It’s safe to watch small aortic aneurysms

DEAR DR. DONOHUE: I have a 4.5-cm aortic aneurysm. Should I be taking precautions, like not lifting, driving or working? My doctor told me not to worry. I didn't ask why because I am scared. -- L.T.

ANSWER: The aorta, the body's largest artery, runs from the heart to the bottom of the abdomen, where it divides into two arteries, one for each leg. Along its entire route, it sends out branches that supply blood to all parts of the body.

An aneurysm is a bulge that juts through a weak spot in an artery wall. In the aorta, the common site for aneurysms is the abdominal portion of that artery. The danger of an aneurysm is the chance that it might burst and result in a lethal internal hemorrhage.

A normal abdominal aorta has a width of 3 cm (1.2 inches). When an aneurysm increases the aorta's width to 5.5 cm (about 2.25 inches), the possibility of rupture is great, and surgery is recommended. Aneurysms with widths of less than 5 cm (2 inches) are not likely to burst, and they can be safely watched by taking ultrasound pictures on a scheduled basis. What to do for those between 5 and 5.5 cm is a gray area, and other factors determine the optimum time for surgical correction.

Your aneurysm is not at a danger point. You don't have to limit your activities. You do have to do things that keep aneurysms from enlarging. One of the most important is keeping blood pressure normal. You must not even think about smoking. Your diet should be a low-fat, low-cholesterol one. Unless your doctor has placed specific restrictions on your activities, you don't need to limit them.

As an aside to readers, some experts are now recommending that men between the ages of 65 and 75 who are or have been smokers get an ultrasound picture of their abdominal aorta, since smoking is such a risk factor for causing aneurysms. Whether this applies to women of the same age is something that has not yet been determined.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.