An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel.
A thoracic aortic aneurysm occurs in the part of the body's largest artery (the aorta) that passes through the chest.
See also: Aneurysm
The most common cause of a thoracic aortic aneurysm is hardening of the arteries (atherosclerosis). This condition is more common in people with high cholesterol, long-term high blood pressure, or who smoke.
Other risk factors for a thoracic aneurysm include:
Aneurysms develop slowly over many years. Most patients have no symptoms until the aneurysm begins to leak or expand. Chest or back pain may mean sudden widening or leakage of the aneurysm.
Symptoms often begin suddenly when:
If the aneurysm presses on nearby structures, the following symptoms may occur:
Other symptoms may include:
The physical examination is often normal unless a rupture or leak has occurred.
Most thoracic aortic aneurysms are detected by tests performed for other reasons, usually a chest x-ray, echocardiogram, or a chest CT scan. A chest CT scan shows the size of the aorta and the exact location of the aneurysm.
An aortogram (a special set of x-ray images made when dye is injected into the aorta) can identify the aneurysm and any branches of the aorta that may be involved.
The treatment depends on the location of the aneurysm. The aorta is made of three parts:
For patients with aneurysms of the ascending aorta or aortic arch:
For patients with aneurysms of the descending thoracic aorta:
See also: Aortic aneurysm repair - endovascular
The long-term prognosis for patients with thoracic aortic aneurysm is determined by other medical problems such as heart disease and diabetes, which may have caused or contributed to the condition.
Serious complications after aortic surgery can include:
Death soon after the operation occurs in 5 - 10% of patients.
Complications after aneurysm stenting include damage to the leg, which may require another operation.
Tell your doctor if you have:
To prevent atherosclerosis:
Aortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aortic
Safi HJ, Estrera AL, Miller CC 3rd, Azizzadeh A, Porat EE. Thoracic vasculature with emphasis on the thoracic aorta. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 63.
Reviewed by: Shabir Bhimji MD, PhD, Specializing in Cardiothoracic and Vascular Surgery, Midland , TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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