An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel.
A thoracic aortic aneurysm occurs in the part of the body's largest artery (the aorta) that passes through the chest.
Aortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aortic
The most common cause of a thoracic aortic aneurysm is hardening of the arteries. This condition is more common in people with high cholesterol, long-term high blood pressure, or who smoke.
Other risk factors for a thoracic aneurysm include:
Aneurysms develop slowly over many years. Most people have no symptoms until the aneurysm begins to leak or expand.
Symptoms often begin suddenly when:
If the aneurysm presses on nearby structures, the following symptoms may occur:
Other symptoms may include:
The physical exam is often normal unless a rupture or leak has occurred.
Most thoracic aortic aneurysms are detected on imaging tests performed for other reasons. These tests include chest x-ray, echocardiogram, or chest CT scan or MRI. A chest CT scan shows the size of the aorta and the exact location of the aneurysm.
An aortogram (a special set of x-ray images made when dye is injected into the aorta) can identify the aneurysm and any branches of the aorta that may be involved.
There is a risk that the aneurysm may open up (rupture) if you do not have surgery to repair it.
The treatment depends on the location of the aneurysm. The aorta is made of three parts:
For people with aneurysms of the ascending aorta or aortic arch:
For people with aneurysms of the descending thoracic aorta:
The long-term outlook for people with thoracic aortic aneurysm depends on other medical problems, such as heart disease, high blood pressure, and diabetes. These problems may have caused or contributed to the condition.
Serious complications after aortic surgery can include:
Death soon after the operation occurs in 5% to 10% of people.
Complications after aneurysm stenting include damage to the blood vessels supplying the leg, which may require another operation.
Tell your health care provider if you have:
To prevent atherosclerosis:
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Braverman AC, Schermerhorn M. Diseases of the aorta. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 63.
Lederle FA. Diseases of the aorta. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 69.
Singh MJ, Makaroun MS. Thoracic and thoracoabdominal aneurysms: endovascular treatment. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 78.
Reviewed By: Deepak Sudheendra, MD, RPVI, FSIR, Director of DVT & Complex Venous Disease Program, Assistant Professor of Interventional Radiology & Surgery at the University of Pennsylvania Perelman School of Medicine, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.