An aneurysm is a swelling or bulge, usually in a blood vessel. An aortic aneurysm is a swelling or bulge on your aorta that can grow and rupture if it’s not treated.
The aorta is largest artery in your body. It has the diameter of a garden hose. Your aorta exits from the left chamber of your heart, curves downward, and runs through your chest and into your abdominal area. There, it branches out into smaller blood vessels. These deliver oxygen-rich blood to the rest of your body.
The aorta is the main blood vessel for delivering oxygen to all parts of your body. Aortic aneurysms begin small, but they can become life-threatening if they’re not monitored. If you’re at high risk for an aneurysm, talk to your doctor about having an aneurysm screening.
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’re discovered during a routine doctor’s visit.
A ruptured aneurysm, in contrast, is a medical emergency with serious symptoms. These can include:
- sudden, intense, and unremitting pain in your abdomen or back
- falling blood pressure
- rapid pulse
- shortness of breath
- loss of consciousness
Aneurysms can be caused by anything that weakens the walls of your 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 your aorta may grow weak from high blood pressure, smoking, or high cholesterol levels.
The weak spot in your 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. This can be fatal if it’s not treated immediately.
Types and Risk Factors
There are two basic types of aortic aneurysms:
Thoracic Aortic Aneurysms
Thoracic aortic aneurysms are bulges in the portion of your aorta running through your chest. Thoracic aneurysms may be further distinguished as either ascending or descending, depending on their specific location in your aorta.
Thoracic aortic aneurysms are more common in people who were born with an abnormal aortic valve or in people who have other conditions that affect their tissues and blood vessels, such as Marfan’s syndrome or Ehlers-Danlos syndrome. Injury to your aorta from sports or a car accident can also weaken your thoracic aorta.
Abdominal Aortic Aneurysms
Abdominal aortic aneurysms occur in the abdominal part of your aorta. They’re more common than thoracic aortic aneurysms.
Abdominal aortic aneurysms are more common in people with:
- a history of smoking
- atherosclerosis, or hardening of the arteries
- high blood pressure
- a family history of the condition
Thoracic aortic aneurysms are generally found during routine medical exams. Diagnostic tests for thoracic aortic aneurysms include:
- chest X-rays
- CT scans
- magnetic resonance angiography (MRA), which is an MRI that creates images of your blood vessels
Abdominal aneurysms are often discovered by chance during routine doctor’s visits. Diagnostic tests for abdominal aortic aneurysms include:
- an abdominal ultrasound
- a chest X-ray
- an echocardiogram
- a CT scan
- an MRA scan
Preventive screening is recommended for people over the age of 60, especially those who have ever smoked or have a family history of aneurysms.
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 that are commonly used for aneurysms include open surgery and endovascular surgery.
Open surgery involves making an incision in your chest or abdominal area, removing the damaged portion of your aorta, and replacing it with a graft. Recovery after surgery can take several weeks.
Endovascular surgery is less invasive than open surgery. Your surgeon runs a small catheter through your femoral artery in your leg to the damaged portion of your aorta. Then, a small graft is inserted into the damaged part and fastened to your aorta. This strengthens the weak wall of your aorta to prevent a rupture. Because the surgery is less invasive than open surgery, the recovery time is faster and typically takes a few days.
Your doctor may also prescribe medications to control high blood pressure and other conditions that can worsen your aneurysm.
There are no specific measures to prevent aortic aneurysms, but lifestyle changes can improve your overall heart health and decrease your risk.
You should take the following steps to lower your risk of an aneurysm:
- Reduce your blood pressure to a healthy range.
- Lower your cholesterol levels to the recommended range.
- Get regular aerobic exercise.
- Keep your weight within a normal body mass index (BMI) range.
- Stop using tobacco in any form.
- Limit fatty foods, sugar, and salt in your diet.