Description

A thoracic aortic aneurysm is a weakened area in the main artery of the body in the chest. The main artery of the body is called the aorta. When the wall of the aorta is weak, the artery may be more extensive. When the artery becomes very wide, it is called an aneurysm. An aneurysm can happen anywhere in the thoracic aorta, including close to the heart.

A thoracic aortic aneurysm, also called a thoracic aneurysm. If the aneurysm is between the upper and lower parts of the aorta, which is called an aneurysm thoracoabdominal.

Thoracic aortic aneurysms are less common than aneurysms in the lower part of the aorta, called abdominal aortic aneurysms.

The treatment of a thoracic aortic aneurysm depends on the cause and size of the aneurysm and how fast it is growing. The treatment may vary from regular medical checkups to emergency surgery. An aneurysm of the thoracic aorta that breaks or makes a tear is called a dissection is a medical emergency that can lead to death.

Symptoms

Thoracic aortic aneurysms tend to grow slowly. There are usually no symptoms. That makes them hard to find. Many start small and stay small. Others are larger with time. How quickly a thoracic aortic aneurysm can grow is difficult to predict.

As an aneurysm of the thoracic aorta grows, symptoms may include:

  • Back pain.
  • For cough.
  • Weak, raspy voice.
  • Shortness of breath.
  • Tenderness or pain in the chest.

Symptoms of a thoracic aortic aneurysm has ruptured or caused a rupture called an aortic dissection include:

  • Sharp, sudden pain in the upper back that extends down the body.
  • Pain in the chest, jaw, neck, or arms.
  • Difficulty breathing.
  • The low blood pressure.
  • The loss of consciousness.
  • Shortness of breath.
  • Difficulty swallowing.

Some aneurysms can never break or cause the dissection.

When to see a doctor

The majority of people with thoracic aortic aneurysms have no symptoms until a aortic dissection or rupture occurs. An aortic dissection or aneurysm rupture is a medical emergency. Call 911 or the local emergency number for immediate assistance.

Causes

Causes of thoracic aortic aneurysms may include:

  • Atherosclerosis. A buildup of fat, cholesterol and other substances in the walls of the arteries and causes the arteries to get stiff. Over time, the walls of the arteries can get weak. High blood pressure and high cholesterol increases the risk of atherosclerosis, especially in older people.
  • Genetic conditions.Aortic aneurysms in younger people often are caused by changes in genes. A genetic condition called Marfan syndrome can weaken the wall of the aorta. If you have Marfan syndrome or a related condition, such as Loeys-Dietz syndrome, or vascular Ehlers-Danlos syndrome, down syndrome, has a much higher risk of an aneurysm of the thoracic aorta. These conditions also are more likely to have an aortic rupture or aortic dissection.
  • Inflammation of the blood vessels. The conditions that cause the irritation and inflammation of the blood vessels, such as takayasu arteritis and giant cell arteritis, are associated with thoracic aortic aneurysms.
  • The bicuspid aortic valve. Normally the valve between the lower left chamber of the heart and the aorta has three flaps. A valve bicuspid has only two. People who are born with a bicuspid aortic valve are more likely to suffer a thoracic aneurysm.
  • The infection is not treated. Although it is rare, it is possible to obtain an aneurysm of the thoracic aorta if you have had an untreated infection, such as syphilis and salmonella.
  • The traumatic injury. Some people are injured in falls or collisions of motor vehicles to get thoracic aortic aneurysms. But this is rare.

Genetic conditions. Aortic aneurysms in younger people often are caused by changes in genes. A genetic condition called Marfan syndrome can weaken the wall of the aorta.

If you have Marfan syndrome or a related condition, such as Loeys-Dietz syndrome, or vascular Ehlers-Danlos syndrome, down syndrome, has a much higher risk of an aneurysm of the thoracic aorta. These conditions also are more likely to have an aortic rupture or aortic dissection.

Risk factors

Anything that harms or weakens the blood vessels may increase the risk of an aneurysm. Aneurysm of the thoracic aorta risk factors include:

  • Age. Thoracic aortic aneurysms occur more frequently in people of 65 years of age and older.
  • Smoking and tobacco use. If you smoke or chew tobacco, it is important that you stop smoking. The use of tobacco can also worsen an aneurysm and health in general.
  • The high blood pressure. Increased blood pressure damages the blood vessels in the body. This poses the risk of an aneurysm.
  • Disease of the coronary artery. This type of heart disease that reduces blood flow to the heart. It is often caused by atherosclerosis. Atherosclerosis can cause damage to the lining of the blood vessels, increasing the risk of an aneurysm. This is a more common risk in older people.
  • The history of the family. You are more likely to get an aneurysm of the aorta and rupture if you have a parent, brother, sister or child with one. You can develop aneurysms at a younger age.

If you are at risk of an aneurysm of the aorta, you may receive medicines to lower your blood pressure and relieve stress on a weakened arteries.

Complications

The possible complications of an aneurysm of the thoracic aorta are:

  • A tear in the wall of the aorta, also called an aortic dissection. This life-threatening condition that causes bleeding into and along the wall of the aorta. The emergency surgery is necessary to prevent the death.
  • The rupture of the main artery of the body, which is called aortic rupture. If a tear in the aorta that causes bleeding out of the aorta is called aortic rupture. This is also a life-threatening condition that requires immediate treatment. In general, the larger the aneurysm, the greater the risk of rupture.
  • The blood clots. Small blood clots can develop in the area of the aneurysm of the aorta. If a blood clot breaks away from the inner wall of an aneurysm, it can block a blood vessel in other parts of the body. This can cause serious complications.
  • Stroke. The signs and symptoms of a stroke include: weakness or inability to move one side of the body. It can be difficult to talk about.

Prevention

To avoid an aneurysm, keep the blood vessels healthy as possible. Try these healthy lifestyle tips.

  • Do not smoke or use tobacco.
  • Control of blood pressure and cholesterol levels.
  • Maintain a healthy weight and stay active.
  • Eating nutritious food.

Detection

Detection means that you have regular imaging tests, typically an echocardiogram to look for an aneurysm.

Your healthcare provider may suggest the detection of a thoracic aneurysm if:

  • You have a parent, brother, sister, son or daughter with a genetic disease linked to aneurysms of the thoracic aorta. An example is Marfan syndrome.
  • You have a family history of aneurysms of the aorta and the desire to get pregnant.

If a screening test shows a larger than normal of the aorta or of an aneurysm, the test is usually repeated within 6 to 12 months to check for changes.

Diagnosis

Thoracic aortic aneurysms often have no symptoms. So it can be difficult to diagnose. They are often found when a test image is done for a different reason.

If you have a thoracic aortic aneurysm, your health care professional may ask about your family's medical history. Some aneurysms can be run in families.

Tests

Tests are carried out for the diagnosis or the detection of an aneurysm of the thoracic aorta. Tests may include:

  • The echocardiogram. The sound waves show how blood moves through the heart and blood vessels, including the aorta. This test can be used for the diagnosis or the detection of aneurysms of the thoracic aorta. An echocardiogram standard is seen in the aorta from the outside of the body. If you do not provide the sufficient information, a transesophageal echocardiogram may be done. This type is seen in the aorta from the inside of the body.
  • Computed tomography. The X-rays to make cross-sectional images of the body, including the aorta. This test can show the size and shape of an aneurysm.
  • Magnetic resonance imaging of the heart, also called a cardiac mri. A magnetic field and radio waves to create images of the heart and of the aorta. A heart mri can diagnose an aneurysm, and show their size and location. This test does not use radiation. May be an option for the CT scans for people who need frequent imaging tests.

Treatment

The goal of treatment of an aneurysm of the thoracic aorta are:

  • Stop the aneurysm growth.
  • To prevent aortic rupture.

The treatment depends on the size of the aneurysm and how fast it is growing.

Treatment for thoracic aortic aneurysm may include:

  • Regular medical checkups, sometimes called watchful waiting.
  • Drugs.
  • Surgery.

Regular check-ups

Small aneurysms thoracic only need the medicine, and regular testing of image to view the aneurysm.

Usually you get an echocardiogram, CT scan, or magnetic resonance angiography scan at least six months after the aneurysm is diagnosed. How often do you need of these tests depends on the cause and size of the aneurysm and how fast it is growing.

Drugs

You can use medications to treat high blood pressure, high cholesterol, and other conditions associated with aneurysms.

  • Beta-blockers. These drugs slow the heart rate and blood pressure. You can reduce how fast the aorta is the expansion in people with Marfan syndrome.
  • Angiotensin 2 receptor blockers (arbs). These medicines may be used if beta-blockers may not be, or if you do not lower your blood pressure enough. They are often recommended for people who have Loeys-Dietz syndrome, even if they do not have high blood pressure. Examples of Arbs include losartan (Cozaar), valsartan (Diovan), and olmesartan (Benicar).
  • Statins. These medications help to reduce cholesterol. They can help reduce the risk of blockages in the arteries and the aneurysm complications. Examples of statins include atorvastatin (Lipitor), lovastatin (Altoprev), simvastatin (Zocor, FloLipid), and others.

Surgery or other procedures

It is generally recommended that the surgery of aneurysms of the thoracic aorta, about 1.9 to 2.4 inches (about 5 to 6 inches) and larger. Surgery may be recommended for smaller aneurysms if you have a family history of aortic dissection or a condition linked to aneurysm of the aorta, such as Marfan syndrome.

The type of surgery depends on:

  • The cause of the aneurysm.
  • Your health in general.
  • The location of the aneurysm.

Types of surgeries and procedures for aneurysms of the thoracic aorta are:

  • The open surgery. Most people with an aneurysm of the thoracic aorta have this surgery. A surgeon removes the part of the aorta is damaged by the aneurysm. Is replaced with a tube, called a graft, which is sewn into place.
  • Aortic root surgery. This surgery is performed to prevent an aortic aneurysm rupture. A surgeon who carries out the part of the aorta, and sometimes of the aortic valve. A graft replaces the removed part of the aorta. The aortic valve can be replaced with a mechanical or biological valve. If the valve is not removed, the surgery is called a valve-replacement of the aortic root repair.
  • Endovascular aortic aneurysm repair (EVAR).This treatment is a less invasive option to open surgery. That means it uses small surgical incisions and may allow a more rapid recovery. The surgeon places a thin, flexible tube into a blood vessel, usually in the groin, and leads to the aorta. A graft at the end of the tube is where the aneurysm. Small hooks or pins to hold the graft in place. The graft strengthens the weakened part of the aorta. EVAR can't be done all over the world. Ask your health care provider if it is right for you. After EVAR, you need regular imaging tests to ensure that the graft is functioning correctly.
  • Emergency surgery. A ruptured aneurysm of the thoracic aorta needs an emergency surgery. This open-chest surgery is risky. There is a high probability of complications. That is why it is important to detect and treat thoracic aortic aneurysms before rupture.

Endovascular aortic aneurysm repair (EVAR). This treatment is a less invasive option to open surgery. That means it uses small surgical incisions and may allow a more rapid recovery. The surgeon places a thin, flexible tube into a blood vessel, usually in the groin, and leads to the aorta. A graft at the end of the tube is where the aneurysm. Small hooks or pins to hold the graft in place. The graft strengthens the weakened part of the aorta.

EVAR can't be done all over the world. Ask your health care provider if it is right for you. After EVAR, you need regular imaging tests to ensure that the graft is functioning correctly.

Lifestyle and home remedies

If you have a thoracic aortic aneurysm, your health care team may tell you not to do the heavy lifting. You may also be told not to do some of the energy of the physical activities. Such activities may increase the blood pressure. High blood pressure can put pressure on an aneurysm.

If you want to do a particular activity, talk with your health care team. You may need a stress test to see how activity affects your blood pressure. Moderate physical activity is in general good health.

The emotional stress can also raise the blood pressure. It is important to control or reduce stress. The following are some tips for doing more exercise and the practice of mindfulness.

Coping and support

You can find that connection with others who have experienced similar situations can be useful. Ask your health care team about support groups in your area.

Preparing for your appointment

If you have a family history of aneurysms of the thoracic aorta or the conditions attached to them, make an appointment for a health checkup. If an aneurysm is detected early, treatment can be easier and more effective.

Appointments can be brief and there's often a lot to talk about. So it's a good idea to be prepared. Here's some information to help you prepare for your appointment.

What you can do

  • Ask if there is something that you need to do to prepare. For example, you may be asked not to eat or drink anything for a while before some of the tests.
  • Write down your symptoms. Include any that may seem unrelated to an aneurysm of the thoracic aorta.
  • Write important personal information, including a family history of heart disease, aneurysms, or connective tissue disease.
  • Make a list of all medications, vitamins or supplements you take. To include in the dose.
  • Bring someone along, if possible. It can be difficult to remember the information given to you during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Be prepared to talk about your diet, exercise habits and the consumption of tobacco. If you do not already follow a diet or workout routine, tell your health care professional about the challenges that you might face in the introduction. Be sure to tell your healthcare team if you smoke or have ever smoked.
  • Send images from reports, and keeping records. It is helpful if you can send pictures of your report to your healthcare provider in advance. Carry your medical records.
  • Write questions to ask their health professional.

An aneurysm of the thoracic aorta, some basic questions to ask your health care professional are:

  • What tests do I need?
  • What size is my aneurysm?
  • What treatments are available, and which do you recommend for me?
  • What is an appropriate level of physical activity?
  • Do I have to change my diet?
  • How often should I be screened for an aneurysm?
  • Should I tell other family members to be screened for an aneurysm?
  • I have other health conditions. How can I best manage these conditions?
  • Is there any information that I can take my house? What sites do you recommend?

Do not hesitate to ask any other questions.

What to expect from your doctor

Your healthcare team will usually ask you several questions. Be prepared to answer them you can save your time to go through any of the points that you want to devote more time. Your health care team may ask:

  • When did the symptoms begin?
  • Do your symptoms come and go, or do you have all the time?
  • On a scale of 1 to 10, with 10 being the worst, how bad are your symptoms?
  • Do you have a family history of aneurysms or genetic diseases, such as Marfan syndrome?
  • Do you smoke? Have you ever smoked?
  • Have you ever been told that you have high blood pressure?
  • What, if anything, do your symptoms improve?
  • What, if anything, make your symptoms worse?

What you can do in the meantime

Changes healthy lifestyle can help protect the heart and blood vessels. It is never too early to start. Eating healthy foods, staying active and not smoking. Taking these steps can help prevent the aneurysm of the thoracic aorta and its complications.

If you're diagnosed with an aneurysm of the thoracic aorta, ask how often you need health screenings.

Symptoms and treatment of aneurysm of the Thoracic aorta