Definition of "Aneurysm"

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Aneurysm (from Greek "aneurysm" meaning "dilation") is a localized, blood-filled balloon-like bulge in the wall of a blood vessel.

Patient information

What is an aneurysm?
It's a bulge in the wall of a blood vessel, that's filled with blood. It looks a bit like a balloon.

Pathophysiology
  • Caused by a weakened blood vessel wall, which can be a result of a hereditary condition or an acquired disease
  • It can occur in any blood vessel (e.g. circle of Willis in the brain, or aortic aneurysms affecting the thoracic aorta, and abdominal aortic aneurysms), including within the heart itself

Patient information

What causes a balloon bulge in a blood vessel?
A weak wall. It can basically happen in any vessel... even in the heart itself!

Classification
  • Type:
    • True aneurysm, which involves all 3 layers of the artery wall (i.e. intima, media, and adventitia). It includes:
      • Atherosclerotic
      • Syphilitic
      • Congenital aneurysms
      • Ventricular aneurysms, that follow transmural MI
    • False aneurysm (hematoma caused by blood leaking out of an artery)
  • Morphology, based upon their macroscopic shape and size:
    • Saccular aneurysm, spherical in shape, and involve only a portion of the vessel wall, varying in size from 5-20cm in diameter, often filled, either partially or fully by a thrombus
    • Fusiform aneurysm, variable in both their diameter and length, diameters extending up to 20cm, often involving large portions of the ascending and transverse aortic arch, the abdominal aorta, or less frequently, the iliac arteries
  • Location, including:
    • Arterial and venous, with arterial being more common
    • Heart, including coronary artery aneurysms, ventricular aneuryss, aneurysm of sinus of Valsalva, aneurysms following cardiac surgery
    • Aorta (aortic aneurysm), including thoracic aortic aneurysm, abdominal aorta aneurysm
    • Brain, including cerebral aneurysm, berry aneurysm, Charcot-Bouchard aneurysm
    • Legs, including popliteal arteries
    • Kidney, including renal artery aneurysm, intraparenchymal aneurysm
    • Capillaries (capillary aneurysm)

Patient information

What's the difference between a true and false aneurysm? Is that like a fakey?
Sort of. So a true aneurysm is that balloon bulge in a blood vessel wall that we were just talking about. A false aneurysm actually has nothing to do with the wall, it's actually blood that's leaked OUT of an artery, and caused a clot. So something different altogether.

Complications
  • Ruptured aneurysm, which increases in risk as the aneurysm increases in size. This can in turn cause:
    • Bleeding
    • Subsequent hypovolemic shock
    • Eventually death
  • Can be a nest for thrombosis (formation of a clot) and subsequent embolization

Patient information

What can happen to a balloon bulge of a blood vessel wall?
It can pop. So blood leaks, and if you lose tons of blood, you can get low blood pressure, called shock. And eventually... die. Damage to the wall also increases the likelihood of clotting, which can detach causing problems.

See also
  • Pseudoaneurysm (aka false aneurysm)
  • AAA

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Definition of Aneurysm | Autoprac


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