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Thoracic Aortic Aneurysm

The aorta is the largest artery in the body and is the blood vessel that carries oxygen-rich blood away from the heart to all parts of the body. The section of the aorta that runs through the chest is called the thoracic aorta and, as the aorta moves down through the abdomen it is called the abdominal aorta.

What is a thoracic aortic aneurysm?

When an artery wall in the aorta weakens, the wall abnormally expands or bulges as blood is pumped through it, causing an aortic aneurysm. The bulge or ballooning may be defined as a:

Fusiform: Uniform in shape, appearing equally along an extended section and edges of the aorta.
Saccular aneurysm: Small, lop-sided blister on one side of the aorta that forms in a weakened area of the aorta



Who is affected by thoracic aortic aneurysms?

 Thoracic aortic aneurysms affect approximately 15,000 people in the United States each year. Up to 47,000 people die each year from all types of aortic disease; more than from breast cancer, AIDS, homicides, or motor vehicle accidents, making aortic disease a silent epidemic.


Is a thoracic aortic aneurysm serious?

A thoracic aortic aneurysm is a serious health risk because, depending on its location and size, it may rupture or dissect (tear), causing life-threatening internal bleeding. When detected in time, a thoracic aortic aneurysm can often be repaired with surgery or other less invasive techniques. Small aneurysms place one at increased risk for:

• Atherosclerotic plaque (fat and calcium deposits) formation at the site of the aneurysm

• A clot (thrombus) may form at the site and dislodge, increasing the chance of strokeIncrease in the aneurysm size, causing it to press on other organs, causing pain

• Aortic dissection, or tearing of the layers of the aorta, a potentially fatal complication and a medical emergency. • Aneurysm rupture, because the artery wall thins at this spot, it is fragile and may burst under stress. A sudden rupture of an aortic aneurysm may be life threatening and is a medical emergency


What causes a thoracic aortic aneurysm?

Thoracic aortic aneurysms are most often caused by atherosclerosis, a hardening of the arteries that damages the artery’s walls. While your arteries are normally smooth on the inside, as you age they can develop atherosclerosis. When atherosclerosis occurs, a sticky substance called plaque builds up in the walls of the arteries. Over time, excess plaque causes the aorta to stiffen and weaken.

Your risk for atherosclerosis increases if you:

• Are a smoker

• Have high blood pressure

• Have high cholesterol

• Are overweight

• Have a family history of cardiovascular or peripheral vascular disease (a narrowing of the blood vessels)


Certain diseases can also weaken the layers of the aortic wall and increase the risk of thoracic aortic aneurysms, including:

• Marfan syndrome (a genetic connective tissue disorder)

• Other non-specific connective tissue disorders (characterized by a family history of aneurysms)

• Presence of a bicuspid aortic valve

• Syphilis

• Tuberculosis

Rarely, trauma, such as a severe fall or car accident can cause a thoracic aortic aneurysm. As you age, your risk of developing a thoracic aortic aneurysm increases. More men than women are diagnosed with thoracic aortic aneurysms, and are often affected with the condition at a younger age. Recent research indicates that a substantial amount of aneurysms have familial patterns, or are inherited from previous generations. It is important to tell your physician if there is a history of aortic aneurysms in your family to ensure that the best preventative screenings are completed.


What are the symptoms of a thoracic aortic aneurysm?

Thoracic aortic aneurysms often go unnoticed because patients rarely feel any symptoms. While only half of those with thoracic aortic aneurysms complain of symptoms, possible warning signs include:

• Pain in the jaw, neck, and upper back

• Chest or back pain

• Coughing, hoarseness, or difficulty breathing