MANILA, Philippines - Christmas is a time of joy where we gather with friends and family to celebrate. It is also the time when people are more likely to over exert themselves in revelry and to over indulge in food and alcohol.
It certainly doesn’t help that many of the party dishes are high in cholesterol, salt and sugar. Letting one’s usual guard down for the festivities coupled with the stress brought by the myriad of activity, many are put at risk, particularly those with high blood pressure, high cholesterol, and other existing heart and blood conditions.
The holidays are meant to spread cheer and not fear. Before the height of the festivities and less guarded consumption, remember to prioritize health. Doctors highly encourage people to be aware of the state of their health to avoid potentially fatal situations.
Aortic aneurysms: the lesser-known silent killer
Data from the Philippine Department of Health shows that diseases of the heart and vascular system are the top two causes of death in the country.
“At least 30 percent of all deaths are caused by heart and vascular disease. This covers a range of ailments which includes heart attacks, stroke, and ruptured aneurysms, all of which can eventually lead to cardiac arrest. And there is traditionally an increased incidence of these during the Christmas and New Year holidays,” says Dr. Timothy Dy, Head of Aortic Endovascular Unit, Heart Institute, Chinese General Hospital and Medical Center.
While there is high awareness on the fatality of heart attacks and strokes, not many Filipinos are aware of two other equally fatal conditions that affect the vascular system – abdominal aortic aneurysm (AAA) which occurs in the abdominal area, and thoracic aortic aneurysm (TAA) which occurs in the chest area. Aneurysms develop when the wall of the aorta deteriorates due to deposits of cholesterol thus weakening it. It then enlarges and becomes thinner making it more vulnerable to rupture.
The danger of aortic aneurysm lies in the fact that it usually doesn’t exhibit symptoms and rupture can occur abruptly, leading to sudden death.
“Unlike the increased rate of heart attack survival, the chances of surviving a burst AAA or TAA are only 25 to 55 percent, even if a patient makes it to the hospital. Half of patients rushed to the hospital do not make it there alive. For those that do reach the hospital, around 40 percent die after emergency repair of the aneurysm,” said Dr. Nelson C. Lee, MD, Thoracic Cardiovascular Surgery, Chinese General Hospital and Medical Center.
Causes and early detection of aneurysm
There is no direct cause for aortic aneurysms but there are risk factors that contribute to the formation of these vascular enlargements. Some are factors that people have no control over such as increasing age, gender and family history.
In particular, males in their 60s have a higher chance of aneurysm incidence. This is compounded by habits and conditions such as smoking, a sedentary lifestyle, high blood pressure, high blood cholesterol and obesity. Lastly, other risk factors are the presence of diseases such as diabetes mellitus, and hypertension.
Many of these risk factors are not exclusive to aortic aneurysm as other heart and vascular diseases share the same indicators. “When one is at risk for cardiovascular diseases, there is a chance that he may be at risk for aortic aneurysms as well,” said Dr. Dy.
He adds that aortic aneurysms are usually discovered by accident when a patient is being tested for other ailments. Often, they remain undetected until it’s too late.
Smaller aneurysms are normally monitored and managed with medication. Larger AAA or TAA, which are at risk of rupture, can be addressed either through a minimally invasive route called endovascular therapy or through open-heart or open-abdominal surgery.
Thankfully, there are a number of endovascular therapy options available in the Philippines for aneurysm patients. Endovascular Aneurysm Repair (EVAR) for is one of the newer treatments where an endovascular stent graft is used to reinforce the aorta wall to keep the damaged area from rupturing. It is placed inside the aneurysm with the help of a long, very thin, soft, plastic tube. Because it is less invasive, it is known to be less risky. The recovery time for endovascular stent grafting is also generally faster.
The different routes have their own pros and cons therefore, if an aneurysm is detected, it’s best to have a thorough conversation with your doctor.