Definition
An "aortic aneurysm" is defined as an abnormal and exaggerated dilation of a wall of the aorta artery, expression of the weakening of its elastic component; the aortic aneurysm manifests itself as a sort of balloon swelling, the consequences of which can be lethal for the patient.
Abdominal aortic aneurysm: the pathological dilation of the aorta is localized in its abdominal tract
Thoracic aortic aneurysm: the dilation of the aorta is limited to the thoracic area of the artery
Causes
The precise triggering cause of the aortic aneurysm is unknown; however, numerous elements have been identified that can contribute to the manifestation of the disease: previous injuries to the aorta (eg. Laceration of the aortic wall), traumatic injuries (eg road accidents) , connective tissue diseases (eg Marfan syndrome, Ehlers-Danlos syndrome). Smoking and hypertension are two of the most important risk factors for aortic aneurysm.
Symptoms
Sometimes, the aneurysm develops so slowly that the patient is unaware of the disease and does not present any symptoms. In other cases, the aortic aneurysm can involve altered appetite, swallowing and breathing difficulties during even a slight effort (aneurysm aortic thoracic), chest pain, back pain, perception of heartbeat near the navel, hoarseness and cough.
The information on Aortic Aneurysm - Drugs to Treat "Aortic Aneurysms is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Aortic Aneurysm - Drugs to Treat" Aortic Aneurysm.
Medicines
The presence of an aortic aneurysm reflects a clinical emergency, given the extremely dangerous possible complications. In some patients, the aortic aneurysm is diagnosed late because it is asymptomatic, despite the fact that the possibility of complications is still high; in other patients, the aortic aneurysm manifests itself suddenly: in the latter case, the risk of rupture of the aneurysm increases exponentially, as does the risk of death. Not surprisingly, patients with a previous history of aneurysm must be constantly monitored over time by specialized personnel, precisely to avoid any possible relapses.
There is no drug capable of reversing the disease, after it has manifested itself: however, drugs are essential as a prevention to the aortic aneurysm. (In the next paragraph, the most used drugs in therapy to reduce the risk will be listed)
The therapy for the aortic aneurysm is purely surgical (indicated when the diameter of the aorta exceeds 5.5 cm):
- "Open" surgery: consists in the removal of the damaged section of the aorta and its subsequent replacement with a synthetic tube
- Endovascular surgery: practice reserved only for some patients
- Other heart surgery (when, for example, the aneurysm is due to heart valve dysfunction)
- Emergency surgery: indicated for the rupture of the aneurysm. Many patients who experience a similar breakdown die even before they reach the hospital.
The following are the classes of drugs most used in the therapy for aortic aneurysm, and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and the dosage most suitable for the patient, based on the severity of the disease, the state health of the patient and his response to treatment:
THE DRUGS LISTED BELOW ARE USEFUL EXCLUSIVELY FOR PREVENTIVE THERAPY TO AORTIC ANEURISM
Medicines for the treatment of hypertension: considering that hypertension is one of the risk factors most involved in the onset of the aortic aneurysm, the administration of drugs to control blood pressure is essential to reduce the risk of aneurysm.
Beta-blocker drugs are able to reduce blood pressure by slowing the heart rate, such as:
- Atenolol (eg. Atenol, Tenoretic, Tenormin): for the treatment of arterial hypertension, also for the prevention of aortic aneurysm, it is recommended to take 100 mg of active ingredient per day. After 15 days of treatment, the patient should begin to reap the first benefits; if this is not the case, a diuretic drug can be associated with the beta blocker.
- Metoprolol tartrate (eg. Seloken, Lopresor, Metoprolol AGE): take 1-2 tablets of 100 mg, 1-2 times a day. The dosage just described is approximate: consult your doctor.
- Bisoprolol hemifumarate (eg Concor): for the treatment of hypertension as a prevention of aortic aneurysm, it is recommended to take 5-10 mg of active ingredient per day. The dose can be adjusted according to the severity of the disease and the patient's response. Consult your doctor.
Sartan drugs are indicated when the administration of a beta blocker is not sufficient to ensure control of blood pressure. In addition, sartans (angiotensin II antagonists) are also indicated in the context of Marfan's syndrome, regardless of an imbalance in blood pressure (remember briefly that this syndrome is one of the possible triggers of the aortic aneurysm).
- Losartan (eg. Neo-Lotan, Lortaan, Lozid): for the prevention of aortic aneurysm, in the context of hypertension, it is recommended to start therapy with a dose of 50 mg of active, to be taken orally once a day. day. The maintenance dose ranges from 25 to 100 mg per day.
- Valsartan (eg Tareg): start therapy for the treatment of hypertension as a prevention of Marfan syndrome, with a minimum dose of drug (80 mg), to be taken once a day. one month of therapy, increase the dose up to a maximum of 320 mg per day Consult your doctor.
- Olmesartan (eg. Olmetec): initially, the dosage suggests administering low doses of the drug (10 mg / day), and then possibly increasing the dosage up to 40 mg per day. It is possible to combine another antihypertensive drug (Hydrochlorothiazide: Esidrex, belonging to the class of diuretics).
Medicines for the treatment of high cholesterol: since high cholesterol favors the formation of atherosclerotic plaques in the arteries, responsible for the narrowing of the lumen of the vessels, the administration of cholesterol-lowering drugs reduces both the risk of hypercholesterolemia and complications in the context of a possible aortic aneurysm. Statins are the most used in therapy for this purpose:
- Atorvastatin (eg Totalip, Torvast, Xarator): this statin is probably the most used in therapy for the treatment of high cholesterol, together with simvastatin. Typically, the starting dose ranges from 10 to 40 mg per day, to be taken orally. The dose of 40 mg per day is indicated for patients requiring a decrease in bad cholesterol greater than 45%. Continue with this dosage for 2-4 weeks. The maintenance dose foresees the assumption of 10-80 mg of active per day. Consult your doctor.
- Lovastatin (eg. Lovinacor, Tavacor, Rextat): start the treatment with a dose of 20 mg of the drug, to be taken once a day, together with the meal. The maintenance dose involves taking 10-80 mg per day, possibly divided into two doses. The drug is also available in the form of slow-release tablets: in this case, start therapy with 20-40-60 mg of the drug, to be taken once a day, before going to bed; patients who require a small reduction in bad cholesterol, at risk of aortic aneurysm, can take only 10 mg of the drug per day. The maintenance dose ranges from 10 to 60 mg per day, depending on the severity of the condition. The active ingredient is also available in association with niacin.
- Simvastatin (eg Zocor, Simvastat, Omistat, Quibus, Setorilin). It is recommended to start treatment with a dose ranging from 10 to 20 mg, to be taken orally, once a day. The maintenance dose involves taking 5-40 mg of active daily (once a day, in the evening). Sometimes the drug is formulated with other active ingredients, such as sitagliptin (eg Juvisync), useful for fighting diabetes in the context of hypercholesterolemia, and ezetimibe (eg Vytorin).
For further information: see the article on drugs for the treatment of high cholesterol
Medicines to quit smoking
Among the most used drugs in therapy to quit smoking, we remember:
- Nicotine based patches for quitting smoking (eg Nicopatch): generally, apply one patch a day, on dry, cleansed skin; the patch should be applied to the arm, or to an upper part of the body, always trying to place it in a different place, to avoid local irritation.
- Varenicline (eg Chapmix, 25-28-56 tablets): take 0.5 mg of active orally once a day in the first three days of treatment to stop smoking. From the 4th to the 7th day of therapy, increase the dose to 0.5 mg of active twice daily. From the eighth day onwards, take 1 mg of active twice a day.
The smoking habit can adversely affect the origin and the manifestation of the aortic aneurysm, therefore it is recommended to stop smoking.
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