Aortic Aneurysm

Written by Janet Barwell and Matthew Solan | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

Overview

Aneurysm is a medical term for a swelling or bulge. An aortic aneurysm is a swelling or bulge on the aorta that can grow and rupture if not treated. Aortic aneurysms begin small, but can become life-threatening if they are not monitored. If you are at high risk for an aneurysm, talk to your doctor about having an aneurysm screening.

Where is my Aorta?

The aorta is largest artery in your body. About the diameter of a garden hose, the aorta exits from the left chamber of your heart, curves downward, and then runs through your chest and into the abdominal area. There, it branches out into smaller blood vessels, delivering oxygen-rich blood to the rest of your body. The aorta then is the main blood vessel for delivering oxygen to all parts of your body.

How do Aortic Aneurysms Develop?

Aneurysm can be caused by anything that weakens the walls of the aorta. In healthy adults, the walls of the aorta are pliable and can stretch to handle normal changes in blood flow. However, as you age, the walls of the aorta may grow weak from high blood pressure, smoking, or high cholesterol levels.

The weak spot in the aorta wall can then begin to bulge outward like a bubble on a tire. The larger the bulge grows, the greater the risk that it can burst. When the aneurysm bursts, massive internal bleeding can occur, which can be fatal if not treated immediately.

Are There Different Types of Aortic Aneurysms?

There are two basic types of aortic aneurysms:

Thoracic Aortic Aneurysms

Thoracic aortic aneurysms are bulges in the portion of the aorta running through the chest. Thoracic aneurysms may be further distinguished as either ascending or descending, depending on the specific location on the aorta. 

Abdominal Aortic Aneurysms

Abdominal aortic aneurysms occur in the abdominal part of the aorta, and are the most common type of aneurysm. 

What Causes Aortic Aneurysms?

It depends on the type of aneurysm. Thoracic aortic aneurysms are more common in people who have other conditions that affect the tissues and blood vessels, such as Marfan’s syndrome and Ehlers-Danlos syndrome, or anyone born with an abnormal aortic valve. Injury to the aorta from sports or perhaps a car accident can also weaken the thoracic aorta.

Abdominal aortic aneurysms are more common in people with a history of smoking, atherosclerosis (hardening of the arteries), high blood pressure, or a family history of the condition.

What are the Symptoms of an Aortic Aneurysm?

In the early stages, aneurysms may have no symptoms. As they grow larger, they may cause abdominal, chest, or back pain. Most go undiagnosed until they are discovered during a routine doctor’s visit.

A ruptured aneurysm, in contrast, is a medical emergency with serious symptoms, including:

  • sudden, intense, and persistent pain in the abdomen or back
  • dizziness
  • clamminess
  • falling blood pressure
  • rapid pulse
  • shortness of breath
  • loss of consciousness

What Types of Diagnostic Tests Can Detect Aortic Aneurysms?

Thoracic aortic aneurysms are generally found during routine medical exams. Diagnostic tests for thoracic aortic aneurysms include chest X-rays, echocardiograms, computed tomography (CT) scans, and/or magnetic resonance angiography (MRA), which is an MRI that creates images of the blood vessels.

Abdominal aneurysms are often discovered by chance during routine doctor’s visits. Diagnostic tests for abdominal aortic aneurysms include abdominal ultrasound, chest X-rays, echocardiograms, CT scans, and/or MRA.

Preventive screening is recommended for people over the age of 60, and especially those who have ever smoked, or have a family history of aneurysms.

How are Aortic Aneurysms Treated?

Aneurysms in the early stages may not require any treatment. If you have a small aneurysm, your doctor will want to monitor it for changes. If it becomes a risk to your health, your doctor may recommend surgery to correct it before it has a chance to burst.

Two types of corrective surgery are common for aneurysms: open chest surgery and endovascular surgery.

Open chest surgery involves making an incision in the chest or abdominal area, removing the damaged portion of the aorta, and replacing it with a graft. Recovery after surgery can take several weeks.

Endovascular surgery is less invasive. The surgeon runs a small catheter through the femoral artery in the leg to the damaged portion of the aorta. Then a small graft is inserted into the damaged part and fastened to the aorta. This strengthens the weak wall of the aorta to prevent a rupture. Because the surgery is less invasive, recovery time is faster—typically a few days.

Your doctor may also prescribe medications to control high blood pressure and other conditions that can worsen your aneurysm.

Can Aortic Aneurysms Be Prevented?

There are no specific measures to prevent aortic aneurysms, but lifestyle changes can improve your overall heart health and decrease your risk:

  • reduce blood pressure to a healthy range.
  • lower cholesterol levels to the recommended range.
  • get regular aerobic exercise.
  • keep your weight within a normal body mass index (BMI).
  • stop using tobacco in any form.
  • avoid fatty foods, sugar, and salt in your diet.
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