What is an Enlarged Aorta or Aortic Aneurysm?

The aorta is your largest artery and it brings oxygenated blood to all parts of the body. If the walls of the aorta become weak, an enlargement can occur, which is known as an aortic aneurysm. Aneurysms can form in any section of the aorta, but are most common in the abdomen (abdominal aortic aneurysm) or the upper body (thoracic aortic aneurysm). Dilated valves near the aortic root closest to the heart are also common. Thoracic aortic aneurysms are also known as ascending or descending aortic aneurysms.

There is reason to be concerned if you have an aortic aneurysm: If the vessel becomes too large, it could rupture, which is extremely dangerous and can cause life-threatening bleeding.

Baptist Health is known for advanced, superior care for patients with heart disease and the diagnosis, management and repair of aortic aneurysm. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Enlarged Aorta or Aortic Aneurysm Signs and Symptoms

An aortic aneurysm can be slow to grow and exhibit no symptoms. That’s why regular checkups are important. However as it enlarges, aortic dilation symptoms like these may include:

• Pain in the chest or upper back. The pain may be deep, aching, gnawing, and/or throbbing, and may last for hours or days. It is generally not affected by movement, although certain positions may be more comfortable than others.
• Shortness of breath, a raspy voice.
• Pain in the left shoulder or between the shoulder blades.
• Pain in the groin.

Aortic Aneurysm Diagnosis

Early diagnosis is critical in managing an aortic aneurysm. To diagnose an aortic aneurysm, we ask questions about your medical history and do a physical exam. We then use advanced technology to effectively diagnose, inform treatment and carefully monitor the condition. Common diagnostic procedures can include:

Abdominal ultrasound: During this test, sound waves are transmitted through the body tissues of the abdomen. The echoes from the sound waves are converted into video or photographic images.

Angiogram: A thin tube (catheter) is inserted into a blood vessel and dye is injected to make the blood vessel visible during an X-ray. This can show any blood clots or other blood vessel issues.

Chest X-ray: A common imaging test of the lungs, heart and aorta.

CT scan: X-rays and computers are used to create images of the aorta, heart and blood vessels. This provides a more detailed picture than an ultrasound.

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves.

Magnetic resonance imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels.

Aortic Aneurysm Causes

There are a number of factors that can cause the walls of the arteries to weaken and lead to an aneurysm:

• Buildup of fat and plaque on the lining of the arteries
• High blood pressure
• Infection in the aorta
• Tobacco use

Risk Factors

Risk factors that could contribute to an aortic arch aneurysm include:

Age: Most aortic aneurysms occur in people over age 65.

Aortic valve problems: People born with a bicuspid aortic valve are at higher risk for aortic aneurysm.

Congenital conditions: Conditions like Marfan Syndrome, an inherited weakness in the blood vessel wall, can contribute to aortic aneurysms. Marfan syndrome is a genetic disorder that weakens the body’s connective tissue which can affect how the heart and blood vessels work. If Marfan syndrome affects the aorta—the main blood supplier to the body— it can be life threatening.

Family history: People with a family history of aneurysms tend to develop them at a younger age and are at higher risk of a rupture.

Infection: Some infections, like syphilis or salmonella, that are untreated can lead to aortic aneurysm.

Prevention

While some risk factors like age and heredity cannot be controlled, there are ways you can help to prevent an aortic aneurysm:

Practice good heart health: Watch what you eat, exercise and avoid smoking.

Take your medications as prescribed: If you have high blood pressure, high cholesterol or diabetes, be certain to take your prescribed medications as directed.

Get scanned: The Society for Vascular Surgery and the Society for Vascular Medicine and Biology recommend abdominal ultrasound screening for all: men age 65 or older, and men as young as age 55 with a family history of aortic aneurysm; and women age 65 or older with a family history of aortic aneurysm or those who have smoked.

Aortic Aneurysm Prognosis

Prognosis is usually good when an aortic aneurysm is treated before it ruptures.

Treatment and Recovery

Treatment for an aortic aneurysm depends on its size, location and your overall health. Once an aortic aneurysm has been diagnosed, our goal is to develop an individualized plan to treat it so it will not develop to a dangerous level and rupture. Depending on the size of the aortic aneurysm, treatment can include:

Medication

If the size of the aortic aneurysm is small, medication may be used to slow its growth rate. It is imperative that your blood pressure be monitored and blood pressure medication be taken as prescribed. A statin medication, which lowers cholesterol and can help keep your blood vessels healthy, may also be prescribed. Regular testing is an important way to keep a watchful eye on the aneurysm.

Surgery

The most effective treatment for a larger, fast-growing or leaking aneurysm is surgery. You may be recommended for aortic aneurysm repair via traditional open surgery or a less invasive procedure called endovascular surgery. The type of procedure recommended for you depends upon the location and appearance of the aneurysm and your health.

During open surgery, the weakened section of the vessel will be removed and replaced with a graft. If the aneurysm is close to the aortic valve (the valve that regulates blood flow from the heart into the aorta), a valve replacement may also be recommended during the procedure.

During endovascular surgery, a stent graft is positioned inside the diseased section of the aorta. The stent acts as a liner to divert blood flow away from the aneurysm.

Recovery After Surgery

Depending upon how your body heals, you will be in the hospital for up to 10 days after open surgery and it may be three to six months before you feel able to fully resume your normal activities. After endovascular surgery, you will be in the hospital for a few days and it may be four to six weeks before you fully recover.

Complications

If an aortic aneurysm is not diagnosed and treated, the aneurysm could cause serious health problems. Those problems can include:

Rupture: Because the aorta is the main supplier of blood to the body, a rupture could cause life-threatening bleeding. This creates an emergency surgical situation.

Blood clots: Blood clots can weaken the heart and affect its ability to pump blood through the body. If a blood clot breaks loose, it could block a blood vessel anywhere in your body.