(AAA; Abdominal Aortic Aneurysm; Aneurysm, Abdominal Aortic; Thoracic Aortic Aneurysm; Aneurysm, Thoracic Aortic)
An aortic aneurysm is a bulge in the wall of the aorta. The aorta is the body's largest artery. It carries blood from the heart to the rest of the body. The aorta goes through the chest and the abdomen.
An aneurysm tends to get bigger over time. It can burst and lead to heavy, uncontrollable bleeding.
Aortic aneurysms include:
- Thoracic—happens in the chest
- Abdominal—happens below the chest
Abdominal Aortic Aneurysm
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An aortic aneurysm is caused by weakness in the walls of the aorta. This may be due to aging, genes, and certain conditions. When the aorta walls weaken, a bulge forms.
Aortic aneurysms are more common in older adults. Other things that raise the risk are:
- Family members with aneurysms
- High blood pressure
- Prior aneurysm
- Arteriosclerosis and atherosclerosis
- Certain genetic conditions such as Marfan syndrome or Ehlers-Danlos syndrome
- Conditions that can inflame the aorta, such as:
- Great vessel arteritis (Takayasu disease)
- Polyarteritis nodosa
- Infections from certain bacteria
Many aneurysms do not have symptoms. Symptoms may happen as it gets bigger.
Symptoms depend on the size and site of the aneurysm. They may include:
- Pain in the belly or lower back that may be:
- Deep, gnawing, or constant
- Sudden, severe, or stabbing
- Spreading to the groin, buttocks, or leg
- Pulsing sensation in the belly
- Coughing, problems breathing, or chest pain
- Problems swallowing
- Coughing up blood
- Weight loss
The doctor will ask about symptoms and health history. A physical exam will be done. Most aortic aneurysms are found during a physical exam.
Images of the heart and blood vessels may be done with:
The goal of treatment is to repair the aortic aneurysm. This is done to prevent more problems. If the aneurysm bursts, it is life-threatening. It needs treatment right away.
The type of treatment depends on the site of the problem and how severe it is.
- Surgery called (aneurysmectomy)—Part of the aorta (with the aneurysm) is removed. It is replaced with a mesh graft. In some thoracic aneurysms—the aortic valve or other nearby vessels are replaced or repaired.
- Stents—a tube is inserted into the aorta. It channels the blood away from the aneurysm. This is to prevent it from bursting.
There are no current guidelines to prevent an aneurysm. Screening may be advised for those with certain risks.
- Abdominal aortic aneurysm (AAA). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/abdominal-aortic-aneurysm-aaa. .
- Aortic aneurysm. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/heartdisease/aortic_aneurysm.htm.
- Sakalihasan N, Michel J, et al. Abdominal aortic aneurysms. Nat Rev Dis Primers. 2018;4(1):34.
- Screening for abdominal aortic aneurysm: recommendation statement. US Preventive Services Task Force website. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening.
- Thoracic aortic aneurysm. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/thoracic-aortic-aneurysm.
- 7/17/2017 DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/abdominal-aortic-aneurysm-aaa: Reis SP, Majdalany BS, Ali F, et al. ACR Appropriateness Criteria for pulsatile abdominal mass, suspected abdominal aortic aneurysm. Available at: https://acsearch.acr.org/docs/69414/Narrative.
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