OFTEN UNNOTICED KILLERS: ANEURYSMS OF THE AORTA;
DR. ROCK POSITANO.
It is a silent killer, and one of the leading causes of death in the U.S., but it is rarely looked for by doctors during physical exams.
Too often people die from aortic aneurysms - a potentially life- threatening widening of a major blood vessel near the heart - without even suspecting they have the problem.
But if an aneurysm ruptures, you have less than a one in five chance of survival.
Lucille Ball, Albert Einstein, George C. Scott and Conway Twitty all were victims of aortic aneurysms. But a simple noninvasive test available today could have discovered their condition in time for it to be corrected.
Dr. George Todd, chairman of the Department of Surgery at Mount Sinai St. Luke's-Roosevelt Hospital and one of the nation's leading vascular surgeons, says that if discovered early, aneurysms can be monitored and, when necessary, repaired. A noninvasive ultrasound test can spot an aneurysm and allow doctors to monitor its growth - often for many years before it poses a threat to the patient. However, if the aneurysm becomes large enough, it has to be treated.
Bob Dole, Joe DiMaggio and Rodney Dangerfield are just a few of those who have survived aortic aneurysms because proper treatment was given when the threat was discovered.
Todd estimates that aortic aneurysms cause nearly as many deaths each year in the United States as AIDS, breast cancer or prostate cancer.
According to the American Heart Association's 2001 heart and stroke statistical update, aortic aneurysms are responsible for more than 16,000 U.S. deaths annually, and they may contribute to an additional 24,000 deaths that are mistakenly reported as heart attacks.
The recent sudden death of actor John Ritter, caused by a different type of problem with his aorta, has raised the public's awareness and concern about their hearts.
The number of aortic aneurysms occurring in the U.S. is increasing as the population ages. They will be found in 5% of men older than 70 who have an ultrasound screening.
Men older than 65, as well as smokers, are especially susceptible to developing aneurysms. People with high cholesterol are also at higher risk, as are those with family members who have suffered an aneurysm.
Aneurysms often are discovered by accident when a doctor is testing the patient for something else, and they are frequently misdiagnosed. "As we begin to test for, and detect more aneurysms, we are learning that even more people than we had guessed are carrying this time bomb in their bodies," said Todd. "If untreated, it will develop silently and if it does rupture, [it] will kill them."
Doctors now use stents - small, expandable tubes used for holding open a blocked vessel or other part - to treat aneurysms, a relatively new procedure that isolates the growth rather than removing it. This is one of the most effective and least invasive treatments, and it results in far less pain than previous methods. It also significantly shortens recovery time.
Dr. Rock Positano, M.S., M.P.H., D.P.M., is on the faculty and staff of the Weill Medical College of Cornell University.