What is an aortic aneurysm?

An aortic aneurysm is a bulge in the wall of the body’s largest artery, the aorta, which carries oxygen-rich blood to smaller arteries throughout the body. The aorta runs from the heart through the center of your chest to the abdomen. The upper portion of the vessel, located in the chest, is called the thoracic aorta, and the lower portion (below the diaphragm) is called the abdominal aorta.

If a segment of the aorta’s wall becomes weakened or damaged, it can balloon outward in an aneurysm. Aortic aneurysms can be dangerous if they rupture and cause a person to bleed internally. Aortic aneurysms often produce few symptoms, though an ascending aortic aneurysm may cause chronic vocal hoarseness, and an abdominal aortic aneurysm may cause a pulsing feeling around the navel.

Aortic aneurysms occur in about 5% of the general population, although that rate increases with age. Thoracic aortic aneurysms appear to affect men and women equally, while abdominal aortic aneurysms (AAA) disproportionately affect men, especially those who smoked at any time in their life. Men older than 65 who ever used cigarettes should undergo a one-time, noninvasive imaging study to screen for AAA.

When diagnosed early, doctors can treat aortic aneurysms with medications or repair surgery. However, a tear in the lining of the aorta—called aortic dissection—and ruptured aortic aneurysm requires immediate medical care. Call 911 for signs and symptoms of aortic dissection or a ruptured aortic aneurysm.

What are the symptoms of an aortic aneurysm?

Aortic aneurysms often present no symptoms until they dissect or rupture. Seek immediate medical care (call 911) if you or someone you are with experiences any of the following aortic aneurysm symptoms.

Common symptoms of ruptured thoracic aortic aneurysm

Sudden, severe pain in the jaw, chest or upper back, especially pain that radiates into the abdomen
Shortness of breath
Inability to swallow or trouble swallowing
Coughing or hoarseness
Loss of consciousness, paleness, cool skin

Common symptoms of ruptured abdominal aortic aneurysm

Sudden, severe “tearing” pain or throbbing in the abdomen
Nausea with or without vomiting
Cool, clammy skin
Loss of consciousness

Abdominal aortic aneurysms tend to grow slowly and often can be diagnosed before they rupture. If you experience any of the symptoms of an abdominal aortic aneurysm or if you are at high risk for developing an AAA, you should seek prompt medical care.

Common symptoms of abdominal aortic aneurysm

Pulsing feeling (or visible pulsation) between the sternum (breastbone) and the navel (belly button)
Deep abdominal pain that lingers for hours or days

What causes aortic aneurysms?

Several factors can damage or weaken the aortic wall leading to an aneurysm. Common causes of aortic aneurysms include:

High blood pressure
Atherosclerosis (hardening of the arteries)
Infections and inflammatory conditions like vasculitis
Genetic conditions including Marfan syndrome, Loeys-Dietz syndrome, the vascular type of Ehlers-Danlos syndrome, and Turner syndrome
Chest trauma

What are the risk factors for aortic aneurysms?

Risk factors for aortic aneurysms include:

Male gender older than 65
Smoking
Family history of aortic aneurysm
History of cardiovascular disease including high blood pressure or high cholesterol
History of aneurysms in the legs
Having a malformed aortic valve in the heart

Reducing your risk of aortic aneurysm

You may be able to lower your risk of aortic aneurysms by:

Not smoking
For men, notifying your doctor if you are older than 65 and smoked cigarettes at any time in your life, even if you quit long ago
Following a heart-healthy lifestyle that includes eating wholesome foods and getting regular exercise
Controlling your blood pressure

How is an aortic aneurysm treated?

A ruptured aneurysm requires emergency aortic aneurysm repair. If an aneurysm is detected prior to rupturing, then treatment focuses on slowing the growth of the aneurysm, removing it, or reducing pressure on it. Aortic aneurysm repair and treatment may include:

Monitoring, if the aneurysm is small
Medicine to control blood pressure or relax the blood vessels
Open surgical repair to remove the aneurysm and replace that section of the aorta with a graft of synthetic material
Catheterization procedure—endovascular aortic aneurysm repair, or EVAR—to place a stent inside the aorta

What are the potential complications of aortic aneurysms?

Left untreated, an aortic aneurysm can cause life-threatening bleeding. A thoracic aortic aneurysm also can cause a condition called aortic dissection, in which blood flows between the tissue layers of the artery wall. Other potential complications of aortic aneurysm are: