Aortic Aneurysm

What is an aortic aneurysm?

An aneurysm is a bulge that forms in a blood vessel. It occurs when the vessel wall becomes weak and can no longer handle the pressure of blood flowing through it. An aortic aneurysm is when this happens in the aorta — the body’s largest artery. The aorta pumps oxygen-rich blood from your heart out to the rest of your body.

The aorta is shaped like a cane. It starts at the heart and first travels upward toward the head, sending off branches that supply blood to the brain and upper body. From there, it arches back and downward along the spine, delivering blood to key organs — such as the lungs, liver, intestines, and kidneys — before splitting to carry blood to the legs. The aorta is divided into sections based on its location: the thoracic aorta (in the chest) and the abdominal aorta (in the belly).

There are two types of aortic aneurysms, each affecting different parts of the aorta:

• Abdominal aortic aneurysms occur in the stem-like part of the aorta that goes through your belly.
• Thoracic aortic aneurysms occur in the curved part of the aorta that runs through your chest.

Abdominal aortic aneurysms are more common. Although the damage happens in the aorta, not the heart itself, these aneurysms are sometimes referred to as “heart aneurysms.”

Aortic aneurysms can grow large enough to rupture (burst) or cause an aortic dissection (tear), leading to life-threatening internal bleeding.

Your provider monitors the aneurysm and how fast it grows to determine the right treatment approach. Our Aortic Disease Program provides leading-edge, research-based treatment for aortic aneurysms, delivered by a team of expert heart and vascular specialists.

Symptoms of aortic aneurysms

Aortic aneurysms often don’t cause symptoms unless the aneurysm ruptures or grows large enough to impact other parts of the body. You may find out you have an aneurysm only when you get imaging for another reason.

As an aortic aneurysm grows, you may experience:

• Chest, neck, jaw, shoulder, back, or abdominal pain, depending on where the aneurysm is
• Face, neck, or arm swelling
• Feelings of fullness after only a small meal
• Pain or difficulty breathing
• Pain or difficulty swallowing
• Throbbing sensations in the abdominal region

Aortic aneurysm rupture symptoms

If an aneurysm begins to tear or rupture, symptoms can become severe and sudden. Because the aorta supplies blood to the entire body, symptoms may appear in other organs or limbs. For instance, if blood flow to the arm or leg is affected, you might experience pain, numbness, or even stroke-like symptoms in that area.

• Dizziness or light-headedness
  
• Rapid heart rate
  
• Severe and sudden pain in the back, chest, or abdominal region 
  

If you’ve been diagnosed with an aortic aneurysm, or are at risk, it’s important to recognize the warnings signs of a rupture. A rupture is a medical emergency and can be life-threatening. If you have an aneurysm and experience any of these symptoms, call 911 or seek emergency care immediately.

Causes of aortic aneurysms

Because an aortic aneurysm often doesn’t cause symptoms until it ruptures or dissects, it can be difficult to know when it developed. In many cases, the causes of aortic aneurysms are unknown.

Factors that are known to increase the risk of aortic aneurysm include:

• Genetic and inherited conditions: Aneurysms can run in families, especially in people with connective tissue disorders such as Marfan's syndrome or other inherited heart conditions.
• Atherosclerosis: Plaque build-up and narrowing in the arteries can increase pressure on arterial walls.
• Arterial inflammation: Inflammation of the arteries, including in the aorta (aortitis), can cause damage over time.
• Aortic injuries: Aneurysms can occur due to trauma or damage to the arteries.
• High blood pressure: Chronic high blood pressure (hypertension) puts added strain on artery walls, which can weaken them.
• Diabetes: When left untreated, diabetes can contribute to atherosclerosis.

Risk factors for aortic aneurysms

Almost anything that damages your heart or arteries can increase the risk of an aortic aneurysm. Some of the most important risk variables are lifestyle, personal health, and family history.

Below are some of the most common risk factors associated with aortic aneurysms.

• Age over 65
• Being male or white
• Family history of aortic aneurysms
• Health history of aneurysms elsewhere in your body
• High blood pressure
• High cholesterol

Diagnosis of an aortic aneurysm

Although aortic aneurysms often don’t cause early symptoms, doctors sometimes detect them during routine checkups. Your doctor may:

• Check the strength of your pulse in your arms and legs
• Feel your abdomen for bulges
• Listen to your heart for unusual blood flow
• Look for signs of related conditions that could cause aortic aneurysms

If your doctor suspects an aneurysm, they may order imaging tests to take a closer look at your aorta. These may include:

• CT scan
• Echocardiography
• MRI
• Ultrasound

In many cases, aortic aneurysms are found by chance on imaging done for an unrelated reason, like a chest X-ray for a persistent cough or a CT scan for unrelated abdominal symptoms.

Treatment of aortic aneurysms 

The goal of treatment is to prevent the aneurysm from rupturing. The risk of rupture depends on the aneurysm’s size, location, and how fast it grows.

Your doctor will recommend a treatment plan based on what is best for you. In some cases, that may include treating underlying conditions that contribute to the aortic aneurysm’s growth.

Many aortic aneurysms grow slowly. You may have an aortic aneurysm for a long time before it grows large enough to pose a risk.

How to prevent aortic aneurysms

While the exact cause of aortic aneurysms isn’t always known, there are basic steps you can take to reduce your risk. Many of these are the same habits that support overall heart and vascular health:

• Avoid stimulants and other heart stressors
• Exercise regularly
• Follow a heart-healthy diet
• Maintain a healthy weight
• Reduce and manage stress
• Quit tobacco

Living with an aortic aneurysm

With modern treatments, it’s possible to live comfortably with an aortic aneurysm. In cases of smaller aneurysms in less risky locations, basic treatments may prevent noticeable symptoms. In more extreme cases, surgery can effectively repair the aneurysm. However, in both cases, ongoing monitoring with your physician is important.