the aorta using a long, thin tube like those used
for cardiac catheterization.
This is called endovascular repair. Doctors usually only do this
repair on adults, but it may work for some teens.
What Causes an Aortic Aneurysm?
Aortic aneurysms form because something weakens or damages the wall of the aorta.
A few babies are born with an aortic aneurysm. These are called congenital
aortic aneurysms (CAAs).
What Can Parents Do?
Kids often don't show signs of an aortic aneurysm. There are several things you
can do to protect your child from having an emergency:
If doctors are watching your child for an aneurysm, go to all follow-up visits
and testing.
If your child needs medicine, give it as prescribed. Renew prescriptions before
they run out. Ask the pharmacist or your doctor if you're not sure how to give a medicine.
Tell your doctor if other people in your family have (or had) aneurysms.
If your child has a genetic condition that causes aneurysms, ask about getting
other family members tested. This can reveal an aneurysm before it causes problems.
If your child had an aneurysm repaired, there's still a chance of having another
one. Follow your doctor's instructions about setting up regular ultrasounds, MRIs,
or CT scans.