INDIA: 95% of Aneurysms Result in Death

. NEW DELHI (The Times Of India), November 5, 2007: Looking at 86-year-old Lajwanti's frail and deeply-lined face with a pigtail makes you want to protect her. She gives a weak smile even though she seems lost in the big city hospital where she's been admitted after a near-death experience. On October 24, as she was having lunch, she got a shooting pain in her abdomen and fell unconscious. She was rushed to hospital with no pulse or BP. A CT scan revealed that her abdominal aorta had ruptured due to an aneurysm (swelling). And increasingly, many patients are coming to doctors with this affliction. "Awareness has increased. But sometimes we find even doctors aren't aware of this life-threatening condition. Death is sudden and certain in 95% of rupture cases," says Anil Bhan, director, cardiothoracic vascular surgery, Max Heart Institute. Much depends on the size of the aneurysm. If it's over 5 cms wide, chances of rupture are higher. An aneurysm, incidentally, is a weakened area of a blood vessel that balloons to over 50% the normal size and ruptures. The mean interval from its growth to rupture is about two years and without medical intervention, chances of survival after five years are 20%, says Bhan. According to a Swedish study, it strikes 489 men and 437 women in per 100,000 population. "India would also be reaching these figures soon as its life expectancy increases," says Bhan. Bhan, who has operated upon 561 aneurysms in the last five years, says, "The size of aneurysms vary according to location. The largest I operated on was 18 cm in the abdominal aorta. Brain aneurysms would be much smaller. It can strike at any age, though older people are more prone to it. My oldest patient was 94 years and the youngest, one-and-a-half years." Lajwanti underwent an emergency operation, where a part of her abdominal aorta was replaced with synthetic tube graft made of collagen-impregnated polyester. Her family still can't fathom how this crisis took place. "My mother, despite being 85, is quite fit," says Vinod Bhargava, one of her sons. "She has no health problems, still goes to the market, cooks for us and is generally immune to pain. So it was a shock to see her in this state." Lajwanti smiles through pain-filled eyes and says, "I am ok now." Sometimes, even doctors are ignorant of this problem. Take 61-year-old Balwant Arora, a physician, from Ludhiana. A week back, while out on a brisk walk, he suddenly felt a vice-like grip on his backside. He collapsed and had to drag himself home. "I thought it was a neurological problem. When an MRI was done, the aneurysm was noticed. I was asked to come to Delhi for further surgery." Fortunately, only a clot had developed in his aneurysm; it hadn't ruptured. But he got it removed to be on the safe side. Aneurysms can occur in any part — brain, abdomen, legs....Those in the chest are called thoracic aortic aneurysms. Doctors can often make out if an aneurysm has ruptured. Abdominal aortic aneurysms are felt as a pulsating mass in the abdomen. A ruptured brain aneurysm will show up as bleeding in the brain and the patient will be comatose; others lead to swelling in the face. However, aneurysms are found on routine physical examination and X-rays. This is one 'balloon' you simply can't ignore. By Shobha John,TNN Copyright © 2007 Times Internet Limited.