Sunday, December 11, 2005

aneurysm

aneurysm - An aneurysm is a localized or  diffuse enlargement of an artery at some  point along its course. Aneurysms occur when the vessel wall becomes weakened from trauma, infection, and atherosclerosis.  Most aneurysms occur in people over 60 years of age and are predominantly seen in males. Once an aneurysm develops there is a tendency for it to progress.
Symptoms of an aneurysm include acute pain in the chest or abdomen, abdominal mass, and shock. Symptoms usually do not occur until the aneurysm becomes quite large or begins to leak.
If the aneurysm is small and nonprogressive, conservative treatment can be used. Antihypertensive medications, pain medications, and negative inotropic agents, such as Inderal®, are usually the treatments of choice. Negative inotropic agents decrease the force of cardiac or vascular wall muscular contraction. If the aneurysm enlarges or ruptures, surgical intervention is required. The aneurysm is removed and is replaced with a Teflon® or Dacron® prosthesis.
See also ANEURYSM, ABDOMINAL.
Anderson, H. C. Newton's Geriatric Nursing, 5th ed. St. Louis: C. V. Mosby Co., 1971.
Ham, R. J. Geriatric Medicine Annual-1986. Oradell, N.J.: Medical Economics Books, 1986.
Phipps, W. J., et al. Medical Surgical Nursing. St. Louis: C. V. Mosby Co., 1983.


aneurysm, abdominal - An abdominal aneurysm is a sac formed by the dilation of the wall of the aorta as it traverses the stomach cavity. The abdominal aneurysm is the most common aneurysm, particularly in the elderly. If it ruptures, it can be life threatening. An untreated ruptured aneurysm is 100 percent fatal. For patients with a ruptured aneurysm who live long enough to reach the operating room the mortality rate is 50 percent.
A key factor in considering aneurysm treatment in an elderly person is to weigh the risk of a ruptured aneurysm against the risk of the operative procedure. Generally, aneurysms less than five centimeters (two inches) in diameter and calcified can be observed and no surgery is necessary. Aneurysms that are greater than five centimeters, those that begin to enlarge, or those that become symptomatic should be repaired immediately. Ultrasound is extremely useful in measuring the size and other characteristics of the aneurysm.
Symptoms of an abdominal aneurysm include abdominal pain and a pulsating mass in the abdomen. Many times the aneurysm is found unexpectedly on a routine X-ray. Few symptoms occur until the aneurysm becomes quite large or begins to leak. Symptoms of a ruptured abdominal aneurysm include acute abdominal pain, profound shock, and an abdominal mass. This constitutes a medical emergency and treatment should be sought immediately. Treatment consists of a surgical replacement of the aneurysm with a Teflon® or Dacron® prosthesis.
Anderson, H. C. Newton's Geriatric Nursing, 5th ed. St. Louis: C. V. Mosby Co., 1971.
Ham, R. J. Geriatric Medicine Annual 1986. Oradell, N.J.: Medical Economics Books, 1986.
Phipps, W. J., et al. Medical Surgical Nursing. St. Louis: C. V. Mosby Co., 1983.


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