What is thoracic aortic aneurysm?

A thoracic aortic aneurysm is a bulge in a section of the aorta in the chest (thorax). The section with the aneurysm is overstretched and weak, so it can burst. If the aorta bursts, it can cause serious bleeding that can quickly lead to death.

Most people with thoracic aortic aneurysms don't have symptoms. But symptoms may occur if the aneurysm gets bigger and puts pressure on surrounding organs.

Symptoms are most evident when the aneurysm occurs where the aorta curves down (aortic arch). They may include:

• Chest pain, generally described as deep and aching or throbbing. This is the most common symptom.
• Back pain.
• A cough or shortness of breath if the aneurysm is in the area of the lungs.
• Hoarseness.
• Trouble swallowing, or pain while swallowing.

The symptoms are similar to the symptoms of other problems that cause chest or belly pain. These problems include coronary artery disease, gastroesophageal reflux disease (GERD), and peptic ulcer disease.

If an aortic aneurysm bursts, or ruptures, there is sudden, severe pain, an extreme drop in blood pressure, and signs of shock. Without immediate treatment, it can quickly lead to death.

Thoracic aortic aneurysms are often found by chance during tests done for other reasons.

If your doctor thinks you might have a thoracic aneurysm, you will have a physical exam. You may also have imaging tests. Tests that may be done include:

• Chest X-ray.
• CT scan.
• MRI.
• Echocardiogram.

These tests can help your doctor find where the aneurysm is, how big it is, and how fast it's growing. The doctor can use this information to suggest the best way to treat the aneurysm.

A thoracic aortic aneurysm may be repaired if there's a high risk that it will burst (rupture). Small aneurysms rarely rupture. Aneurysms that are large, cause symptoms, or grow quickly are more likely to rupture.

Small aneurysms.

These usually aren't repaired. You'll have regular tests to check the size and growth of the aneurysm. Many people get tested every 6 to 12 months.

Large or fast-growing aneurysms.

Your aneurysm will need to be fixed if it's large, growing quickly, or causing symptoms. A surgeon will repair the damaged part of the aorta. This can be done using open surgery or a less invasive procedure. Your doctor can help you decide what's right for you.

For any aneurysm, you may take medicines to help lower your blood pressure and cholesterol. Your doctor may also advise you to make lifestyle changes that are good for your heart, like quitting smoking.

• Manage blood pressure. A healthy lifestyle along with medicines may help you lower your blood pressure.
• Manage cholesterol to help keep your blood vessels healthy. A healthy lifestyle along with medicines may help you manage cholesterol.
• Do not smoke. Smoking can make the aneurysm grow faster. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Stay at a healthy weight. Lose weight if you need to.
• Eat heart-healthy foods. These include fruits, vegetables, whole grains, fish, and low-fat or nonfat dairy foods. Limit sodium, alcohol, and sweets.
• Ask your doctor what type and level of activity is safe for you. If your doctor recommends it, get regular exercise. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least 30 minutes on most days of the week. You also may want to swim, bike, or do other activities.
• Manage other health problems. If you think you may have a problem with alcohol or drug use, talk to your doctor.