Aneurysm

Definition

An aneurysm is a pathologic dilation of a weakened blood vessel wall, typically at least 1.5 times the normal vessel diameter. Rupture of an aneurysm causes catastrophic, often fatal, hemorrhage.

Common Locations

• Abdominal aortic aneurysm (AAA): Pulsating mass, back pain, shock on rupture.
• Thoracic aortic aneurysm: Chest/back pain, hoarseness from recurrent laryngeal nerve compression.
• Cerebral (berry) aneurysm: 'Worst headache of my life' on rupture.

Risk Factors

Hypertension, atherosclerosis, smoking, male sex, advanced age, family history, and connective tissue disorders (Marfan, Ehlers-Danlos).

Nursing Considerations

Do NOT palpate a suspected AAA. It may precipitate rupture. Maintain systolic BP below 120 with antihypertensives. Teach patients to avoid Valsalva maneuvers (straining), heavy lifting, and strenuous activity. Monitor for signs of rupture: sudden severe pain, hypotension, tachycardia, altered LOC. Surgical repair is indicated for AAAs greater than 5.5 cm or rapidly expanding.

NCLEX Relevance

High-priority topic. Rupture is an emergency. Recognize pulsatile mass as a critical cue.