India’s Overlooked Cardiac Risk: The Dangers Of Aortic Aneurysms

Aortic aneurysms, often asymptomatic, are the third leading cause of sudden cardiac death, experts emphasized on Sunday, highlighting the need for greater awareness of this fatal heart condition.

Aortic aneurysms involve the ballooning of the aorta, the major blood vessel that carries blood from the heart to the rest of the body.

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Factors Increasing Cardiac Risk

This condition affects approximately 2 to 3 percent of the population, with risks increasing due to factors such as atherosclerosis (cholesterol buildup in blood vessels), hypertension, and genetic deficiencies.

“Aortic aneurysms represent a critical yet under-recognized health concern, ranking as the third leading cause of sudden cardiac death, following heart attacks and cardiac arrests,” said Niranjan Hiremath, a senior consultant cardiovascular and aortic surgeon at Indraprastha Apollo Hospital, New Delhi, to IANS.

“When the aorta’s wall weakens, it can dilate to twice or even three times its normal diameter, creating a significant risk of sudden rupture, which can result in immediate death or lead to aortic dissections, another severe complication,” he added.

Awareness About Cardiac Risks

In India, awareness about cardiac risks mainly focuses on heart attacks and cardiac arrests, while the dangers posed by aortic aneurysms have not received similar attention.

“The lack of awareness is concerning, especially considering that about 75 percent of aortic aneurysms are asymptomatic and go undetected until they present a sudden, life-threatening emergency. These aneurysms are often discovered incidentally during examinations for other medical conditions,” Hiremath said.

“Most intact aortic aneurysms do not produce symptoms. As they enlarge, symptoms such as abdominal pain and back pain may develop. Untreated, aneurysms tend to become progressively larger and can present with life-threatening complications,” added Shiv Choudhary, Executive Director – Adult Cardiothoracic & Vascular Surgery, Fortis Escorts Heart Institute, Okhla Road, New Delhi.

Aneurysms can develop in any segment of the aorta, but most commonly affect the abdominal aorta. Experts noted that genetic predispositions, trauma, infection, and tobacco use also contribute to the risk of aortic aneurysms.

“The weakening of the aorta’s wall can eventually lead to aortic rupture. In such cases, massive internal bleeding occurs, and unless treated immediately, shock and death can result. Another fatal complication is aortic dissection, where the layers of the aorta’s wall split, potentially causing mal-perfusion to the brain or visceral organs or eventual rupture. Both situations require emergency intervention,” Choudhary told IANS.

Primary Treatment Of Cardiac Risk

Open surgery was once the primary treatment, but there has been a shift towards minimally invasive techniques like endovascular stent implantation, which carry lower risk, minimal morbidity, and low mortality, explained (Surg Cmde) V S Bedi, NM, Chairman & Senior Consultant at the Institute of Vascular & Endovascular Sciences, Sir Ganga Ram Hospital, New Delhi.

“Aneurysms should be treated once the aorta’s size exceeds 5 cm, as an increase beyond 6 cm can cause sudden leak or rupture, which can be fatal,” Bedi added.

Experts also advised strict blood pressure control for patients with the condition and the prohibition of tobacco use in any form. Patients with diagnosed aneurysms should avoid intense physical sports and isometric exercise but can walk and engage in light aerobic activities.