The aorta is the main artery leaving the heart and is divided into two: the chest and the abdomen. The aorta is just like the large pipes that the municipality lays on the streets to carry water to buildings. Just as all those in need receive water from these pipes, all our tissues and organs receive the necessary blood from the aorta through the arteries.
The width of our aorta varies depending on the person's race, body area, gender and age. In general, the average aortic diameter varies between 2.5-3.7. However, if the aortic diameter is 50% larger than expected or required, it is considered an aneurysm. In other words, if the aortic diameter is measured as 4.5 cm in a person expected to be 3 cm, an aneurysm is mentioned.
The aortic wall consists of three layers. There are collagen and elastic lamellae in the middle layer, which allow it to expand and regain its previous shape with each heartbeat and prevent it from expanding against high blood pressure. While this amount of collagen and elastin is found at a very high rate in the part of the aorta in the chest, this rate decreases by 50% as you move down into the abdomen. Accordingly, 75% of aortic vessel enlargements develop in the abdominal section and 25% in the chest section. Aging and smoking reduce collagen and elastin production, paving the way for aneurysm development. There are also many genetic diseases such as Marfan syndrome, which cause disorders in collagen and elastin production.
These enlargements in the aortic vessel pave the way for very serious complications that often result in sudden deaths. The most important of these is the rupture of the aorta at its widest and thinnest point and sudden discharge of blood into the chest or abdominal cavity. This situation often results in sudden deaths.
Another important complication is the rupture of the thinned inner layer of the aorta, which is described as aortic dissection, and the blood passes to the middle layer and progresses along the entire aorta and its branches in the wall. Thus, some of the blood coming out of the heart moves on the false path, that is, within the wall, and the other on the normal path. The blood that progresses by dividing the wall into two layers also reaches the artery that comes out of the aorta and goes to the organs, feeding these organs. disrupts its formation. Due to this, many complications develop such as deterioration of the aortic valve, heart attack, stroke, paralysis, kidney failure, malnutrition in the intestines, malnutrition in the legs, and shock.
% of patients due to dissection Sudden death develops in 40 of them.
In autopsies, it was determined that a significant portion of the patients who were thought to have sudden death due to heart attack were due to aortic dissection.
If patients hospitalized due to aortic dissection are kept waiting without being operated on, within two days. 90% of these patients die.
Due to these serious complications, aortic aneurysm is also described as THE TICKING BOMB WITHIN US.
The risk of aneurysm surgeries performed before complications develop is very low. The risk of sudden death and the risk of surgery increase significantly in those who develop complications. For this reason,first of all, patients whose time has come should undergo surgery without delay.
People with aortic dilatation or aneurysm and who are being monitored may encounter these very vital complications if they do not comply with the necessary rules.
At the beginning of these rules;
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It is of great importance to determine the cause of the enlargement.
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Because the aorta Patients with enlarged veins and a bi-leaflet aortic valve or a genetic collagen tissue disease such as Marfan have higher growth rates and risks than patients with tri-leaflet aortic valve who do not have a genetic disease. We have to take more strict precautions in these patients.
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Blood pressure control: high blood pressure must be brought down to normal levels. Even if his blood pressure is normal, beta blocker type medication should be used.
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Obesity should be avoided
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It is necessary to pay attention to nutrition.The main factor that causes aneurysm is arteriosclerosis (Atherosclerosis). Therefore, fatty and salty foods rich in cholesterol should be avoided.
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Smoking should be strictly avoided: Individuals who smoke Compared to those who do not use it, the expansion rate increases on average by 2-4 times. This rate increases more in those who develop chronic lung disease.
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Regular walks should be taken and competitive sports should be avoided.
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Actions such as weight lifting or sports activities performed by holding your breath should be avoided.
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During sports activities, breathing should be done regularly.
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Nutrition and measures to prevent constipation should be taken
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Periodic follow-ups should be done regularly:
Aortic diameter Patients whose diameter is between 3.5-4 cm should be followed up annually, and those between 4-5 cm should be followed up every 6 months. Abdominal aortic aneurysms can be followed up with ultrasound and ascending aortic aneurysms can be followed up with ECHO. Tomography gives the most accurate results for definitive evaluation in cases where an increase is detected.
People with an enlargement of the aortic vein can significantly reduce the risk of developing vital complications by following the rules specified in their lifestyle and having periodic follow-ups regularly.
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