October 01, 2019

Thoracic aortic aneurysm

Often silent, sometimes serious

The aorta is the body's largest blood vessel, a superhighway responsible for carrying oxygen-filled blood from the heart to the body. Shaped like a candy cane, and about as wide as a garden hose, the aorta exits from the top of your heart with initial branches that supply blood to the head, including the brain. It then curves downward through the abdomen, with additional branches to the internal organs, arms and legs.

An aneurysm occurs when one or more areas along the wall of the aorta becomes weak or damaged. With time, the pressure of blood flowing through the weakened area can cause it to enlarge or bulge — typically silently, without signs or symptoms.

Most commonly, bulges occur in the abdomen (abdominal aortic aneurysm). However, aneurysms may also develop closer to the heart in the chest area (thoracic aortic aneurysm).

The main concern with aortic aneurysms is a tear (dissection) or, more seriously, a rupture, which allows blood to leak into the aorta's lining or into the body. A dissection or rupture requires quick recognition of symptoms that may include:

  • Sharp, severe, sudden chest or upper back pain that radiates downward, or includes the jaw, neck or arms
  • Difficulty breathing or swallowing
  • Clamminess

Immediate emergency care — including open-chest surgery — is necessary for a dissection or rupture. Unfortunately, both are often fatal.

A bulge near the heart

Most aortic aneurysms are small and develop slowly. Most are discovered when imaging is performed on the chest...