Aortic Aneurysm

What is an aortic aneurysm?

An aortic aneurysm (say "a-OR-tik AN-yuh-rih-zum") is a bulge in a section of the aorta, the body's main artery. The aorta carries oxygen-rich blood from the heart to the rest of the body. Because the section with the aneurysm is overstretched and weak, it can burst. If the aorta bursts, it can cause serious bleeding that can quickly lead to death.

Aneurysms can form in any section of the aorta, but they are most common in the belly area (Reference abdominal aortic aneurysm Opens New Window Reference Opens New Window). They can also happen in the upper body (Reference thoracic aortic aneurysm Opens New Window Reference Opens New Window). Thoracic aortic aneurysms are also known as ascending or descending aortic aneurysms.

What causes an aortic aneurysm?

The wall of the aorta is normally very elastic. It can stretch and then shrink back as needed to adapt to blood flow. But some medical problems, such as high blood pressure and Reference atherosclerosis Opens New Window (hardening of the arteries), weaken the artery walls. These problems, along with the wear and tear that naturally occurs with aging, can result in a weak aortic wall that bulges outward.

What are the symptoms?

Most aortic aneurysms don't cause symptoms. Sometimes a doctor finds them during exams or tests done for other reasons. People who do have symptoms complain of belly, chest, or back pain and discomfort. The symptoms may come and go or stay constant.

In the worst case, an aneurysm can burst, or rupture. This causes severe pain and bleeding. It often leads to death within minutes to hours.

An aortic aneurysm can also lead to other problems. Blood flow often slows in the bulging section of an aortic aneurysm, causing clots to form. If a blood clot breaks off from an aortic aneurysm in the chest area, it can travel to the brain and cause a Reference stroke Opens New Window. Blood clots that break off from an aortic aneurysm in the belly area can block blood flow to the belly or legs.

How is an aortic aneurysm diagnosed?

Aneurysms are often diagnosed by chance during exams or tests done for other reasons. In some cases, they are found during a screening test for aneurysms. Screening tests help your doctor look for a certain disease or condition before any symptoms appear.

Experts recommend screening tests for abdominal aneurysms for men who are:

• Ages 65 to 75 and have ever smoked.^{Reference 1}
• At least 60 years old and have a first-degree relative (for example, father or brother) who has had an aneurysm.^{Reference 2}

These men are more likely to have an aneurysm than are women or nonsmoking men.

Experts recommend screening tests for a thoracic aneurysm for anyone who has a close relative who has had a thoracic aortic aneurysm.^{Reference 3}

If your doctor thinks you have an aneurysm, you may have tests such as an Reference ultrasound Opens New Window, a Reference CT scan Opens New Window, or an Reference MRI Opens New Window to find out where it is and how big it is.

How is it treated?

Treatment of an aortic aneurysm is based on how big it is and how fast it is growing. If you have a large or fast-growing aneurysm, you need surgery to fix it. A doctor will repair the damaged part of the blood vessel during open surgery or a minimally invasive procedure.

Small aneurysms rarely rupture and are usually treated with high blood pressure medicine, such as Reference beta-blockers Opens New Window. This medicine helps to lower blood pressure and stress on the aortic wall. If you don't have a repair surgery or procedure, you will have routine ultrasound tests to see if the aneurysm is getting bigger.

Even if your aneurysm does not grow or rupture, you may be at risk for heart problems. Your doctor may suggest that you exercise more, eat a heart-healthy diet, and stop smoking. He or she may also prescribe medicines to help lower high cholesterol.

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