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Aortic Aneurysm

The aorta is the largest artery in the body. It is the primary blood vessel, responsible for carrying oxygen-rich blood away from the heart, throughout the abdomen, to all parts of the body.

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An aortic aneurysm is an abnormal enlargement, or bulging, of the wall of the aorta. The walls of the aorta are elastic and filled with blood at high pressure. Because of this pressure, the aorta can become stretched and weakened, resulting in swelling or the formation of a balloon-like blister, or sac.

If an aneurysm ruptures or tears, life-threatening internal bleeding can result. Fortunately, if detected in time, an aneurysm may be repaired with surgery and minimally invasive, nonsurgical techniques.

An Overview of the Aorta

The aorta has the following segments:

  • Ascending aorta: The section that starts at the left ventricle of the heart (the aortic root) and continues up to the arch of the aorta.
  • Arch of the aorta: The crest of the aorta, which is shaped like an upside-down "U."
  • Descending aorta: The section that continues from the arch through the chest, to the common iliac arteries.

The descending aorta has two parts:

  • The thoracic aorta runs through the chest, above the diaphragm. Aneurysms in this section of the aorta (including the aortic root, ascending aorta, aortic arch or top half of the descending aorta) are called thoracic aortic aneurysms.
  • The abdominal aorta is the lower half, continuing below the diaphragm. Aneurysms in this section of the aorta are called abdominal aortic aneurysms.

Aneurysms involving both parts of the descending aorta are called thoracoabdominal aortic aneurysms.

Aortic aneurysms have two notable shapes. A fusiform aneurysm is uniform swelling that appears along an extended section of the aorta. A saccular aneurysm is a small bulge, or blister that forms in a weakened area of the aorta wall.

Aortic Aneurysm Symptoms

Aneurysms are usually discovered before they produce symptoms. However, they develop very slowly over time, making them difficult to detect.

Symptoms of aortic aneurysm can vary with the location of the aneurysm:

In thoracic aortic aneurysm, symptoms are apparent in just half of all cases. Patients may experience chest pain or back pain that continues to the jaw, neck or upper back. Warning signs also can include coughing, hoarseness, or difficulty breathing. In abdominal aortic aneurysm, a patient may feel ongoing pain in the back, abdomen or groin. Likewise, a physician may notice a pulsating enlargement or tender mass when performing a physical examination.

If you are experiencing the aortic aneurysm symptoms, see your doctor immediately. Detecting aneurysm early will reduce the likelihood of life-threatening rupture.

Persons who have a family history of aortic aneurysm, or a genetic connective tissue disorder such as Marfan syndrome, may require preventive ultrasound screenings by their physicians.

Aortic Aneurysm Causes

The exact causes of aortic aneurysm are not known. However, certain factors can contribute to the disorder. For example, connective tissue diseases can weaken the walls of the fragile aorta. Traumatic injury, resulting from falls or motor vehicle accidents, are other contributing factors.

Risk factors for aortic aneurysms include:

  • Heart disease (atherosclerosis): Fatty deposits of plaque in the blood can damage the lining of the aorta, which may stiffen and become weak. Heart disease risk factors include smoking, high blood pressure (which damages blood vessel walls), high blood cholesterol and being overweight.
  • Age: Aneurysms typically develop in persons age 60 an older.
  • Gender: More men than women develop aortic aneurysms.
  • Family history: Recent research has shown that aneurysms follow genetic patterns, where the condition is inherited from previous generations. A family history of cardiovascular or peripheral vascular disease (a narrowing of the blood vessels) also can contribute to aortic aneurysm risk.

Learn about aortic aneurysm surgery at John C. Lincoln Hospitals.