What is Thoracic Aortic Aneurysm

Thoracic aortic aneurysm is an aneurysm that occurs in the first part of the aorta, between the heart and the diaphragm. An aneurysm is a bulge in an artery. It happens when blood pushes up against a weakened or damaged artery wall.

The aorta is the main artery of the body. It supplies blood from the heart to the rest of the body.

Some aneurysms may not cause symptoms or problems. However, the major concern with a thoracic aortic aneurysm is that it can enlarge and burst (rupture), or blood can flow between the layers of the wall of the aorta through a tear (aorticdissection). Both of these conditions can cause bleeding inside the body and can be life threatening if they are not diagnosed and treated right away.

What are the causes?

The exact cause of this condition is not known.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Being 65 or older.
• Having hardening of the arteries caused by the buildup of fat and other substances in the lining of a blood vessel (arteriosclerosis).
• Having inflammation of the walls of an artery (arteritis).
• Having a genetic disease that weakens the body’s connective tissue, such as Marfan syndrome.
• Having a family history of aneurysms.
• Having an injury or trauma to the aorta.
• Using tobacco.
• Having high blood pressure (hypertension).
• Having high cholesterol.
• Having an infection that is caused by bacteria, such as syphilis or staphylococcus, in the wall of the aorta (infectious aortitis).

What are the signs or symptoms?

Symptoms of this condition vary depending on the size of the aneurysm and how fast it is growing. Most grow slowly and do not cause symptoms. When symptoms do occur, they may include:

• Pain in the chest, back, sides, or abdomen. The pain may vary in intensity. Sudden, severe pain may indicate that the aneurysm has ruptured.
• Hoarseness.
• Cough.
• Shortness of breath.
• Swallowing problems.
• Swelling in the face, arms, or legs.
• Fever.
• Unexplained weight loss.

How is this diagnosed?

This condition may be diagnosed with:

• An ultrasound.
• X-rays.
• A CT scan.
• An MRI.
• Tests to check the arteries for damage or blockages (angiogram).

Most unruptured thoracic aortic aneurysms cause no symptoms, so they are often found during exams for other conditions.

How is this treated?

Treatment for this condition depends on:

• The size of the aneurysm.
• How fast the aneurysm is growing.
• Your age.
• Risk factors for rupture.

Small aneurysms (2.2 inches, or 5.5 cm, or less) may be managed with:

• Medicines to:
  • Control blood pressure.
  • Manage pain.
  • Fight infection.
• Regular monitoring. This may include an ultrasound or CT scan every year or every 6 months to see if the aneurysm is getting bigger.

Large or fast-growing aneurysms may be treated with surgery.

Follow these instructions at home:

Eating and drinking

• Eat a healthy diet. Your health care provider may recommend that you:
  • Lower your salt (sodium) intake. In some people, too much salt can raise blood pressure and increase the risk for thoracic aortic aneurysm.
  • Avoid foods that are high in saturated fat and cholesterol, such as red meat and dairy.
  • Eat a diet that is low in sugar.
  • Increase your fiber intake by including whole grains, vegetables, and fruits in your diet. Eating these foods may help to lower your blood pressure.
• Limit or avoid alcohol as recommended by your health care provider.

Lifestyle

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Maintain a healthy weight.
• Check your blood pressure regularly. Follow your health care provider’s instructions on how to keep your blood pressure within normal limits.
• Have your blood sugar (glucose) level and cholesterol levels checked regularly. Follow your health care provider’s instructions on how to keep levels within normal limits.

Activity

• Stay physically active and exercise regularly. Talk with your health care provider about how often you should exercise and ask which types of exercise are best for you.
• Avoid heavy lifting and activities that take a lot of effort. Ask your health care provider what activities are safe for you.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Talk with your health care provider about regular screenings to see if the aneurysm is getting bigger.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

• Unexplained weight loss.

Get help right away if you have:

• Pain in your upper back, neck, or abdomen. This pain may move into your chest and arms.
• Trouble swallowing.
• A cough or hoarseness.
• Shortness of breath.

Summary

• A thoracic aortic aneurysm is an aneurysm that occurs in the first part of the aorta, between the heart and the diaphragm.
• As a thoracic aortic aneurysm becomes larger, it can burst (rupture), or blood can flow between the layers of the wall of the aorta through a tear (aorticdissection). These conditions can be life threatening if they are not diagnosed and treated right away.
• If you have a thoracic aortic aneurysm, its growth will be closely monitored. Surgical repair may be needed for larger or faster-growing aneurysms.