Aneurysms and lotteries
You might have heard about the lottery winner who had to be within half an hour of a hospital at all times because of his medical condition - an aneurysm. An aneurysm is caused by a weakening in the internal wall of an artery, which allows the artery to bulge alarmingly under the pressure of blood inside. Eventually they can burst. If the aneurysm is on an artery inside your brain (as many as a third of us walk around with these potential widow-makers inside our heads I’m afraid) the result is a brain haemorrhage. If the aneurysm is situated on your abdominal aorta (the main artery that carries blood away from the heart and down towards the pelvis), then the result of rupture is usually immediately fatal. A thoracic aortic aneurysm is higher up, and more difficult to operate on. This story had me a bit confused.
In the not too distant past, triple As or Abdominal Aortic Aneurysms were part and parcel of work in most A&E departments, but the condition is usually very treatable - the tricky bit is spotting it in the first place. But this too can be done quite easily using ultrasound. Thanks to a screening program, ruptured AAAs are now quite rare. They are diagnosed early, and repaired - usually by stitching an artificial aortic graft in place of the arterial wall defect.
If our lottery winner has already been diagnosed with an aneurysm, what’s he doing hanging around buying lottery tickets, giving interviews to the press and waiting for it to burst? Why hadn’t he already had surgery?
Well, now he has - as an emergency procedure by the sounds of things. It may have been that his aneurysm was judged too dangerous to repair ‘electively’ (that is planned in advance on a patient with no symptoms) and he was forced to wait until it started to leak before the operation could be done. But it’s still a slightly odd story. Albeit one that lends itself to good headlines - lottery winners with time-bombs ticking inside them make good journalistic copy.
If you are concerned about having an aneurysm, you can be screened in the UK under the national health service screening scheme, although at present you have to be at least 60 years old. Although confusingly according to the official NHS screening website, screening for AAA is not yet available. But it should be soon…
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