Aortic Aneurysm

An aortic aneurysm is an abnormal bulge that occurs in the wall of the major blood vessel (aorta) that carries blood from your heart to your body. Aortic aneurysms can occur anywhere in your aorta and may be tube-shaped (fusiform) or round (saccular).

Aortic aneurysms include:

  • Abdominal aortic aneurysm. An abdominal aortic aneurysm occurs along the part of the aorta that passes through the abdomen.
  • Thoracic aortic aneurysm. A thoracic aortic aneurysm occurs along the part of the aorta that passes through the chest cavity.

In some cases, an individual may have an abdominal aortic aneurysm and a thoracic aortic aneurysm.

Having an aortic aneurysm increases your risk of developing an aortic dissection. An aortic dissection occurs when a tear develops in the inner layer of the wall of the aorta. This causes one or more of the layers of the wall of the aorta to separate, which weakens the wall of the aorta. Having an aortic aneurysm also increases your risk that the aneurysm can burst (rupture).

Symptoms

Abdominal Aortic Aneurysm

Abdominal aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. Others expand quickly. Predicting how fast an abdominal aortic aneurysm may enlarge is difficult.

As an abdominal aortic aneurysm enlarges, some people may notice:

  • A pulsating feeling near the navel
  • Deep, constant pain in your abdomen or on the side of your abdomen
  • Back pain

If you have any of these signs and symptoms, such as sudden severe back or abdominal pain, get immediate emergency help.

When to see a doctor

You should see your doctor if you have any of the symptoms listed above. The recommendations below are for those who have no symptoms.

Because being male and smoking significantly increase the risk of abdominal aortic aneurysm, men ages 65 to 75 who have ever smoked cigarettes should have a screening for abdominal aortic aneurysms using abdominal ultrasound. If you are a man between ages 65 and 75 and you have never smoked, your doctor will decide on the need for an abdominal ultrasound, usually based on other risk factors, such as a family history of aneurysm. Those with a family history of aneurysm may have an ultrasound at age 60.

Thoracic Aortic Aneurysm

Thoracic aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. How quickly an aortic aneurysm may grow is difficult to predict.

As a thoracic aortic aneurysm grows, some people may notice:

  • Tenderness or pain in the chest
  • Back pain
  • Hoarseness
  • Cough
  • Shortness of breath

Aneurysms can develop anywhere along the aorta, which runs from your heart through your abdomen. When they occur in the upper part of the aorta, they are called thoracic aortic aneurysms. Aneurysms can occur anywhere in the thoracic aorta, including the ascending aorta near the heart, the aortic arch in the curve of the thoracic aorta and the descending aorta in the lower part of the thoracic aorta.

Aneurysms that form in the lower part of your aorta — called abdominal aortic aneurysms — are more common than thoracic aortic aneurysms. An aneurysm can also occur in between the upper and lower parts of your aorta. This type of aneurysm is called a thoracoabdominal aneurysm.

When to see a doctor

Most people with aortic aneurysms do not have symptoms unless a tear (dissection) or rupture has occurred. A rupture or dissection is a medical emergency. Call 911 or your local emergency number for immediate assistance.

If an aneurysm ruptures or one or more layers of the artery wall splits (dissection), you may feel:

  • Sharp, sudden pain in the upper back that radiates downward
  • Pain in your chest, jaw, neck or arms
  • Difficulty breathing

If you have a family history of aortic aneurysm, Marfan syndrome or other connective tissue disease, or bicuspid aortic valve, your doctor may recommend regular ultrasound exams to screen for aortic aneurysm.