Thickening of the aortic walls: what it is, causes and symptoms, treatment, and possible consequences and prognosis

Violation of the functional activity of blood vessels is a common problem in cardiological practice. Mainly of organic origin, defects lead to the impossibility of adequate blood circulation in the tissues. Is it dangerous.

Aortic thickening is not a diagnosis. We are talking about a random clinical finding obtained as a result of an instrumental study. Objectively, it represents hypertrophy (proliferation) of tissue throughout the entire thickness of the vessel structure.

Contrary to possible misconception, this is not good. Rigidity (decrease in elasticity) affects the vessel’s ability to withstand enormous loads.

It is possible and even probable that many dangerous complications will develop: from an aneurysm to an instant rupture with massive bleeding and death in a matter of seconds.

If the aorta is compacted, this means that there is a third-party pathology; the deviation is not primary, it is always caused by another disease.

The vast majority of cases are associated with tuberculosis, arterial hypertension and atherosclerosis. Accordingly, therapy for the underlying condition is indicated.

Development mechanism

The basis of the pathological process is destruction of the aortic wall or a constant increased impact on the structure.

In the first case, we are talking about infectious-inflammatory, less often autoimmune processes. As a result of the constant violation of the anatomical integrity of the endothelium and other tissues, severe scarring occurs.

Epithelization leads to a gradual overgrowing of the lumen with dense connective tissue and its narrowing. The blood flow weakens, and the pressure in the local area becomes higher due to the need to overcome a mechanical obstacle.

The second factor is approximately identical, in terms of creating excess load on the walls of blood vessels. The main etiological point is an increase in blood pressure and the constant preservation of tonometer readings at consistently high numbers.

Both options pose a colossal danger to human life and health.

Organic disorders are difficult to treat, and not every doctor is ready to take on such unpredictable cases. Therefore, the logical solution would be to carry out treatment in the early stages, when there are no anatomical abnormalities yet.

Causes

There are both fundamental factors and risk factors that do not directly determine the development of the pathological process. First group:

Current or previous tuberculosis

This is a dangerous infectious disease. It is provoked by mycobacterium, also called Koch's bacillus. Can exist for a long time without symptoms. The clinic is already formed at pronounced stages.

Damage to the aorta is a complication, the prevalence is up to 25% of the total number of cases. Timing does not matter; involvement is possible at the very first stages, which affects the overall forecast.

The walls of the vessel are destroyed and scarred, the lumen narrows, and the process progresses independently. Recovery is possible only with comprehensive treatment of tuberculosis in a hospital setting.

The total duration of supervision is 6-12 months. Hospital stage - no more than 3. The rest of the period is spent on outpatient care. Throughout the rest of life, the patient should be monitored for relapses.

Syphilis

Danger does not come immediately. This sexually transmitted infection can be transmitted non-sexually, but the likelihood of this option is extremely low.

Urgent treatment of the condition is required. Because aortic damage occurs in approximately 30% of situations.

Thickening of the aortic walls does not occur immediately; it is a later complication. There are known cases of the development of a delayed phenomenon after 10-20 years from the conditional cure of syphilis.

Therefore, such patients are recommended to undergo at least echocardiography every 6 months and closely monitor their well-being.

Aortitis

Inflammatory process in the corresponding vessel. Relatively rare. Again, as a consequence of an infectious disease.

It is a complication of herpes, damage by pyogenic flora, and septic myocarditis. In rare cases, it develops as a result of autoimmune pathologies. For example, rheumatism or vasculitis.

Inflammatory diseases need to be treated in a timely manner, because the likelihood of complications is significant.

Aortitis can be treated with antibiotics or immunosuppressants, depending on the etiology of the process. In any case, hospitalization in a cardiac hospital is indicated.

Hypertension

Stable increase in blood pressure. It occurs for many reasons, which themselves require identification and qualified assessment by doctors.

At the first stage of deviation, when the disease is still unstable in its manifestations, there is a chance for normalization. As the condition progresses, the risks of impairment increase. The third degree of hypertension cannot be treated.

As mentioned, hardening of the aorta of the heart is the result of degeneration, excessive stress on the walls, or a combination of these factors.

In the absence of therapy, there is a high probability of vessel rupture. Sooner or later this will happen. Specific medications are prescribed to lower blood pressure (ACE inhibitors and others, as indicated).

Age-related changes

Violation of the functional activity, anatomical characteristics of the connective tissue that makes up the aorta and its walls. Mainly appears to be the result of age-related changes.

Variations are possible. The same phenomena are observed in diabetes mellitus, genetic pathologies, anomalies of intrauterine development with spontaneous features.

Atherosclerosis

There are two types.

The first is a narrowing of the vessel, stenosis. Occurs in smokers, alcoholics, drug addicts, and people with arterial hypertension. It is a complication and requires urgent help. If the process is stable, surgery may be required if conservative methods do not have an effect.

The second option is occlusion or blockage of the vessel with a cholesterol plaque. The result of a disorder of lipid metabolism in the body. It is less dangerous because the condition develops over months or even years.

Gradually, the formation becomes calcified and becomes covered with mineral salts. Such an atherosclerotic plaque cannot be dissolved with statins. Surgical treatment is required.

Degrees of atherosclerosis of the aorta

05.11.2021

Atherosclerosis of the aorta occurs as a result of the deposition of cholesterol inside the vessels . This causes the formation of blood clots, leading to narrowing and blockage of the arteries . The blood supply of oxygen to the heart and brain decreases, and various types of pathologies appear. The disease develops in stages; there are three degrees atherosclerosis .

Degrees of atherosclerosis of the aorta

The aorta is the largest artery in the body; it blood to various organs. The aorta consists of three sections:

ascending, from which the coronary arteries
aortic arch - blood goes to the brain , goes to the shoulders and neck
descending - directs blood to the limbs, abdominal and pelvic organs, and chest.

Atherosclerosis of the aorta occurs in three stages:

1. Fatty lipid spot 2. Liposclerosis 3. Atherocalcinosis

If the first two degrees are treated, then the last is incurable. Timely initiation of therapy improves the prognosis of the disease. Prerequisites for the development of the disease are frequent stress, the presence of diabetes mellitus , old age, smoking, and alcoholism. It is worth noting that vascular atherosclerosis than women.

First degree - Fatty lipid spot

The onset of the disease is characterized by the penetration of lipids into the arteries . Cholesterol spots form on the vascular walls, which gradually grow. The artery loses elasticity, becomes fragile, and the internal lumen narrows. Atherosclerosis must be treated immediately, when the first symptoms appear. This disease is characterized by increased fatigue, shortness of breath even after minor exertion, and the limbs begin to go numb. However, at an early stage the disease may not manifest itself in any way. Initial stage treatment includes:

physical exercise
special diet
traditional medicine recipes

Typically, the disease begins to make itself felt at the age of 50-60 years. The initial degree atherosclerosis is diagnosed using instrumental methods. The doctor prescribes a blood : general and biochemical, ultrasound diagnostics or computed tomography will help find the location of atherosclerotic plaques.

Second degree - Liposclerosis

At the second stage, connective tissue grows around fatty deposits, blood clots begin to form, and thrombosis . The brain suffers from oxygen starvation. At this stage, diagnosis is necessary. Which will show the level of increase in cholesterol and lipids. The patient needs drug treatment. At this stage, the disease is still treatable, the plaques can dissolve, but there is a risk of them breaking off and moving through the vessels .

At the second stage, the symptoms become more distinct, they depend on the affected part of the aorta:

ascending part - in this case, the patient experiences prolonged pain in the sternum area , it radiates to the right arm or shoulder, neck , upper abdomen , the pain may not go away for several days, tinnitus appears , discomfort during physical activity
aortic arch - weakness, dizziness , loss of consciousness, weakening of one half of the body, instability of blood pressure, coldness and numbness of the fingers
abdominal aorta - nausea , numbness of the legs , decreased sensitivity, problems with urination , kidney failure, diseases of the genital area.

The organ to which the affected vessel . But even at the second stage, in some cases, the symptoms of the disease may not clearly appear. To establish a diagnosis, a comprehensive diagnosis will be required. The patient is prescribed medications that reduce the level of fat in the body; every year the patient must be observed by a doctor , undergo examination, and take tests .

Third degree - Atherocalcinosis

The third degree atherosclerosis is characterized by a severe course. The plaques thicken and calcium salts accumulate in them. The patient is affected by cerebral palsy, and irreversible impairment of cardiac function appears. This stage is called fibrotic and is incurable. If there is a risk of complications: stroke, heart attack , aneurysm , the doctor prescribes surgical treatment. It is possible to excise the atherosclerotic plaque, replace the damaged area of the artery with a prosthesis, or widen the narrowed area. The patient will have to take medications throughout his life and be observed by a specialist.

In addition to the main therapy , which is aimed at slowing down the synthesis of cholesterol molecules and reducing the concentration of fats, treatment of concomitant pathologies is prescribed. Atherosclerosis of the aorta is a dangerous, rapidly progressive disease that affects the circulatory system and the entire body, leading to serious complications. The disease must be diagnosed promptly and treated . At risk are the elderly and people with bad habits.

Published in Cardiology Premium Clinic

Risk factors

And the corresponding groups with an increased likelihood of developing compaction:

Physical inactivity

Insufficient physical activity of a person. It is common both for bedridden patients confined to a wheelchair and for persons leading a sedentary lifestyle. Which is the majority these days.

Blood stasis develops, general hemodynamics are disrupted. A hardening of the aorta is a possibility, but not the only problem.

To reduce the risks of the process, at least an hour of walking or cycling is enough. More is possible, at the discretion of the person himself. If there are no contraindications.

Excessive physical activity

Leads to an increase in blood pressure, the release of inadequate amounts of cortisol, strerlide hormones and catecholamines.

This provokes a narrowing of the lumen of blood vessels, including the aorta. Blood flow is disrupted, and the load on structures increases. The body is forced to resist.

In general, the thickening of the aortic walls is a compensatory mechanism aimed at preventing rupture as a result of excess load.

Obesity

It is not increased body weight that has an effect, although it plays a role. Responsibility lies with disruption of normal lipid metabolism. Fats are deposited (deposited), there is no rapid catabolism, that is, breakdown.

The excess enters the bloodstream. Due to their structure, lipids are well attached to blood vessels. Then the process continues, the formation grows, the walls of the aorta thicken and lose elasticity.

The disorder can only be stopped with the help of drugs, statins. A change in diet is also indicated. Less fat and easily digestible carbohydrates, more protein, plant foods.

Excess weight causes an increase in blood pressure, acceleration of cardiac activity due to the high load on the muscles (just imagine who will have it easier: a person with empty hands or someone carrying a bag of potatoes).

Diabetes

Causes generalized disruption of all organs and systems. Including circulatory.

The process is twofold. On the one hand, there is a stable narrowing of the aorta and other structures, on the other, a violation of lipid metabolism. Atherosclerosis develops.

The likelihood of death from blood vessel rupture increases without treatment every month, if not daily. Therefore, timely diagnosis of endocrine disease is necessary.

Smoking

Long lasting. Against the background of constant consumption of tobacco, tar, and cadmium compounds, a physiological addiction of the body is formed. Stenotic atherosclerosis develops.

Even after giving up the bad habit, spontaneous regression of narrowing does not occur. Treatment is needed. Considering that many return to addiction, the likelihood of further development of pathology increases.

Finally, alcoholism and the use of psychoactive substances have an effect. Many drug addicts do not have time to live to see either a rupture or an aortic aneurysm. Death occurs from heart failure much earlier. Alcoholics have a better chance.

Reasons are being eliminated gradually. One at a time during the diagnosis.

Drug therapy

If cholesterol levels do not decrease with preventive measures, treatment of atherosclerosis with medications is prescribed.

Drug treatment normalizes the metabolism of fats and cholesterol in the body

Bile acid sequesters (colestipol) interfere with the absorption of bile acids in the digestive tract and cholesterol from food.
Statins (simvastatin) normalize cholesterol metabolism in the body, stabilize atherosclerotic plaque, and prevent complications associated with its disintegration.
Vitamin PP improves fat metabolism, reduces the concentration of low and very low density cholesterol in the blood.
Fibrates (gemfibrozil) participate in enzymatic reactions of fat breakdown, thereby regulating cholesterol metabolism.

In case of irreversible changes in the aorta of the lungs and aorta of the heart, which causes a critical change in hemodynamics and the development of severe complications, surgical removal of a section of the vessel is performed, followed by prosthetics.

Symptoms

There are no such manifestations. If the walls of the aorta are compacted, there is no clinical picture. Signs and disturbances in well-being arise later, after complications of the pathological process.

Organic changes, such as an aortic aneurysm, give the following moments:

Pain syndrome. Localization and nature depend on the location of the violation. If the abdominal region is affected, there is discomfort in the abdomen, and in the chest there is a pressing, burning sensation. If the aortic arch is compacted, there is pain in the neck, turning into discomfort at the location of the heart.
Dyspnea. Disruption of a natural physiological process.

Further manifestations depend on which area has undergone changes.

Abdominal:

Nausea, vomiting, heartburn, belching, other dyspeptic symptoms. Such patients are falsely sent to gastroenterology.
Increased gas formation in the intestines.
Pulsating sensations in the abdomen.

Arc, descending section:

Inability to swallow normally.
Violations of voice, timbre and general ability to speak.
Excessive saliva production.
Weakness.
Numbness of the upper and lower extremities. In exceptional cases, paresis and paralysis occur. This is the result of compression of the nerve roots.

Such conditions require urgent treatment; irreversible changes in the musculoskeletal system are possible.

Compaction of the aortic root and ascending section:

Chest pain.
Dyspnea.
Abnormal heart rate, other arrhythmias.
Cephalgia, vertigo.
Loss of consciousness, fainting.

Classic signs of damage to cardiac structures.

Attention:

You cannot focus on symptoms when identifying the causes of poor health. These are unreliable clinical signs.

What it is

We should start by defining the aorta. The aorta is the largest vessel in our body, and accordingly its importance is high. An aneurysm is an enlargement of a blood vessel. An aortic aneurysm can form in the thoracic or abdominal regions. Moreover, aneurysm of the abdominal aorta is much more common. This condition of the vessel may not cause any harm for a long time, however, an aneurysm is very dangerous due to the unpredictable course of expansion and the threat of rupture of the vessel walls when they become thinner - and this condition already poses a threat to life due to severe internal bleeding. In addition, blood clots can form at the site of vessel expansion due to changes in blood flow - the danger of this condition is the risk of the blood clot breaking off and clogging a smaller vessel.

Diagnostics

It takes place on an outpatient basis, under the supervision of a cardiologist or vascular surgeon. The following activities are shown:

Oral interview with a person. To get a rough picture.
Anamnesis collection. Family history, addictions, past pathologies.
Measurement of blood pressure and heart rate.
Echocardiography. One of the first methods. Gives an idea of the state of the muscular organ itself and the ascending aorta, arch.
Aortography. Targeted assessment of the largest vessel. It is used both to verify the diagnosis and to determine the effectiveness of the treatment.
MRI. Used to clarify the localization of the pathological focus. Typically, tomography is prescribed before surgery as an informative way to visualize tissue.
ECG. To identify functional disorders that inevitably arise at advanced stages of changes in the aorta.
Ultrasound of the abdominal cavity.
Plain chest x-ray.

Methods provide nuggets of valuable information. To get a complete picture, you need to carry out all these activities. They are not dangerous and painless. Therefore, it is not recommended to hesitate.

Causes of aortic aneurysm in the abdominal region

Experts identify several reasons for the formation of an abdominal aortic aneurysm:

heredity (it is worth undergoing additional examinations if one of your close relatives had such a diagnosis);
trauma or surgery on the aorta;
atherosclerosis (approx. link to article);

There are also risk factors for aneurysm formation:

smoking,
excess weight,
high blood pressure,
The disease is most often encountered by men over 50 years of age.

Quitting smoking and maintaining a normal weight remain factors that you can get rid of, protecting yourself from the risk of not only an aneurysm, but also other serious diseases.

Treatment

Depends on the primary diagnosis. The goals of therapy are to prevent complications and eliminate the origin of the condition. Medicines are used.

Which ones are determined by the doctor based on the underlying disease:

Antihypertensive. ACE inhibitors, calcium antagonists, centrally acting agents, beta blockers, mild diuretics.
Statins. They dissolve cholesterol and prevent its further deposition on the walls of blood vessels.
Thrombolytics, antiplatelet agents. They prevent blood from stagnating, improve its fluidity and rheological properties, and prevent the formation of dangerous clots.
Antituberculosis drugs. Also medications for the treatment of syphilis.

Surgery is required when a threatening aneurysm forms due to calcification of the cholesterol plaque. At the discretion of the specialist after careful consideration of all options.

A change in diet is shown throughout life. Less fat, easily digestible carbohydrates, more protein and plant foods, walking, minimal physical activity, proper rest at night. Issues of lifestyle correction are also resolved by a specialist.

Forecast

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In itself, aortic thickening is not a diagnosis, but just an instrumental finding. You can say anything concrete after assessing the root cause.

The following factors play a major role:

Dynamics of deviation. Progression is associated with more severe general condition and outcome.
The age of the person. Elderly people have a relatively unfavorable prognosis.
Family history. If there was at least one representative in the family with the condition in question, it is necessary to carefully check every six months. In such individuals, the anomaly progresses rapidly. Therefore, delay reduces the chances of successful treatment.
The presence of concomitant somatic pathologies. Among the especially dangerous ones are hypertension, diabetes mellitus, metabolic syndromes, and atherosclerosis.
Possibility and necessity of radical treatment. If surgery is required, the prognosis is initially worse. Further, everything depends on the success of the therapy. The absence of such a need gives a better outcome, although it does not guarantee it.

In general, even an aneurysm, as one of the most severe complications, is associated with a survival rate of 85-90%.

Attention:

Heart failure and circulatory disorders in the brain reduce the patient's chances by 30-40%.

Complications

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Possible consequences:

Thrombosis. The formation of a clot in one of the arteries, sometimes in the aorta itself. Causes local ischemia. When torn off and moved along the riverbed, it often blocks the pulmonary vessel and coronary structures, which immediately leads to death.
Aneurysm. Wall protrusion. It is observed against the background of stable degeneration and dystrophy of aortic tissue.
Rupture, delamination. Leads to death within a matter of seconds. There were cases to the contrary, but they were casuistic. There are hardly more than 0.5%.

Thickening of the aortic walls is not an independent disease. It is not considered a diagnosis and is not represented in the ICD-10 classifier. This is a consequence, an accidental find.

After eliminating the root cause, there is every chance to stop the progression and achieve results without affecting the quality and length of life.

Damage to the abdominal part of the artery

Sclerosis of the abdominal aorta leads to disruption of the blood supply to the abdominal organs (intestines, liver, stomach), retroperitoneal space (kidneys), and pelvic organs (uterus, gonads, bladder). The disease can also cause the development of an abdominal form of myocardial infarction. The development of pathology at the level of the artery bifurcation leads to a decrease in blood flow in the lower extremities and the occurrence of trophic disorders in them.

Sclerotic lesions of the vessels of the legs lead to the formation of trophic disorders

Clinical manifestations of sclerotic aorta in the abdominal part:

aching pain in the abdomen of an incoming nature;
tendency to constipation, flatulence;
loss of appetite, weight loss;
coldness of the lower extremities, decreased sensitivity, numbness;
intermittent claudication syndrome (pain in the legs when moving);
swelling of the lower extremities, trophic ulcers;
decreased tone of the calf muscles;
sexual impotence in men.

Changes in the aorta can be detected by palpation (feeling) through the abdominal wall in the form of compaction and curvature of its wall. In severe cases, there is no pulsation at the level of the navel, in the groin and popliteal areas, or on the vessels of the feet. Thrombosis of the mesenteric arteries is considered a dangerous complication of aortic atherosclerosis, which is accompanied by intense abdominal pain; the attack is not controlled by analgesics and leads to the development of sepsis.