Aortic Aneurysm

Aneurysm India

The aorta, which is the main artery in the body, transports blood from your heart to all other parts of the body. The aorta is defined by the part of the body it runs through. As it courses the chest, it is called the thoracic aorta; through the abdomen it is called the abdominal aorta.

What is an Aortic Aneurysm ?

At times the aorta will weaken, bulge or expand and when it does it is referred to as an aneurysm. Over time, the weakening of the aorta due to vascular disease, injury or a hereditary defect of the tissue within the arterial wall can cause an aneurysm.

If the aneurysm occurs in the chest it is called a thoracic aortic aneurysm(TAA). If it occurs in the abdomen it is called an abdominal aortic aneurysm(AAA). The most common site in the abdomen, is below the area where the aorta divides to supply blood to the kidneys. This is called an infrerenal abdominal aortic aneurysm.

Abdominal Aneurysm India

What are the signs & symptoms of an Aortic Aneurysm ?

Majority of the thoracic and abdominal aortic aneurysms do not have any symptoms, hence they are known as 'silent killers'.

They are incidentally detected on routine examinations, such as X-ray of the chest/spone, echocardiography, ultrasound and other radiological investigations(CT & MRI)

When symptoms are present, they are usually present as...

In cases of thoracic aneurysms/dissections:

  • Chest pain - often radiating to the back and shoulders
  • Back pain - which is often mistaken as spine problems
  • Hoarseness of voice

In cases of abdominal aortic aneurysms:

  • Abdominal pain
  • Lower back pain
  • Feeling a pulse, soft mass in the abdomen

If the aneurysm enlarges rapidly, it can burst and is known as a ruptured aortic aneurysm, which is life threatening. This requires immediate emergency care.

Ruptured aneurysms should be avoided, since the results of treating them are very poor. Hence early detection and treatment of aneurysms are mandatory

Am I at risk?

Risk factors for developing an aneurysm are family history, smoking, heart disease, high blood pressure and high fat diet.

They are known to occur more frequently in the older population, although thoracic aneurysms and dissections are known to occur in younger individuals also.

The most significant risk factors are smoking, history of heart disease and a family history. If you are in the high risk category, screening tests such as ultrasound and computed tomography can be done.

Aneurysm rupture

What to do if I have an aneurysm/dissection ?

If there is a high risk of an aneurysm/dissection or you have been detected to have one, you could consult your physicican or head to

A detailed physical examination and blood ivestigation should be done for assessing the fitness of the patient for treatment. If there is no contraindication a computed tomography angiography (16 slice minimum, preferably 64 slice) should be performed.

A CT scan will give the location, exact dimensions and relationship of the aneurysm to the main branch arteries of the body. This will help plan whether treatment is required and what sort of treatment should be planned. In a few cases of a CT scan cannot be performed or if additional information is required, then a digital subtraction angiogram (DSA) or a magnetic resonance imaging (MRI) mmay be done.

Size is an important criterion for aneurysms. The normal aorta in the chest measures 2.5-3.2 cms, and in the abdominal aorta measures 1.8-2.3 cms. If the thoracic or abdominal aneurysm is less than 4.5cms in its maximum diameter, then medical management id advised with regular radiologic follow up. If the size is greater than 4.5cms then treatment should be planned. In cases of dissections, detailed discussion and planning has to be done to decide the treatment.