Aortic Aneurysm -is a bulge in a section of the aorta, the bodys main artery.

The aorta carries oxygen-rich blood from the heart to the rest of the body. Because the section with the aneurysm is overstretched and weak, it can burst. If the aorta bursts, it can cause serious bleeding that can quickly lead to death. Arteries are muscular tubes. The wall of the artery is made up of three layers: the innermost layer (the intima), the middle layer (the media), and the outer layer (the adventitia). Bulges in an artery are classified as true aneurysm, false aneurysm, or dissection.

A true aneurysm involves all three layers of the blood vessel wall. A false aneurysm of the artery is contained only by the two outer layers of the blood vessel wall and clot. This is a very fragile condition with high risk of bursting. False aneurysms are usually a result of an infection.

There are two types of aortic aneurysm:

Thoracic aortic aneurysms occur in the part of the aorta running through the chest. Abdominal aortic aneurysms occur in the part of the aorta running through the abdomen.

What causes an aortic aneurysm? The wall of the aorta is normally very elastic. It can stretch and then shrink back as needed to adapt to blood flow. But some medical problems, such as high blood pressure and arteriosclerosis (hardening of the arteries), weaken the artery walls. These problems, along with the wear and tear that naturally occurs with aging, can result in a weak aortic wall that bulges outward. What are the symptoms? Most aortic aneurysms don't cause symptoms. Sometimes a doctor finds them during exams or tests done for other reasons. People who do have symptoms complain of belly, chest, or back pain and discomfort. The symptoms may come and go or stay constant. In the worst case, an aneurysm can burst, or rupture. This causes severe pain and bleeding. It often leads to death within minutes to hours. An aortic aneurysm can also lead to other problems. Blood flow often slows in the bulging section of an aortic aneurysm, causing clots to form. If a blood clot breaks off from an aortic aneurysm in the chest area, it can travel to the brain and cause a stroke. Blood clots that break off from an aortic aneurysm in the belly area can block blood flow to the belly or legs.

How is an aortic aneurysm diagnosed? Aneurysms are often diagnosed by chance during exams or tests done for other reasons. In some cases, they are found during a screening test for aneurysms. Screening tests help your doctor look for a certain disease or condition before any symptoms appear. Experts recommend screening tests for abdominal aneurysms for men who are:

Ages 65 to 75 and have ever smoked. At least 60 years old and have a first-degree relative (for example, father or brother) who has had an aneurysm.

These men are more likely to have an aneurysm than are women or nonsmoking men. Experts recommend screening tests for a thoracic aneurysm for anyone who has a close relative who has had a thoracic aortic aneurysm. If your doctor thinks you have an aneurysm, you may have tests such as an ultrasound, a CT scan, or an MRI to find out where it is and how big it is. How is it treated? Treatment of an aortic aneurysm is based on how big it is and how fast it is growing. If you have a large or fast-growing aneurysm, you need surgery to fix it. A doctor will repair the damaged part of the blood vessel with a stent or replace it with a graft during open surgery. Small aneurysms rarely rupture and are usually treated with high blood pressure medicine, such as beta-blockers. This medicine helps to lower blood pressure and stress on the aortic wall. If you don't have surgery, you will have routine ultrasound tests to see if the aneurysm is getting bigger. Even if your aneurysm does not grow or rupture, you may be at risk for heart problems. Your doctor may suggest that you exercise more, eat a hearthealthy diet, and stop smoking. He or she may also prescribe medicines to help lower high cholesterol. Nursing Management: The goal of treatment is to limit the progression of the disease by modifying risk factors , controlling the BP to prevent strain on the aneurysm, recognizing symptoms early, and preventing rupture.

Medical or surgical treatment depends on the type of aneurysm. For a rupture aneurysm, prognosis is poor and surgery is performed immediately. When surgery can be delayed, medical measures include: Strict control of blood pressure and reduction in pulsatile flow. Systolic pressure maintained at 100 to 120 mm Hg with antihypertensive drugs, such as nitroprusside. Pulsatile flow reduced by medications that reduce cardiac contractility, such as propanolol. Nursing Intervention 1. Monitor vital signs. 2. Assess risk factors for the arterial disease process. 3. Obtain information regarding back or abdominal pain. 4. Question the client regarding the sensation of palpation in the abdomen. 5. Inspect the skin for the presence of vascular disease or breakdown. 6. Check peripheral circulation, including pulses,temperature, and color. 7. Observe for signs of rupture. 8. Note any tenderness over the abdomen. 9. Monitor for abdominal distention. Instruct the patient to lift nothing heavier than 5 pounds for about 6 to 12 weeks and to avoid driving until her or his physician permits. Braking while driving may increase intra-abdominal pressure and disrupt the suture line. Most surgeons temporarily discourage activities that require pulling, pushing, or stretchingactivities such as vacuuming,changing sheets,playing tennis and golf,mowing grass,and chopping wood. Surgical Management Removal of the aneurysm and restoration of vascular continuity with a graft (resection and bypass graft or endovascular grafting) is the goal of surgery and the treatment of choice for abdominal aortic aneurysms larger than 5.5 cm (2 inches) in diameter or those that are enlarging. Intensive monitoring in the critical care unit is required. Nonsurgical Intervention 1. Modify risk factors. 2. Instruct the client regarding the procedure for monitoring BP. 3. Instruct the client on the importance of regular physician visits to follow the size of the aneurysm. 4. Instruct the client that if severe back or abdominal pain or fullness, soreness over the umbilicus, sudden development of discoloration in the extremities, or a persistent elevation of BP occurs to notify the physician immediately. 5. Instruct the client with a thoracic aneurysm to report immediately the occurrence of chest or back pain, shortness of breath, difficulty swallowing, or hoarseness.

Reference: http://www.webmd.com/heart-disease/tc/aortic-aneurysmoverview?page=2