Aneurism Symptoms:

Are They Reliable In
Diagnosing An Aneurism?

Aneurism Symptoms: It Is Possible To Have a Thoracic Aortic Aneurism and Not Know It

How reliable are aortic aneurism symptoms?

All of us hate discomfort. Unfortunately the absence of pain is no guarantee that we are well. This is especially true with aortic aneurisms.

Simply put, many aneurisms develop to a dangerous size without being accompanied by symptoms. In such cases 'out of sight, out of mind,' is not the safest policy. What then can we do?

What we cannot do is diagnose ourselves. The presence or absence of aneurism symptoms is no sound indication of our condition. Aortic aneurism detection requires sophisticated machinery operated by those who are trained to do so.

Of course it would be nice if there were a home aneurism detection kit that we could purchase from late night infomercials. But such devices do not exist. 

I am afraid you will have to see your doctor on this one. But it is nice to know that your doctor has a number of options for detecting aneurisms. Among them are…

  • plain radiography
  • ultrasounds
  • CT scans
  • MRI
  • angiography

Because we like to be informed, let’s take a look at these.


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Plain Radiographs

Plain radiographs (x-rays) are often obtained for patients complaining of discomfort – there sometimes are aneurism symptoms - before the possibility of a thoracic aortic aneurism has been considered.

X-rays often miss the presence of an aneurism because calcification - the process by which organic tissue becomes hardened by a deposit of calcium salts - of the aortic wall is seen less than half the time. Because of this radiographs can be somewhat limited for aneurism detection.

Ultrasounds

Ultrasounds are noninvasive and may be performed at the patient’s bedside. They tend to be sensitive and are often helpful in determining the presence and size of an aneurism.

However, ultrasonography is limited in its ability to detect leakage or rupture of an aneurism. It further cannot easily detect aneurisms that involve branch arteries or those behind or above the kidneys. Further, if the patient is obese or suffers from gas in the bowels the ultrasound will have difficulty locating an aneurism.

CT Scans

CT scans - computed tomography – are special radiographic techniques that use computers to assimilate multiple X-ray images into a 2 dimensional cross-sectional image. They are very sophisticated and are nearly 100% effective in locating aneurisms.

Computed tomography has certain advantages over ultrasounds. It is more accurate in…

  • defining the size of a thoracic aortic aneurism
  • detecting the involvement of certain arteries
  • finding aneurisms in proximity to the kidneys.

CT scans can also be used in the detection of abdominal aortic aneurisms since they are not limited by obesity or the presence of abdominal gas. They are also helpful in detecting hard to find aneurisms associated with the most posterior area of the abdominal cavity.

Spiral CT scans produce three-dimensional imaging of abdominal contents enhancing the ability to see aneurisms adjacent to certain organs or branch arteries.

CT scans are more cost prohibitive and require specially trained technicians that might not be readily available. However they can be very useful in determining aneurism treatments.

MRI

MRI - Magnetic Resonance Imaging - is a special imaging technique used to image internal structures of the body, particularly the soft tissues. An MRI image is often superior to a normal X-ray image. It uses the influence of a large magnet to polarize hydrogen atoms in the tissues and then monitors the summation of the spinning energies within living cells.

MRI images are very clear and are particularly good for…

  • soft tissue
  • brain
  • spinal cord
  • joints
  • abdomen

These scans may be used for detecting some cancers or for following their progress. For aortic aneurisms an MRI produces aorta imaging comparable to CT scanning and ultrasound without the patient having to be exposed to radiation and dyes. It often produces superior results in imaging branch arteries but can be less effective in discovering aneurisms close to the kidneys. The use of MRI is costly and requires a stable patient.

Angiography

Angiography involves a radiographic technique using a radio-opaque contrast material by injecting it into a blood vessel for the purpose of identifying its anatomy on X-ray. (Radio-opaque is simply a substance that shows up on X-ray.) This technique is used to image arteries in the…

  • brain
  • heart
  • kidneys
  • gastrointestinal tract
  • aorta
  • neck (carotids)
  • chest
  • limbs
  • pulmonary circuit

It is useful in determining the anatomy of an aorta especially in searching for a suspected aneurism behind or above the kidneys. It is also useful in diagnosing other aneurisms such as femoral and popliteal aneurisms.

The test is, however, invasive and expensive and is not recommended for routine use. However, because of the high risk associated with some aneurisms you should not hesitate to undergo any test your doctor prescribes if he or she suspects you have an aneurism. 

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