What is Aortic Aneurysm? Symptoms, Causes, & Treatment

An aortic aneurysm is a balloon-like bulge that forms in your aorta, the main artery carrying blood from your heart to the rest of your body. Think of it like a weak spot in a garden hose that swells outward when water pressure builds up inside.

This condition happens when the wall of your aorta becomes weakened and stretches beyond its normal size. While the word "aneurysm" might sound scary, many people live with small aortic aneurysms without ever knowing they have them. The key is understanding what to watch for and when to seek care.

What are the symptoms of aortic aneurysm?

Most aortic aneurysms don't cause symptoms in their early stages, which is why they're sometimes called "silent killers." You might have one for years without feeling anything unusual. This is actually quite common and doesn't mean you're in immediate danger.

When symptoms do appear, they often depend on where the aneurysm is located and how large it has grown. Let's look at the signs your body might give you:

For abdominal aortic aneurysms (in your belly area):

• Deep, steady pain in your abdomen or lower back
• A pulsating feeling near your navel, like a strong heartbeat
• Pain that spreads to your groin, buttocks, or legs
• Feeling full even after eating small amounts
• Nausea or vomiting that seems unexplained

For thoracic aortic aneurysms (in your chest area):

• Sharp, sudden chest or upper back pain
• Difficulty swallowing or a feeling like food gets stuck
• Shortness of breath or trouble breathing deeply
• Hoarse voice that develops without a cold
• Persistent cough that won't go away

In rare cases, you might experience more concerning symptoms that require immediate attention. These include sudden, severe pain that feels like tearing, fainting spells, rapid heartbeat, or clammy skin. Remember, these symptoms can have many causes, so try not to panic if you experience them.

What are the types of aortic aneurysm?

Aortic aneurysms are classified based on where they occur in your aorta. Understanding the different types can help you better communicate with your healthcare provider about your specific situation.

Abdominal aortic aneurysm (AAA) is the most common type, occurring in the part of your aorta that runs through your abdomen. These tend to grow slowly and are more likely to be discovered during routine medical exams or imaging tests done for other reasons.

Thoracic aortic aneurysm (TAA) develops in the portion of your aorta that passes through your chest. These can be further divided into ascending, arch, or descending aneurysms depending on their exact location. Thoracic aneurysms are less common but can sometimes be associated with genetic conditions.

Thoracoabdominal aneurysms are rare and involve both the chest and abdominal portions of your aorta. These require specialized care due to their complex location and the multiple organs they can affect.

What causes aortic aneurysm?

Aortic aneurysms develop when the walls of your aorta become weakened over time. The exact cause isn't always clear, but several factors can contribute to this weakening process.

The most common underlying factor is atherosclerosis, where fatty deposits build up in your artery walls over many years. This buildup makes the artery walls stiffer and more prone to developing weak spots. High blood pressure also plays a significant role by putting extra stress on your artery walls day after day.

Here are the main factors that can lead to aortic aneurysms:

• Atherosclerosis (hardening of the arteries)
• High blood pressure that's poorly controlled
• Smoking, which damages blood vessel walls
• Family history of aortic aneurysms
• Age-related wear and tear on your arteries
• Infections that affect the aortic wall
• Injury or trauma to your chest or abdomen

Some people are born with genetic conditions that make their connective tissue weaker. These include Marfan syndrome, Ehlers-Danlos syndrome, or bicuspid aortic valve disease. While these conditions are less common, they can significantly increase your risk of developing an aneurysm at a younger age.

Inflammatory conditions like giant cell arteritis or Takayasu arteritis can also weaken your aortic wall, though these causes are quite rare. The good news is that understanding these risk factors can help you and your doctor develop a plan to monitor and protect your health.

When to see a doctor for aortic aneurysm?

You should contact your healthcare provider if you experience persistent abdominal or back pain, especially if it feels deep and doesn't improve with rest. This is particularly important if you have risk factors like high blood pressure, smoking history, or family members who've had aneurysms.

Seek immediate emergency care if you experience sudden, severe pain in your chest, abdomen, or back that feels like tearing or ripping. Other emergency signs include fainting, rapid heartbeat, sweating, or feeling like something is terribly wrong with your body.

Regular check-ups become especially important if you're over 65, have a family history of aneurysms, or have cardiovascular risk factors. Many doctors recommend screening for abdominal aortic aneurysms in men over 65 who have ever smoked, as this group has the highest risk.

Don't hesitate to discuss your concerns with your doctor, even if your symptoms seem mild. Early detection and monitoring can make a significant difference in outcomes, and your healthcare provider would rather evaluate something that turns out to be harmless than miss something important.

What are the risk factors for aortic aneurysm?

Several factors can increase your likelihood of developing an aortic aneurysm. Understanding these risk factors can help you take steps to protect your health and work with your doctor on prevention strategies.

Age is one of the strongest risk factors, with most aneurysms occurring in people over 60. As we get older, our arteries naturally become less flexible and more prone to developing weak spots. Men are also at higher risk than women, particularly for abdominal aortic aneurysms.

Here are the key risk factors to be aware of:

• Being male and over age 65
• Smoking or history of tobacco use
• High blood pressure (hypertension)
• Family history of aortic aneurysms
• Atherosclerosis (hardening of arteries)
• High cholesterol levels
• Chronic obstructive pulmonary disease (COPD)

Genetic conditions, while less common, can significantly increase your risk. These include Marfan syndrome, Ehlers-Danlos syndrome, Turner syndrome, and polycystic kidney disease. If you have any of these conditions, your doctor will likely recommend more frequent monitoring.

Lifestyle factors like smoking are particularly important because they're within your control. Smoking damages blood vessel walls and accelerates atherosclerosis, making it one of the most significant modifiable risk factors for aneurysm development.

What are the possible complications of aortic aneurysm?

The main concern with aortic aneurysms is rupture, which occurs when the weakened artery wall finally gives way under pressure. While this sounds frightening, it's important to know that most aneurysms grow slowly and can be monitored safely for years.

Rupture becomes more likely as an aneurysm grows larger, which is why your doctor will carefully track the size if you're diagnosed with one. Small aneurysms (less than 5.5 cm for abdominal aneurysms) have a very low risk of rupture and are usually just monitored with regular imaging.

Here are the potential complications to be aware of:

• Rupture, leading to life-threatening internal bleeding
• Dissection, where the artery wall layers separate
• Blood clots forming inside the aneurysm
• Pressure on nearby organs or structures
• Reduced blood flow to organs below the aneurysm

Aortic dissection is another serious complication where the inner layer of the aortic wall tears, allowing blood to flow between the wall layers. This can happen with or without an aneurysm and typically causes sudden, severe chest or back pain.

Blood clots can occasionally form inside an aneurysm and travel to other parts of your body, potentially blocking blood flow to your legs, kidneys, or other organs. Large aneurysms might also press on nearby structures, causing symptoms like difficulty swallowing or breathing.

While these complications sound serious, remember that with proper monitoring and treatment, most people with aortic aneurysms live normal, healthy lives. Your healthcare team will work with you to minimize these risks through careful observation and timely intervention when needed.

How can aortic aneurysm be prevented?

While you can't prevent all aortic aneurysms, especially those related to genetic factors, you can significantly reduce your risk by taking care of your cardiovascular health. The same habits that protect your heart also protect your aorta.

Quitting smoking is the single most important step you can take. Smoking damages your blood vessel walls and accelerates the development of atherosclerosis, making it a major modifiable risk factor for aneurysm formation.

Here are key prevention strategies you can implement:

• Stop smoking and avoid secondhand smoke
• Keep your blood pressure under control
• Maintain healthy cholesterol levels
• Exercise regularly with your doctor's approval
• Eat a heart-healthy diet rich in fruits and vegetables
• Manage diabetes if you have it
• Maintain a healthy weight

Regular medical check-ups are crucial, especially if you have risk factors. Your doctor can monitor your blood pressure, cholesterol, and overall cardiovascular health. If you have a family history of aneurysms, discuss screening options with your healthcare provider.

Managing stress through healthy coping mechanisms like meditation, regular exercise, or hobbies you enjoy can also benefit your cardiovascular health. While stress alone doesn't cause aneurysms, chronic stress can contribute to high blood pressure and other risk factors.

How is aortic aneurysm diagnosed?

Most aortic aneurysms are discovered accidentally during imaging tests performed for other reasons, such as CT scans for abdominal pain or chest X-rays for respiratory symptoms. This "incidental" discovery is actually quite common and often leads to early detection.

Your doctor will start with a physical examination, listening to your heart and feeling your abdomen for any unusual pulsations. However, physical exams alone can't reliably detect most aneurysms, especially smaller ones or those in people with larger body sizes.

The main diagnostic tools include:

• Ultrasound - painless and often used for initial screening
• CT scan - provides detailed images of the aneurysm size and location
• MRI - offers excellent detail without radiation exposure
• Chest X-ray - may show signs of thoracic aneurysms
• Echocardiogram - used specifically for aneurysms near the heart

If you're at high risk, your doctor might recommend screening even without symptoms. The U.S. Preventive Services Task Force suggests one-time ultrasound screening for abdominal aortic aneurysms in men aged 65-75 who have ever smoked.

Once an aneurysm is found, your doctor will measure its size and monitor how quickly it's growing through regular follow-up imaging. The frequency of these follow-ups depends on the aneurysm's size and your individual risk factors.

What is the treatment for aortic aneurysm?

Treatment for aortic aneurysms depends mainly on their size, location, and how fast they're growing. Small aneurysms that aren't causing symptoms are usually monitored with regular imaging rather than treated immediately.

For small aneurysms (typically less than 5.5 cm for abdominal aneurysms), your doctor will recommend "watchful waiting" with imaging every 6-12 months. During this time, you'll also work on controlling risk factors like blood pressure and cholesterol.

Treatment options include:

• Monitoring with regular imaging studies
• Blood pressure medications to reduce stress on the artery
• Cholesterol-lowering medications
• Open surgical repair for larger aneurysms
• Endovascular repair using stent grafts
• Emergency surgery for ruptured aneurysms

When aneurysms reach a certain size (usually 5.5 cm for abdominal aneurysms or 6 cm for thoracic aneurysms), your doctor will recommend preventive repair. This threshold represents the point where the risk of rupture becomes higher than the risks of surgery.

Endovascular aneurysm repair (EVAR) is a less invasive option where a stent graft is inserted through small incisions in your groin and guided to the aneurysm site. Open surgical repair involves replacing the damaged section of aorta with a synthetic graft through a larger incision.

Your surgical team will help you understand which approach is best for your specific situation based on factors like your overall health, aneurysm characteristics, and personal preferences. Both procedures have excellent success rates when performed by experienced teams.

How to manage aortic aneurysm at home?

If you've been diagnosed with an aortic aneurysm, there are several important steps you can take at home to support your health and reduce risks. The goal is to minimize stress on your aorta while maintaining a good quality of life.

Blood pressure management is crucial since high pressure puts extra stress on your aneurysm. Take your medications exactly as prescribed, monitor your blood pressure at home if recommended, and keep a log to share with your healthcare team.

Here are key self-care strategies:

• Take all medications as prescribed, especially blood pressure drugs
• Monitor your blood pressure regularly if advised
• Follow a heart-healthy diet low in sodium
• Exercise gently with your doctor's approval
• Avoid heavy lifting or straining
• Quit smoking completely if you haven't already
• Manage stress through relaxation techniques

When it comes to physical activity, gentle exercises like walking, swimming, or light cycling are usually fine, but avoid activities that involve heavy lifting, sudden movements, or holding your breath while straining. Always check with your doctor about what's safe for your specific situation.

Pay attention to your body and report any new or worsening symptoms to your healthcare provider promptly. This includes changes in pain patterns, new shortness of breath, or any symptoms that concern you, even if they seem unrelated to your aneurysm.

How should you prepare for your doctor appointment?

Preparing for your appointment can help you make the most of your time with your healthcare provider and ensure you get all the information you need. Start by writing down any symptoms you've experienced, even if they seem minor or unrelated.

Bring a complete list of your current medications, including over-the-counter drugs and supplements. Also, gather information about your family medical history, particularly any relatives who've had aneurysms, heart disease, or stroke.

Consider preparing these items:

• List of current symptoms and when they started
• Complete medication list with dosages
• Family history of cardiovascular disease
• Previous imaging reports or test results
• Insurance information and referrals if needed
• List of questions you want to ask

Write down questions ahead of time so you don't forget them during the appointment. You might want to ask about your aneurysm's size, how often you'll need monitoring, what symptoms to watch for, or what activities are safe for you.

Consider bringing a trusted family member or friend to help you remember important information and provide emotional support. They can also help you think of questions you might not have considered and take notes during the appointment.

What's the key takeaway about aortic aneurysm?

The most important thing to understand about aortic aneurysms is that they're manageable conditions when detected and monitored properly. While the diagnosis might feel overwhelming at first, remember that many people live full, active lives with aneurysms that are carefully watched by their healthcare teams.

Early detection through screening or incidental findings during other medical tests gives you and your doctors the opportunity to monitor the aneurysm and take action before complications develop. Most aneurysms grow slowly, providing plenty of time for careful decision-making about treatment.

Your active participation in your care makes a real difference. By controlling your blood pressure, quitting smoking, taking medications as prescribed, and keeping up with follow-up appointments, you're taking powerful steps to protect your health and reduce your risk of complications.

Remember that medical technology and surgical techniques for treating aneurysms have improved dramatically over the years. If you do need treatment, you'll have access to proven, effective options performed by experienced teams who specialize in this type of care.