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Most intact aortic aneurysms do not produce symptoms. As they enlarge, symptoms such as abdominal pain and back pain may develop. Compression of nerve roots may cause leg pain or numbness. Untreated, aneurysms tend to become progressively larger, although the rate of enlargement is unpredictable for any individual. Rarely, clotted blood which lines most aortic aneurysms can break off and result in an embolus. They may be found on physical examination. Medical imaging is necessary to confirm the diagnosis. Symptoms may include: anxiety or feeling of stress; nausea and vomiting; clammy skin; rapid heart rate. In patients presenting with aneurysm of the arch of the aorta, a common symptom is a hoarse voice as the left recurrent laryngeal nerve (a branch of the vagus nerve) is stretched. This is due to the recurrent laryngeal nerve winding around the arch of the aorta. If an aneurysm occurs in this location, the arch of the aorta will swell, hence stretching the left recurrent laryngeal nerve. The patient therefore has a hoarse voice as the recurrent laryngeal nerve allows function and sensation in the voicebox. Abdominal aortic aneurysms, hereafter referred to as AAAs, are the most common type of aortic aneurysm. One reason for this is that elastin, the principal load-bearing protein present in the wall of the aorta, is reduced in the abdominal aorta as compared to the thoracic aorta (nearer the heart). Another is that the abdominal aorta does not possess vasa vasorum, hindering repair. Most are true aneurysms that involve all three layers (tunica intima, tunica media and tunica adventitia), and are generally asymptomatic before rupture. The most common sign for the aortic aneuysm is the Erythema nodosum also known as leg lesions typically found near the ankle area. The prevalence of AAAs increases with age, with an average age of 65–70 at the time of diagnosis. AAAs have been attributed to atherosclerosis, though other factors are involved in their formation. An AAA may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some AAAs may swell to over 15 cm in diameter before rupturing. Before rupture, an AAA may present as a large, pulsatile mass above the umbilicus. A bruit may be heard from the turbulent flow in a severe atherosclerotic aneurysm or if thrombosis occurs. Unfortunately, however, rupture is usually the first hint of AAA. Once an aneurysm has ruptured, it presents with a classic pain-hypotension-mass triad. The pain is classically reported in the abdomen, back or flank. It is usually acute, severe and constant, and may radiate through the abdomen to the back. The diagnosis of an abdominal aortic aneurysm can be confirmed at the bedside by the use of ultrasound. Rupture could be indicated by the presence of free fluid in potential abdominal spaces, such as Morison's pouch, the splenorenal space (between the spleen and left kidney), subdiaphragmatic spaces (underneath the diaphragm) and peri-vesical spaces. A contrast-enhanced abdominal CT scan is needed for confirmation. Only 10–25% of patients survive rupture due to large pre- and post-operative mortality. Annual mortality from ruptured abdominal aneurysms in the United States alone is about 15,000. Another important complication of AAA is formation of a thrombus in the aneurysm.
If you have multiple sclerosis (MS), you probably had several tests done before you received your diagnosis. There isn’t one test to diagnosis MS, so testing can vary. Doctors can use neurological exams, information about previous symptoms, blood tests, and spinal fluid tests. A magnetic resonance imaging (MRI) scan isn’t used to diagnose MS but rather to rule out other diseases. A diagnosis of MS requires more information than what a scan alone can give. By looking at more than one test or exam result, doctors can get a clearer picture of what’s going on in your body.
Dr. Kathryn Baerman is a Board Certified General Surgeon specializing in Women's Health and Breast Care. She shares with us that in women, hernias present differently than in men. If you are experiencing groin pain, it may be a hernia.
To visit Dr. Baerman in Apex, Chapel Hill, or Durham, North Carolina, call 919-281-1699 to schedule an appointment with her at EmergeOrtho.
TV interview with Adina Nack, Ph.D. about her own cervical HPV experiences, STD research, her new book (Damaged Goods? Women Living with Incurable Sexually Transmitted Diseases), and women's lives after genital warts, HPV and herpes infections. More info is available on STDdatings.com, which is the official STD dating & support site.
Dr. David L. Sneed discusses the Austin Threadlift procedure, commonly referred to as the non-surgical facelift. This minimally-invasive skin rejuvenation procedure uses non-absorbable sutures to gently lift and tighten sagging, facial tissue and drooping skin, while at the same time stimulating further collagen growth over time. If you would like to find out more about the Silhouette Suture ThreadLift procedure offered in Austin, TX, please visit http://www.amedspa.com/silhouette-threadlift.php
Clonidine lowers blood pressure by decreasing the levels of certain chemicals in your blood. This allows your blood vessels to relax and your heart to beat more slowly and easily. The Catapres brand of clonidine is used to treat hypertension (high blood pressure). The Kapvay brand is used to treat attention deficit hyperactivity disorder (ADHD). Clonidine is sometimes given with other medications