An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. Show A thoracic aortic aneurysm occurs in the part of the body's largest artery (the aorta) that passes through the chest. The most common cause of a thoracic aortic aneurysm is hardening of the arteries. This condition is more common in people with high cholesterol, long-term high blood pressure, or who smoke. Other risk factors for a thoracic aneurysm include:
Aneurysms develop slowly over many years. Most people have no symptoms until the aneurysm begins to leak or expand. Symptoms often begin suddenly when:
If the aneurysm presses on nearby structures, the following symptoms may occur:
Other symptoms may include:
The physical exam is often normal unless a rupture or leak has occurred. Most thoracic aortic aneurysms are detected on imaging tests performed for other reasons. These tests include chest x-ray, echocardiogram, or chest CT scan or MRI. A chest CT scan shows the size of the aorta and the exact location of the aneurysm. An aortogram (a special set of x-ray images made when dye is injected into the aorta) can identify the aneurysm and any branches of the aorta that may be involved. There is a risk that the aneurysm may open up (rupture) if you do not have surgery to repair it. The treatment depends on the location of the aneurysm. The aorta is made of three parts:
For people with aneurysms of the ascending aorta or aortic arch:
For people with aneurysms of the descending thoracic aorta:
The long-term outlook for people with thoracic aortic aneurysm depends on other medical problems, such as heart disease, high blood pressure, and diabetes. These problems may have caused or contributed to the condition. Serious complications after aortic surgery can include:
Death soon after the operation occurs in 5% to 10% of people. Complications after aneurysm stenting include damage to the blood vessels supplying the leg, which may require another operation. Tell your health care provider if you have:
To prevent atherosclerosis:
Aortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aortic Acher CW, Wynn M. Thoracic and thoracoabdominal aneurysms: open surgical treatment. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 77. Braverman AC, Schermerhorn M. Diseases of the aorta. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 63. Lederle FA. Diseases of the aorta. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 69. Singh MJ, Makaroun MS. Thoracic and thoracoabdominal aneurysms: endovascular treatment. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 78. Updated by: Deepak Sudheendra, MD, RPVI, FSIR, Director of DVT & Complex Venous Disease Program, Assistant Professor of Interventional Radiology & Surgery at the University of Pennsylvania Perelman School of Medicine, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Can stress cause aortic aneurysm?Background— Aneurysm expansion rate is an important indicator of the potential risk of abdominal aortic aneurysm (AAA) rupture. Stress within the AAA wall is also thought to be a trigger for its rupture.
What is the most common cause of abdominal aortic aneurysm?Atherosclerosis. Atherosclerosis is a potentially serious condition where arteries become clogged up by fatty deposits, such as cholesterol. An AAA is thought to develop because these deposits (called plaques) cause the aorta to widen in an attempt to keep blood flowing through it. As it widens, it also gets weaker.
Where Do aortic aneurysms most commonly occur?Aneurysms can develop anywhere along the aorta, but most aortic aneurysms occur in the part of the aorta that's in the belly area (abdomen). Several things can play a role in the development of an abdominal aortic aneurysm, including: Hardening of the arteries (atherosclerosis).
Are there warning signs before an aortic aneurysm?The most common symptom is general belly pain or discomfort, which may come and go or be constant. Other symptoms may include: Pain in the chest, belly (abdomen), lower back, or flank (over the kidneys). It may spread to the groin, buttocks, or legs.
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