Aortic Aneurysm

What is an aortic aneurysm?

An aneurysm is a balloon-like bulge in the wall of an artery. Arteries are blood vessels that carry oxygen-rich blood from the heart to other parts of your body. Most aneurysms occur in the aorta, the main artery that runs from the heart through the chest and abdomen.

If an aneurysm grows large, it can burst (rupture) or cause a tear in the artery wall (dissection). Both can lead to bleeding inside the body and be life-threatening.

What are the types of aortic aneurysms?

There are two types of aortic aneurysm:

• Abdominal aortic aneurysms (AAA) occur in the part of the aorta that runs through your abdomen (belly). This is the most common type.
• Thoracic aortic aneurysms (TAA) occur in the part of the aorta that runs through your chest.

What causes an aortic aneurysm?

Aortic aneurysms develop when the aortic wall weakens over time. Sometimes the exact cause is unknown. Possible causes may include:

• Atherosclerosis (a buildup of fat and other substances in the arteries)
• Injury to the aorta
• Certain infections, such as syphilis
• Certain genetic conditions

What increases the risk of an aortic aneurysm?

Factors that may increase your risk of an aortic aneurysm include:

• Smoking
• High blood pressure
• High cholesterol
• Family history of aneurysms
• Being male (higher risk for abdominal aortic aneurysm)
• Older age (higher risk for abdominal aortic aneurysm)
• Being white (higher risk for abdominal aortic aneurysm)

What are the symptoms of an aortic aneurysm?

Most aortic aneurysms don't cause symptoms. If you do have symptoms, they may depend on where the aneurysm is and whether it has become large enough to affect other parts of your body. Possible symptoms may include:

• Painful or difficulty swallowing
• A pulsing or throbbing feeling in your abdomen (belly)
• Pain in the neck, jaw, back, chest, shoulder, or abdomen (belly)
• Shortness of breath or trouble breathing
• Swelling of the face, neck, or arms

If an aneurysm breaks open it is called a rupture. A ruptured aortic aneurysm can cause sudden, severe internal bleeding and is a medical emergency. Call 911 right away if you have:

• Sudden, severe pain in your abdomen (belly), chest, or back
• Dizziness
• A fast heartbeat

How is an aortic aneurysm diagnosed?

A health care provider may find aneurysms during tests done for other health issues. To check for an aortic aneurysm, your provider may:

• Do a physical exam
• Order imaging tests such as an ultrasound, to find or measure an aneurysm
• Order a CT scan, or MRI scan for more details about the shape or location of an aneurysm
• Order an echocardiogram to check the size of the aneurysm and the thoracic aorta, which is close to the heart

Who should be screened for an aortic aneurysm?

Because aneurysms often don't cause symptoms, screening is important if you are at higher risk. Talk to your provider to see whether screening is right for you. In general, screening for an aortic aneurysm is usually done with an ultrasound.

Screening for an abdominal aortic aneurysm is recommended for:

• Men 65 to 75 years old who have smoked or have a close relative with an aortic aneurysm
• Men 65 to 75 years old who have never smoked but have other risk factors, such as family history, other aneurysms, or coronary artery disease
• Men and women older than 75 years old who have smoked or have a close relative with an aneurysm
• People with peripheral artery disease may also need screening

Your provider may recommend screening for a thoracic aortic aneurysm if you have:

• A close relative with a thoracic aortic aneurysm
• Certain genetic conditions such as Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome, or Turner syndrome

What are the treatments for an aortic aneurysm?

Treatment for an aortic aneurysm depends on its size and how fast it's growing. The treatment options may include heart-healthy lifestyle changes, medicines, and surgery.

• Small aneurysms are often monitored with regular imaging tests and treated with medicines to manage blood pressure and cholesterol
• Large or fast-growing aneurysms often require surgery to reduce the risk of rupture

Can an aortic aneurysm be prevented?

You may not be able to prevent an aortic aneurysm, but you can lower your risk by:

• Not smoking (or quitting smoking)
• Managing your blood pressure and cholesterol
• Eating a heart-healthy diet
• Getting regular physical activity
• Managing stress
• Knowing your family history and asking your provider about screening

NIH: National Heart, Lung, and Blood Institute