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Aortic Aneurysm

An aneurysm is a bulge in a blood vessel caused by weakened arterial walls that no longer stand up to the pressure of pumping blood. An aortic aneurysm is when this bulge occurs somewhere within the aortic artery. 

close up of cardiac surgeons operating on patient in an exam room

What is an aortic aneurysm?

An aneurysm is a bulge in a blood vessel caused by weakened arterial walls that no longer stand up to the pressure of pumping blood. An aortic aneurysm is when this bulge occurs somewhere within the aorta. Normally, the artery walls can withstand your blood pressure, but in some patients, these walls can become weak and susceptible to an aneurysm. The risk is that these aneurysms can rupture (burst) or dissect (tear), leading to internal bleeding and potentially lethal danger.

What are the types of aortic aneurysm?

The aorta is the largest artery in your body. It starts at the heart, first traveling up towards the head, supplying branches that supply blood to the brain and the upper body. It then arches backwards and downwards along the spine, giving off branches that supply blood to various organs such as the lungs, liver, intestines, kidneys and then divides to carry blood to the legs. Essentially, it is the main artery that carries blood to the entire body. The different segments are known as the thoracic aorta and the abdominal aorta, respectively. An aneurysm can occur in either of these sections and is labeled by its location:

  • Abdominal aortic aneurysms
  • Thoracic aortic aneurysms 

Of the two types of aortic aneurysms, abdominal are more common. Although the damage occurs within the aorta, these are sometimes referred to as heart aneurysms. 

What are aortic aneurysm symptoms?

One of the dangers of aortic aneurysms is that they often don’t have any noticeable symptoms unless the aneurysm ruptures or grows large enough to impact other parts of the body. Still, some aortic aneurysm symptoms can present before it reaches this stage. Some of the more common symptoms of aortic aneurysms include: 

  • Pain and difficulty while swallowing. With a thoracic aortic aneurysm, the aneurysm may push on your esophagus, causing discomfort
  • Pain or difficulty breathing. A thoracic aortic aneurysm can push on the trachea, restricting how much air you can take in. If the aneurysm pushes against your lung, you may experience shortness of breath
  • Feeling full on minimal food
  • Throbbing sensations in the abdominal region
  • Pain in the abdominal region, back, chest, jaw, or shoulder. Where the pain occurs will depend on the location of the aneurysm
  • Swelling around the arms, face, and neck. The aneurysm may push against the superior vena cava, which carries blood back to the heart from the upper body. This can cause swelling in the affected areas

While the above symptoms are more common, when the aorta tears (dissection), it can involve any body organ and cause symptoms related to that organ. For instance, if the aneurysm were to compromise the blood supply to the arm or leg, one might experience signs similar to a stroke or pain in the arm or leg.

Aortic aneurysm rupture symptoms

If you have been diagnosed with an aortic aneurysm or have reason to believe you might have one, it is vital to be aware of the symptoms of an aneurysm rupture because it can be life-threatening. Aortic aneurysm symptoms before rupture can include the following: 

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

If you have an aneurysm and experience these symptoms, seek medical attention immediately.

What causes aortic aneurysms?

Because symptoms often don’t appear unless the aneurysm ruptures or dissects, it can be difficult to identify when and how the aneurysm developed. In many cases, the causes of aortic aneurysms are unknown. Some of the more commonly considered causes of aortic aneurysms include:

  • Genetic conditions and familial disease: Especially conditions with connective tissue disorder, such as Marfan's syndrome, or other less well defined conditions, where aortic aneurysms may run in families
  • Atherosclerosis: This condition involves a thinning of the arteries, which can increase the pressure on arterial walls
  • Arterial inflammation: Inflammation of the arteries can cause damage over time and make them more susceptible to aneurysms
  • Aortic injuries: Damage to the arteries can increase the risk of an aneurysm 
  • High blood pressure: Chronic high blood pressure can weaken arterial walls over time
  • Diabetes: When left untreated, diabetes can cause increased atherosclerosis

What are the risk factors of 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 (those over 65 are more at risk of developing aortic aneurysms)
  • Family history of aortic aneurisms
  • High blood pressure 
  • High cholesterol  
  • Sex (males are more likely to develop aortic aneurysms)
  • Smoking or using other tobacco products

How are aortic aneurysms diagnosed?

Although aortic aneurysms may be asymptomatic early on, physicians can sometimes catch them during routine checkups. Your doctor may feel your abdominal region for bulges, check the strength of your pulse in your limbs, listen to your heart for atypical blood flow, and look for signs of associated illnesses that could cause aortic aneurysms. If these examinations indicate an aortic aneurysm, the doctor may order some imaging tests. 

Standard imaging tests for an aortic aneurysm diagnosis include the following:

  • CT scan
  • Echocardiography 
  • MRI
  • Ultrasound

Many times, however, the aortic aneurysms are detected incidentally on imaging studies performed for an unrelated reason, such as an X-ray for a cough, or a CT scan performed for unrelated chest or abdominal symptoms.

How are aortic aneurysms treated?

Aortic aneurysm treatment ranges from lifestyle changes to medications to surgical interventions. Depending on your aneurysm and the risks it presents, your physician will determine which treatment is best for you. The risk of the aneurysm rupturing will depend significantly on its size and location. In some cases, the physician may want to treat underlying conditions that contribute to the aortic aneurysm.

Aortic aneurysm treatment without surgery can include lifestyle changes and medications. Lifestyle can significantly impact heart and arterial health. For this reason, doctors often recommend that patients follow a heart-healthy diet, exercise regularly, reduce stress, and quit smoking. With small aneurysms in less risky locations, these lifestyle changes may be the extent of initial treatment. 

Specific medications, like statins, can also help to treat aneurysms. Your physician may select more than one treatment approach.

Elective repair is recommended for larger and more dangerous aortic aneurysms to prevent rupture or dissection. Based on the location of the aneurysm, it may be treated with open surgical repair or minimally invasively using stents.

  • Open surgical repair: It involves surgically removing the aneurysm and replacing the damaged tissue with an artifical graft
  • Endovascular aneurysm repair (EVAR or TEVAR): In this approach, the surgeon uses wires and catheters under X-ray guidance to to maneuver a graft up through your blood vessels and onto the affected area. The stent graft then expands and attaches, covering and sealing the aneurysm from the inside. Although this approach may not be suitable for all patients, it is less invasive and comes with a faster recovery time

How to prevent aortic aneurysms

While the causes of aortic aneurysms aren’t always known, some basic preventative measures may reduce your risks. Due to the nature of aortic aneurysms, these tips overlap with many heart-healthy practices. 

  • Avoid stimulants and heart stressors
  • Get appropriate exercise
  • Implement a heart-healthy diet 
  • Maintain healthy weight levels
  • Reduce and manage stress
  • Quit any tobacco products, especially smoking

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 be sufficient to prevent noticeable symptoms. In more extreme cases, surgical intervention and the use of grafts can effectively repair the aneurysm. However, in both cases, risks remain, and ongoing monitoring by your physician is important. 


The exact impact on life expectancy varies significantly between the size and location of the aneurysm and the treatments used. With modern treatments, life expectancy is no longer as impacted by aortic aneurysms as it once was. That said, this condition is still very dangerous and can reduce life expectancy even once treated.

Avoid activities that endanger your heart, like smoking or using other tobacco products. It’s often advised to avoid lifting heavy weights. Depending on the type of aortic aneurysm, you may need to minimize the amount of weight you push, pull, or lift. Certain exercises might be best avoided so as not to increase the strain on your aneurysm. It’s vital to speak with your physician and ask which activities represent a risk for your aortic aneurysm, as each case is different.

A heart-healthy diet is recommended. Avoid foods high in fats (especially saturated fats) and sugars, red meats, sugary beverages, and alcohol.

Aortic aneurysms do not go away on their own. Not every case requires the same level of treatment, and some present without any noticeable symptoms of an aortic aneurysm. Still, these aneurysms pose a potentially serious threat and must be monitored once diagnosed.

Aortic aneurysms often develop without noticeable symptoms. Therefore, it is essential to have regular check-ups with your provider to detect and prevent the rupture of an aneurysm, which is a life-threatening event.

However, an aortic aneurysm rupture or dissection can cause symptoms. These symptoms may include:

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

If you have an aneurysm and experience these symptoms, seek medical attention immediately.