Bainum's death puts focus on threat of vascular disease


POSTED: Thursday, June 11, 2009

Duke Bainum's sudden death Tuesday turned the focus on aneurysms, which kill about 14,000 Americans each year, according to the National Heart Lung and Blood Institute.

;[Preview]  A Inside Look On What Caused Bainum's Death

KITV's Dick Allgire explains what causes and happens during an aortic aneurysm.

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“;The key is to treat aneurysms before they rupture or dissect or become symptomatic,”; says Dr. Scott Shay, a neurointerventional surgeon at The Queen's Medical Center's Neuroscience Institute.

Speaking generally about aneurysms, Shay explained they are a vascular disease but there are vessels all over the body—in the brain, chest, abdomen, belly and legs—so aneurysms can occur anywhere in the arterial system.

He described two types. One is a saccular aneurysm, a bubble or blister that appears on the aorta, the artery leading from the heart, because of weakness of the artery wall. These aneurysms can be very small or very large, depending where they originate, and they can rupture or tear, he said.

A dissection, where the inner wall of a blood vessel is torn, can extend from the top of the chest to the bottom of the abdominal aorta and can compromise blood flow in any branch vessel of the aorta, “;which can be catastrophic,”; he said.

The other type, a fusiform aneurysm, is a weakness along an extended section of the aorta that appears as a symmetrical bulge. It's called an aneurysm if the diameter of the aorta is more than 1.5 times the size of the normal aorta, Shay said.

Most times, aneurysms of the brain, chest, belly or leg are asymptomatic until a complication occurs, he said.

“;A dreaded complication for brain aneurysms and belly aneurysms are ruptures,”; he said. “;They can occur suddenly without any advance warning.”;

A rupture in the chest or belly is life-threatening because a person can bleed to death, he said. A rupture in the brain can be fatal because it can increase intercranial pressure and the brain can herniate, he said.

Aneurysms in the brain—Shay's area of expertise—are discovered when they rupture or when some type of imaging or scanning is done of the brain for some other reason, he said.

“;The most common scenario is for it not to rupture.”; A patient comes in with “;the worst headache in my life,”; he said. “;We find an aneurysm and treat it.”;

Former New England Patriots tackle Pio Sagapolutele, a graduate of Maryknoll School, died Sunday from complications of a brain aneurysm, according to his wife.

Brain aneurysms are mostly developmental, resulting from a congenital weakness in the wall of the vessel or an inherited condition, Shay said.

“;A sudden onset of a thunderclap headache”; with nausea, vomiting and loss of consciousness may accompany a brain aneurysm. Sometimes a headache is the only symptom, he said.

A chest X-ray can be suggestive of a thoracic aortic aneurysm and a pulsating, swelling in the belly may indicate an abdominal aneurysm, Shay said.

Chest and belly aneurysms usually show up later in life as byproducts of atherosclerosis, Shay said.

“;They occur more commonly in people with hardening of the arteries, high blood pressure, smoking, high cholesterol, a sedentary life style,”; he said. “;Certain congenital diseases can result in aneurysms in the chest in younger ages but are more rare.”;