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- Delis & Glozvick, Perspectives in Vascular Surgery 2005
- Delis & Glozvick, Perspectives in Vascular Surgery 2005
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Abdominal Aorta Stenosis Symptoms
Abdominal aortic stenosis (AAS) refers to abnormal narrowing of the aorta anywhere along its course in the abdomen. The aorta enters the abdomen through the thoracic hiatus at the level of the 12th thoracic vertebra in front of the spinal cord and terminates as the right and left iliac arteries. Stenosis can result from congenital or acquired lesions. AAS produces a bottleneck effect, where there is hypertension above the lesion and hypotension below and can often be diagnosed based on the difference in blood pressure between the upper and lower extremities. Symptoms can be divided into three categories based on the major groups of arteries supplied by the abdominal aorta.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Renal Insufficiency/Hypertension
The renal arteries that supply blood to the kidneys are branches of the abdominal aorta. When narrowing of the abdominal aorta reduces renal blood flow, the kidneys respond by releasing a hormone called renin.
When decreased blood flow is caused by AAS, these compensatory measures are ineffective 1. The kidney responds by trying harder, and blood pressure above the level of the lesion can become dangerously high. Common symptoms of high blood pressure include:
- headache (especially morning headache)
- ringing in the ears
- dizziness
- confusion
- fatigue
- shortness of breath
- changes in vision
Left untreated, hypertension may produce myocardial infarction, congestive heart failure or stroke.
- The renal arteries that supply blood to the kidneys are branches of the abdominal aorta.
- The kidney responds by trying harder, and blood pressure above the level of the lesion can become dangerously high.
Mesenteric Ischemia
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The blood vessels of the digestive system are also supplied by the abdominal aorta. Mesenteric ischemia typically presents as severe pain in the middle or upper abdomen, which begins 15 to 60 minutes after eating. Pain lasts for 60 to 90 minutes and then disappears until the next time you eat. The types of symptoms are less important than the overall pattern and their association with eating.
- The blood vessels of the digestive system are also supplied by the abdominal aorta.
- Mesenteric ischemia typically presents as severe pain in the middle or upper abdomen, which begins 15 to 60 minutes after eating.
Intermittent Claudication
Intermittent claudication refers to symptoms of muscle pain, cramps, numbness or fatigue that occur when the muscles are at work and which are relieved by rest. Normally, blood vessels dilate, increasing blood flow during exercise or work. In patients with AAS, supply cannot keep up with demand, and the affected individual needs to rest. Symptoms may be felt anywhere in the lower extremities, but calf pain is considered classic. Muscles in the upper extremities are supplied by the brachial arteries and are unaffected by AAS 1.
- Intermittent claudication refers to symptoms of muscle pain, cramps, numbness or fatigue that occur when the muscles are at work and which are relieved by rest.
- In patients with AAS, supply cannot keep up with demand, and the affected individual needs to rest.
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References
- Delis & Glozvick, Perspectives in Vascular Surgery 2005
- Merck Manual
- O’Gara Patrick T. Aortic Aneurysm. Circulation. 2003;107(6):e43-e45. doi:10.1161/01.CIR.0000054210.62588.ED
- Deepthinath R, Satheesha Nayak B, Mehta RB, et al. Multiple variations in the paired arteries of the abdominal aorta. Clin Anat. 2006;19(6):566-568. doi:10.1002/ca.20207
- Guirguis-Blake JM, Beil TL, Sun X, Senger CA, Whitlock EP. Primary Care Screening for Abdominal Aortic Aneurysm: An Evidence Update for the U.S. Preventive Services Task Force. Evidence Synthesis No. 109. AHRQ Publication No. 14-05202-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2014.
- Shaw PM, Loree J, Gibbons RC. Abdominal Aortic Aneurysm (AAA). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2019.
- Forsythe RO, Newby DE, Robson JMJ. Monitoring the biological activity of abdominal aortic aneurysms Beyond Ultrasound. Heart. 2016;102(11):817-824. doi:10.1136/heartjnl-2015-308779
- Kimura-Hayama ET, Meléndez G, Mendizábal AL, Meave-González A, Zambrana GFB, Corona-Villalobos CP. Uncommon congenital and acquired aortic diseases: role of multidetector CT angiography. Radiographics. 2010;30(1):79-98. doi:10.1148/rg.301095061
- Kuivaniemi H, Ryer EJ, Elmore JR, Tromp G. Understanding the pathogenesis of abdominal aortic aneurysms. Expert Rev Cardiovasc Ther. 2015;13(9):975-987. doi:10.1586/14779072.2015.1074861
- Tang ELS, Chong CS, Narayanan S. Isolated abdominal aortic dissection. BMJ Case Rep. 2014;2014. doi:10.1136/bcr-2013-203097
Writer Bio
Heather Gloria began writing professionally in 1990. Her work has appeared in several professional and peer-reviewed publications including "Nutrition in Clinical Practice." Gloria earned both a Bachelor of Science in food science and human nutrition from the University of Illinois. She also maintains the "registered dietitian" credential and her professional interests include therapeutic nutrition, preventive medicine and women's health.