What is the Aorta?
The aorta is the major blood vessel of the body which originates from the top of the heart. It transports blood from the heart to the rest of the body including the heart itself. The aorta is the main blood vessel that travels through the chest and abdomen giving off branches to all organs (see Anatomy page).
What is an aortic aneurysm?
An aneurysm can occur in any blood vessel and is defined a weakening of the walls of the vessels leading to a balloon-like structure. The definition of an aortic aneurysm is when the diameter increases to twice its normal size. The normal diameter of the aorta can vary depending on its anatomical location in the body, gender, and age of the patient. In general, the diameter of the aorta is between 1.5 and 2.5 centimeters.
Ballooning of the ascending aorta
What causes the weakening of the aorta?
An aortic aneurysm occurs when there is a weakening of the layers of the wall of the aorta. The various reasons for weakening of the aortic wall are infection, atherosclerosis, trauma, high blood pressure and inheritable/connective tissue diseases. The cause of an aortic aneurysm may give insight of the natural history of the aneurysm, likelihood of rupture and timing of treatment.
How do I know where I have my aortic aneurysm?
Aortic aneurysms are named according to the involved segment of the aorta. If you refer to the anatomy figure, you will see the various segments of the aorta and how aneurysms will be named. Most aortic aneurysms that are discussed in this website are in your chest, hence thoracic aortic aneurysm although, there are aneurysms which span both your thoracic and abdominal cavities.
Do aortic aneurysm expand and how quickly?
Aortic aneurysms can expand over time however to predict when and in whom expansion will occur –is difficult. The size, location and the patient’s other medical problems, smoking habits may influence the growth rate of aortic aneurysms. Aortic aneurysms related to an aortic dissection can expand more rapidly and develop complications. Patients with underlying genetic connective disorder, such as Marfan and Elher-Danlos Syndrome are more likely to develop aortic aneurysms and expand quickly.
Most aortic aneurysms do not cause symptoms until they are very large or develop a complication. As aortic aneurysms enlarge they sometimes cause symptoms such as pressure on adjacent structures, for example, hoarseness by stretching the nerve to the larynx (around the aortic arch) or difficulty swallowing by compressing the esophagus. Most commonly, aortic aneurysms are discovered by a non-specific imaging study performed to work-up another medical condition.
Large thoracic aortic aneurysms are concerning due to the possibility of rupture or development of aortic dissection (a partial tearing of the blood vessel wall). If an aortic aneurysm tears or leaks, the patient usually experiences severe pain. A patient may experience severe pain if the aortic aneurysms expands rapidly. If a patient carries a diagnosis of an aortic aneurysm these symptoms should prompt immediate medical attention preferably at the nearest emergency room. You should inform the emergency physician that you have an aortic aneurysm or aortic dissection.
In an individual with an aortic aneurysm that is not causing symptoms the decision to offer elective surgery is based on the opinion that the risk of rupture is significantly greater than the risk of elective surgery. Individual factors such as age, the presence of heart, lung, and kidney disease impact not only on surgical risk but also the risk of rupture. Determining the need for elective surgery based solely on the maximum aortic diameter to is no longer sufficient. Careful analysis of institutional operative outcomes and the natural course of the untreated aneurysm should be considered in all patients especially in the elderly and frail patient.