It was a Sunday in August 2021. My family and I had arrived in the Algarve the day before. We needed a vacation after an exhausting year, with the Covid-19 pandemic in the middle. The following Wednesday my parents were supposed to join us. We were going to share a house that they had rented, something we hadn’t done in a few years and that I missed.
This Sunday morning we went to the beach for the first time. I remember we stopped at the beach bar to have a coffee. I saw a list of gins written on a blackboard and thought it would be a great place to stop with my dad at the end of a day at the beach. We took a walk on the sand, went to the water and when I lay down on the towel to dry off I really felt like I decompressed. It lasted a short time. My mother was calling me.
I will never forget those words: “Peter, I have very sad news to tell you…”. The tone of voice seemed controlled, but it was clear that something serious had happened to someone close. I braced myself for the crash and remember my head was still starting to spin. But she was far from guessing it: “…his father died” and she began to cry helplessly.
It is news that crushes us. She had been with them two days before. Suddenly, everything ends and there is only a huge void that cannot be filled…
After the shock, I just wanted to understand what had happened so suddenly since my father was in good health. According to my mother, that day after waking up he felt bad. My mother sat him in a chair on the patio to get some air and made him some tea, thinking he had a digestive problem. But he continued to feel bad, with abdominal pain, and asked to lie down in bed. She noticed a certain paleness in him and supported him on the way to her room. On the way he suffered a first loss of consciousness. My mother immediately called 112 and was quickly helped by firefighters and the INEM. She regained consciousness at least once and lost it again, but never left the house alive…
I wanted to hear the opinion of a doctor friend of ours, if he thought we should request an autopsy. He didn’t believe it. From the description we gave, everything indicated that it was a massive heart attack. Furthermore, given my father’s age (76 years old) it did not justify us going through this. We decided not to do it.
Later I tried to find out more and spoke with the firefighters who assisted him. According to them, the heart was fine and the defibrillator gave no indications of resuscitating it. The heart attack hypothesis lost its meaning. They also mentioned some swelling in the abdominal area. I contacted the INEM and requested the data they recorded during the assistance. When I shared the information with our doctor friend again, he changed the diagnosis and it was definitive: my father had died from an Abdominal Aortic Aneurysm (AAA). He had never heard of such a thing.
After a simple search I realized the following:
- It is a deformation of the main artery of our body, in the abdominal area, whose diameter increases to the point that its walls become so fragile that they can break.
- It is more likely to occur in men and is not small. On average, it is possible to diagnose one case of AAA for every 42 to 48 men over 65 years of age.
- The risk increases in smokers or ex-smokers or when there is a history in immediate family members.
What happened to my father is an example of how dangerous this disease is:
- She is silent in life, since she has no symptoms that require seeking a doctor.
- If the AAA ruptures, the chance of survival is low.
- It is a silent disease also in death, due to the tendency to associate a sudden death with a heart attack, not perform an autopsy and move on, which only contributes to it not being spoken of in the same way as a stroke. , heart attack or others.
However, unlike other diseases, all the tools already exist to combat it effectively.
- It is easily detected by abdominal ultrasound or aortic Doppler ultrasound, both simple and inexpensive.
- Whenever it is detected, there is already a well-established protocol for monitoring it and deciding whether or not to require surgical intervention.
- The intervention is usually simple and low risk.
The greatest difficulty in preventing death from AAA is, therefore, our lack of knowledge and the fact that there is no effective screening practice, as already occurs in other diseases and in other countries. Most of the time it is detected by chance, when performing an examination for another purpose (for example, by ultrasound), when in fact screening is recommended for all men aged 65 years and older.
What happened to my father also serves as an example of the lack of screening, even when the specific situation recommends it. Only later did I realize that years before an AAA had been detected (also by chance) in my uncle, his brother, and had been operated on. At that point I didn’t look deeper and thought it was heart surgery, perhaps because I heard the reference to the aorta. However, contrary to what we establish as good practices, it was not recommended by any of the doctors with whom my uncle contacted a trace of family members in the first place, so that the probability of diagnosis could increase by ten times and in which case it would be included or my father.
So, if the age criteria applies, follow the suggestion and offer yourself, your father, husband, family member or friend an AAA exam. In case of a positive diagnosis, do not wait, immediately seek a specialist and inform your first-degree relatives so that they can consult their doctors and also carry out screening tests.
Pedro Fernandes has a degree in Business Organization and Management, the area where he works. In his free time he seeks to help raise awareness about Abdominal Aortic Aneurysm.
Arterial is a section of the Observer dedicated exclusively to topics related to cerebrovascular diseases. It results from a partnership with Novartis and has the collaboration of the Association to Support Patients with Heart Failure, the Portuguese Cardiology Foundation, Portugal AVC, the Portuguese Stroke Society, the Portuguese Atherosclerosis Society and the Portuguese Society of Cardiology. It is completely independent editorial content.
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Source: Observadora
