Thoracic Aortic Aneurysm: Symptoms, Treatment

Overview

The aorta is the major blood vessel that
feeds blood to the body. The section of the aorta that runs through the chest
is called the thoracic aorta. An aneurysm describes an abnormal widening or
ballooning of a portion of an artery due to weakness in the wall of the blood
vessel. So, a thoracic aortic aneurysm refers to a bulge in your thoracic aorta
that occurs when the aorta’s walls are weakened.

A thoracic aortic aneurysm is also known as
thoracic aneurysm and aortic dissection (TAAD).
Because an aneurysm can lead to a tear in the artery wall (dissection) that can
cause life-threatening bleeding. Small and slow-growing thoracic aortic
aneurysms may not ever rupture, but large, fast-growing aneurysms may rupture.

Causes

Most commonly, a thoracic aortic aneurysm
is caused by the hardening of the arteries. People with high cholesterol or long-term
high blood pressure are more likely to develop the condition. Other risk
factors for this disease include:

  • Aging over 65 years
  • Tobacco use
  • Genetic conditions such as Marfan or Ehlers-Danlos syndrome
  • Having a bicuspid aortic valve
  • Inflammation of the aorta
  • Injury from falls or motor vehicle accidents
  • Untreated infection
  • Syphilis

Symptoms

In many cases, thoracic aortic aneurysms
are unnoticed because they are asymptomatic. About half of the patients will
experience symptoms. These possible signs and symptoms include:

  • Pain in the jaw, neck, and upper back
  • Tenderness in the chest
  • Chest or back pain
  • Clammy skin
  • Nausea and vomiting
  • Rapid heart rate
  • Coughing
  • Hoarseness
  • Shortness of breath

Diagnosis

Because thoracic aortic aneurysms usually
have no symptoms, they are often identified incidentally when you are tested
for other conditions. And the physical exam for this disease is often normal unless
a rupture or leak has occurred. Some imaging tests can help your doctor confirm
the disease, such as:

  • Chest X-ray
  • Chest CT scan
  • MRI
  • Echocardiogram, using sound waves to capture real-time images of
    your heart and the ascending aorta
  • An aortogram, which is a special x-ray images made when dye is
    injected into the aorta

Treatment

The goal of treating thoracic aortic
aneurysm are to prevent the aneurysm from growing and preventing it from dissecting
or rupturing. Specific treatment options are based on the size of the aortic
aneurysm and how fast it’s growing. Regular monitoring is the standard treatment
for smaller aneurysms. Other methods for treating the disease include:

  • Medications, such as Beta blockers or statins, to lower your blood pressure and reduce your cholesterol levels
  • Lifestyle changes, like avoiding tobacco use, exercising regularly and reducing cholesterol and fat in your diet

Surgical
treatment
for thoracic aortic aneurysm is recommended
when your aneurysm is big and is getting larger. If you have Marfan syndrome, a
bicuspid aortic valve or a family history of aortic dissection, your doctor may
also recommend surgery for smaller aneurysms because you have a higher risk of aortic
dissection. Some surgeries that you doctor may recommend involve:

  • Open-chest surgery.

This surgery involves removing the damaged
section of the aorta and replacing it with a synthetic tube (graft), which is
sewn into place.

  • Endovascular surgery.

In this procedure, doctors attach a synthetic graft to the end of a thin tube (catheter) that’s inserted through an artery in your leg and threaded up into your aorta. It is to prevent rupture of the aneurysm.

Keyword: thoracic aortic aneurysm.

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