When identified early, aortic aneurysms can be treated successfully
An aneurysm occurs when the wall of a blood vessel weakens and bulges out. An aortic aneurysm develops in the wall of the aorta, the main blood vessel carrying oxygen-rich blood from the heart to the rest of the body.
Types of aortic aneurysm
There are two main types of aortic aneurysms:
- Abdominal aortic aneurysm (AAA): An AAA develops in the part of the aorta that sits in your abdomen, where it supplies blood to the lower part of your body. AAAs are the most common type of aortic aneurysm.
- Thoracic aortic aneurysm (TAA): A TAA occurs in the part of the aorta in your chest (thorax), where it leaves the heart. TAAs are rare, affecting fewer than 10 out of every 100,000 people.
Aneurysms can develop in other places as well. For example, aortic root aneurysms occur in the aortic root, the part of the aorta closest to the heart. An aneurysm in this spot can cause the aortic valve (one of the heart’s main valves) to leak, sending blood backward into the heart.
Aortic aneurysm symptoms
Most people with aortic aneurysms do not have any symptoms unless the bulge has grown very large or bursts. Large AAAs can cause symptoms such as:
- Abdominal tenderness
- Pain in the stomach area, buttocks, groin or lower back
- Sores or discolored skin on the feet or toes
Large TAAs can cause different symptoms, including:
- Chest pain
- Difficulty breathing
- Difficulty swallowing
- Hoarseness
- Upper back pain
An aortic aneurysm that bursts is a life-threatening emergency and requires immediate medical attention. The most common sign is a sharp or tearing pain that appears without warning.
Other signs of aortic aneurysm rupture include:
- Clammy skin
- Fainting or passing out
- Feeling dizzy
- Nausea or vomiting
- Rapid heartbeat
- Sudden, severe pain in the abdomen, back, chest or shoulder
Aortic aneurysm causes
It’s unclear why aortic aneurysms occur. However, people with heart problems are more likely to develop AAAs and TAAs.
You’re at an increased risk of developing an aortic aneurysm if you have the following risk factors:
- 50 years or older
- Male
- White ethnicity
- Family history of aortic aneurysm or atherosclerosis
- Certain genetic conditions such as Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome, Turner syndrome or inflamed arteries
- High blood pressure (hypertension)
- History of smoking
Diagnosing aortic aneurysm
Many AAAs are discovered during imaging for different issues. If a scan for something else shows a suspected AAA, your provider will order an aortic sonogram, a type of vascular ultrasound, to confirm the diagnosis. Depending on the size of the aneurysm, you may need a follow-up CT scan or MRI to determine the right treatment plan.
A TAA may also appear on a chest X-ray or imaging for another condition. Confirming an aortic aneurysm diagnosis will involve additional diagnostics tests, such as:
Medical history and physical exam
If you have any signs of an aortic aneurysm, your doctor will start by asking you questions about your medical and family history and completing a physical exam.
Imaging and ultrasounds
Imaging tests, such as echocardiographs, show blood flow through the heart and blood vessels.
Electrocardiograms
Electrocardiograms are a non-invasive test to record your heartbeat and track for rhythm frequency and changes.
Aortic aneurysm treatment options
Your vascular specialist will recommend a treatment for your aortic aneurysm based on the following factors:
- The type of aneurysm you have
- Its size and location relative to your heart
- Your age, overall health and health history
If you do not have symptoms and your aortic aneurysm is smaller than 5 centimeters in diameter, you may only need monitoring and conservative treatments. Your provider may recommend:
- Having regular imaging exams to see if the aneurysm has grown.
- Making lifestyle changes to improve your heart health, such as getting regular exercise.
- Quitting smoking
- Taking medications to lower your blood pressure, as high blood pressure stresses the aorta’s walls.
If you have a larger aortic aneurysm, you may benefit from vascular surgery. Procedures may include:
- Elective endograft repair: A procedure where vascular surgeons place an implant (the endograft) into the aorta and expand it to allow blood to flow.
- Endovascular aneurysm repair (EVAR): A minimally invasive procedure that allows your vascular surgeon to redirect blood away from the aneurysm using a stent.
- Open aortic aneurysm repair: A surgeon makes a large incision in your stomach to fix the bulge in the artery.
Our specialists participate in research and clinical trials around aortic aneurysm repair so you can have access to the latest treatment options to get back to living your life.
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