Thoracic Aortic Aneurysm – Causes, Symptoms, Diagnosis, And Treatment
What is a thoracic aortic aneurysm?
A thoracic aortic aneurysm is an aortic aneurysm that occurs primarily in the chest. An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. Aorta is the largest artery in the body. The part of this artery that passes through the chest is called thoracic aorta.
This condition can occur anywhere in the ascending aorta near the heart, the aortic arch in the curve of the thoracic aorta, or the descending aorta in the lower part of the thoracic aorta.
What causes thoracic aortic aneurysm?
Atherosclerosis (hardening of the arteries) is the most common cause of a thoracic aortic aneurysm. This condition occurs mostly in people with high cholesterol, long-term high blood pressure, or who smoke.
The following are the other risk factors for a thoracic aneurysm:
- Age-related changes
- Connective tissue disorders such as Marfan or Ehlers-Danlos syndrome
- Inflammation of the aorta
- Injury from falls or accidents
What are the symptoms of a thoracic aortic aneurysm?
Normally, an aneurysm develops slowly over many years. Most people experience no symptoms until an aneurysm starts to leak, expand, or rupture.
Symptoms of an aortic aneurysm often develop suddenly when:
- An aortic aneurysm grows or expands quickly.
- The aortic aneurysm ruptures (tears open).
- Blood leaks along the wall of the aorta (aortic dissection).
The following symptoms may occur if an aneurysm presses on nearby structures:
- Swallowing problems
- Swelling in the neck
- Stridor (high-pitched breathing)
The following are the other symptoms that may occur:
- Chest or upper back pain
- Clammy skin
- Nausea and vomiting
- Rapid heart rate
- Feeling of impending doom
How is thoracic aortic aneurysm diagnosed?
Your doctor will perform a physical exam and review your symptoms. The exam is usually normal unless a rupture or leak has occurred.
For this reason, most aortic aneurysms go undetected until they become complicated. They are mostly detected when tests, such as chest x-ray, echocardiogram, chest CT scan, or MRI are performed for other reasons.
Your doctor may order a chest CT scan to see the size of the aorta and the exact location of an aneurysm.
An aortogram (a set of x-ray images taken after a dye is injected into the aorta) may also be done. This test helps identify an aneurysm and any branches of the aorta that may be involved.
How is thoracic aortic aneurysm treated?
Surgical repair is the standard treatment for thoracic aortic aneurysms. Sometimes, endovascular stenting is also used. The treatment depends on the location of an aneurysm. The aorta is made of the following three parts:
- Ascending Aorta: This part of the aorta moves upward toward the head.
- Aortic Arch: This is the middle part, which is curved.
- Descending Aorta: This is the last part that moves downward toward the feet.
The doctor may recommend the following treatment depending on which part is involved:
For ascending aorta and aortic arch aneurysms:
- Surgery to replace the aorta if an aneurysm is larger than 5 to 6 centimeters. The aorta is replaced with a plastic or fabric graft. This is major surgery that requires a heart-lung machine.
For descending thoracic aorta aneurysms:
- Surgical replacement of the aorta with a fabric graft if an aneurysm is larger than 6 centimeters. This surgery is done through a cut on the left side of the chest, which may reach to the abdomen. This is also a major surgery.
- Endovascular stenting. This is a less invasive procedure than surgery. A stent (a tiny metal or plastic tube)is placed into the artery without cutting the chest. A stent can hold an artery open. However, this procedure is used only in some people because all people with descending thoracic aneurysms are not candidates for stenting.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.