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Thoracic Aortic Aneurysm

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A thoracic aortic aneurysm is a weakened part of the upper aorta, the major blood vessel that sends blood around the body. The weakened area, or aneurysm, bulges outward; the larger it becomes, the more likely it can burst and damage the aortic wall. This can lead to internal bleeding.

Thankfully, this condition is relatively rare and occurs in just six to ten per 100,000 persons according to the Society for Vascular Surgery (SVS).

Thoracic Aortic Aneurysm Symptoms Are Not Always Obvious

Thoracic aortic aneurysms are not always obvious to a patient, particularly in the early stages. Many patients never show symptoms at all until (and unless) the aneurysm bursts.

In fact, most thoracic aortic aneurysm symptoms aren’t particularly alarming:

  • Tenderness around the chest
  • Chest pain
  • Hoarseness
  • Cough
  • Shortness of breath

Except for that second one, these symptoms can easily be explained away by muscle strain, colds, allergies, or asthma.

Symptoms are much more pronounced when the aortic aneurysm ruptures or dissects—when the one or more of the aortic wall layers split:

  • Chest, jaw, neck or arm pain
  • Sudden, sharp pain in the upper back that spreads down
  • Difficulty breathing

Thanks to solid public health education efforts about cardiac arrest, these are precisely the symptoms many people will recognize should be checked out by a hospital ER immediately.

I should point out that an aortic dissection is not the same as an aneurysm and can be deadly on its own depending on where it occurs in the aorta. Treating an aortic aneurysm can prevent a dissection from occurring.

Thoracic Aortic Aneurysm Symptoms Get More Alarming When There is a Burst

In addition to the symptoms listed above, signs of  a thoracic aortic aneurysm burst include:

  • Sudden and intense chest or back pain that may not let up
  • Loss of consciousness
  • Blood pressure drop
  • Trouble swallowing
  • Weakness or paralysis on one side
  • Difficulty speaking

These are similar to those of stroke symptoms and have been well-publicized. Many people understand they are serious and should be evaluated and treated in an emergency room right away.

Who Should Monitor Thoracic Aortic Aneurysm Symptoms?

Some people are more susceptible to a thoracic aortic aneurysm. The condition is most often seen in people over age 65.

Other risk factors include:

  • Genetics. If there is a history of aneurysms in your family, you are at a higher risk for developing one and at a younger age. Unfortunately, the risk for rupture is also higher.
  • High blood pressure. This damages the blood vessels, making it more likely for an aneurysm to develop.
  • Atherosclerosis. A buildup of plaque, fat, and other substances in the arteries damages the linings of blood vessels, which increases the risk of an aneurysm This is also more common in older people.
  • Bicuspid aortic valve. Perhaps 50% of people who have only two cusps in their aortic valves (three is normal) will develop an aneurysm. This is a relatively rare condition seen in about two percent of the population. It’s seen twice as often in males than females. The condition is present at birth, but generally not noticed until the patient is middle-aged and starts to develop symptoms like dizziness, fainting, shortness of breath, or chest pain.
  • Marfan Syndrome and similar rare diseases. Aortic aneurysms, including thoracic, are more common in people diagnosed with Marfan, Loeys-Dietz, or Ehlers-Danlos syndromes.

Physicians monitor patients known to have these risks for aneurysm through symptom education and when necessary, CT scans, ultrasound, or x-rays of the heart or abdomen.

We treat Peripheral Arterial Disease (PAD), which may result from some of these conditions. Learn more about PAD on our website.



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