40 plus? Learn about risks of blood vessel ruptures

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Thoracic aortic aneurysm, or a bulge in the body's main blood vessel, can kill a person in minutes or even seconds once it ruptures, so the importance of having regular examinations cannot be overstated, doctors say.

Doctor Nguyen Hoai Nam, general secretary of Ho Chi Minh City Chest and Cardiological Surgery Association, said between 95 to 98 percent of patients of thoracic aortic aneurysm, which happens primarily at the thorax, have died under treatment in hospitals.

The aorta runs in parallel with the vertebral column, beginning just above the heart and then all the way down the chest, through the diaphragm and into the abdomen where it gives off branches toward the lower body.

It is the main artery in the body that carries blood from the left ventricle of the heart to all the branch arteries in the body except those in the lungs, and has a radius of around 1.4 centimeters depending on the body size.

Nam said aneurysm in the aorta can be congenital, or inherited, while other risk factors include diabetes, obesity, hypertension, tobacco use, alcoholism, high cholesterol, copper deficiency, and increasing age.

Thoracic aortic aneurysm is less common than an abdominal aortic aneurysm, though more dangerous.

Doctors said the fatality rate of rupture from abdominal aortic aneurysm also used to be very high at more than 90 percent also, but local facilities have increased their expertise and reduced the risk to between 15 and 20 percent; and even lower if the patient is taken to the hospital in time, according to a Tuoi Tre report.

In May, doctors with the Kien Giang General Hospital in the Mekong Delta province of the same name performed a four-hour operation and saved the life of an 85-year-old woman who suffered an abdominal blood vessel rupture.

In a similar but more severe case, doctors at the Khanh Hoa General Hospital in central Vietnam late last month saved the life of a 56-year-old man after two surgeries, removing two liters of blood clots, Nguoi Lao Dong said. The doctors were guided on the phone by experts in Ho Chi Minh City's leading hospital Cho Ray.

The chances of rupture increase when the aneurysm gets bigger, and it turns out to be fatal when blood is lost into the chest or abdominal cavities.

What doctors refer to as an aneurysm is true aneurysm, in contrast with a pseudoaneurysm which is a hematoma forming, also through a leaking hole in an artery but outside its wall, and contained by the surrounding tissues.

Doctor Nam said false aneurysms occur in people who have a history of catheterization for drug use, or trauma, and is not as life-threatening as the true one.

He said most victims of the thorax rupture are 70 or older, accounting for 2 to 3 percent of people in the age range. Patients younger than 40 usually suffer the condition due to the weakening of the aortic wall.

He said the chance of survival is low and depends on how severe the rupture is. Prompt surgical treatment can help when the internal layers of body tissues can contain the blood stream temporarily, he added.

Doctors say patients with thorax aneurysm can feel pains behind the breastbone and high in the back, between the shoulder blades. Abdominal aortic aneurysm can be felt with pains in the low back.

The pain usually does not come from any specific activity, and people should consult a specialist to tell if it is a cardiological problem, or something to do with muscles or joints.

But Nam said that most patients do not feel pain from an aneurysm until it ruptures.

Thus, people above 40 need to receive health checks including chest X-rays every six months, especially those with high blood pressure and high level of bad cholesterol, Nam was quoted as saying in a report by the Suc Khoe Gia Dinh (Family's Health) magazine.

He said a senior doctor had died recently with the rupture while he was receiving treatment at a Singapore hospital for aortic dissection, which happens when blood under pressure gets into the wall of the aorta and splits that wall apart.

Patients diagnosed with aneurysm need to receive treatment to lower their blood pressure to normal levels.

An extirpation will be prescribed to remove the aneurysm and replace a section of the vessel with an artificial graft.

Nam said the surgery costs more than VND300 million (US$14,120) and the graft a further VND500 million ($23,530), which is far from affordable for most people in Vietnam.

Some patients who are too old and weak to undergo surgical removal will have stents delivered through a catheter to seal off the aneurysm from the bloodstream.

Nam also said that only a few medical facilities in Vietnam can treat thoracic aortic aneurysms, with the leading facility being the Cho Ray Hospital in Ho Chi Minh City.

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