What is an Aortic Aneurysm?

An aortic aneurysm (say "a-OR-tik AN-yuh-rih-zum") is a bulge in a section of the aorta, the body's main artery. The aorta carries oxygen-rich blood from the heart to the rest of the body. Because the section with the aneurysm is overstretched and weak, it can burst. If the aorta bursts, it can cause serious bleeding that can quickly lead to death.

Aneurysms can form in any section of the aorta, but they are most common in the belly area (abdominal aortic aneurysm). They can also happen in the upper body (thoracic aortic aneurysm). Thoracic aortic aneurysms are also known as ascending or descending aortic aneurysms.

What causes an aortic aneurysm?

The wall of the aorta is normally very elastic. It can stretch and then shrink back as needed to adapt to blood flow. But some medical problems, such as high blood pressure and atherosclerosis (hardening of the arteries), weaken the artery walls. These problems, along with the wear and tear that naturally occurs with aging, can result in a weak aortic wall that bulges outward.

What are the symptoms?

Most aortic aneurysms don't cause symptoms. Sometimes a doctor finds them during exams or tests done for other reasons. People who do have symptoms complain of belly, chest, or back pain and discomfort. The symptoms may come and go or stay constant.

In the worst case, an aneurysm can burst, or rupture. This causes severe pain and bleeding. It often leads to death within minutes to hours.

An aortic aneurysm can also lead to other problems. Blood flow often slows in the bulging section of an aortic aneurysm, causing clots to form. If a blood clot breaks off from an aortic aneurysm in the chest area, it can travel to the brain and cause a stroke. Blood clots that break off from an aortic aneurysm in the belly area can block blood flow to the belly or legs.

How is an aortic aneurysm diagnosed?

Aneurysms are often diagnosed by chance during exams or tests done for other reasons. In some cases, they are found during a screening test for aneurysms. Screening tests help your doctor look for a certain disease or condition before any symptoms appear.

Experts recommend screening tests for abdominal aneurysms for men who are:

  •  Ages 65 to 75 and have ever smoked.
  • At least 60 years old and have a first-degree relative (for example, father or brother) who has had an aneurysm.
  • These men are more likely to have an aneurysm than are women or nonsmoking men.

    Experts recommend screening tests for a thoracic aneurysm for anyone who has a close relative who has had a thoracic aortic aneurysm.

    If your doctor thinks you have an aneurysm, you may have tests such as an ultrasound, a CT scan, or an MRI to find out where it is and how big it is.

Thoracic Aortic Aneurysm Surgery

Your doctor will recommend that you have surgery for a thoracic aortic aneurysm based on many things. These include:

  •  The location of the aneurysm, such as the ascending or descending part of the aorta .
  • The size of the aneurysm. Repair might be recommended if an aneurysm is 5.5 to 6.0 cm in diameter.
  • Whether the aneurysm is part of a genetic problem, such as Marfan's syndrome.
  • Whether you need another heart surgery such as a heart valve replacement surgery.

Open surgery and the less invasive procedure, called endovascular repair, are the two options for repairing a thoracic aortic aneurysm. The choice of repair can depend on the size and location of the aneurysm.

Many of the risks of surgical or endovascular repair are similar for abdominal and thoracic aortic aneurysms.