Aneurysm of the Heart

QUESTION: Following a recent severe heart attack, my father developed an
aneurysm in his heart. We have discussed the situation with his doctor, who
because of a gradual decline in Dad's condition is recommending surgery. We
have tried to study up on this condition, but are becoming confused as we read
of the same condition in the brain and aorta. Is there any chance you can
sort this out for our family?
------------------------------------------------------------------------------
ANSWER: To start the sorting out process, let's define an aneurysm for you.
The word comes from the Greek word that means "a widening," and in fact an
aneurysm is a widening or sac formation in a weakened section of the wall of
any artery, vein or the heart. Aneurysms occur most frequently in the portion
of the aorta (the largest artery in the body) the passes through the abdomen.
They are found less frequently in the heart, the major blood vessels of the
chest, and the brain. In your father's case, a portion of the muscle of the
heart died when he had his heart attack. The artery leading to this section
of the heart wall became blocked, probably by a blood clot, and the blood
flow to the heart tissue stopped. Without the oxygen and nutrients carried by
the blood, the heart tissue could not survive. During the healing process,
the dead heart muscle was replaced by a thin scar, without the necessary
strength to contain the pressure that develops each time the heart contracts.
It is probably this area that is now bulging outward with each beat, forming a
sac or aneurysm. This, in turn, reduces the ability of the remaining heart
muscle to perform the vital function of pumping the blood to the body. While
the heart works harder to compensate, it uses more oxygen, and if the supplies
are inadequate, angina may develop, or heart failure may rear its ugly head.
When the aneurysm is removed surgically, the efficiency of the heart is
improved, angina disappears, and your father's general condition improves.
Frequently, a cardiac artery bypass procedure is performed at the same time as
the aneurysm is removed, to help improve the circulation to the heart. In
your reading, do not be confused by reference to arterial aneurysms, where the
walls of the vessels are weakened by progressive atherosclerosis, or brain (or
berry) aneurysms which are the result of a congenital condition. The
operation sounds well advised in your father's case, and should be performed
as soon as possible, before he worsens further.