Aortic aneurysm
Reading File
Reading File
Finding Sources
Finding Sources
Searching PubMed
"aortic aneurysm"[MeSH Terms]
Searching the Web
aortic aneurysm symptoms screening treatment guidelines Society for Vascular Surgery
Reading File
Reading File
Finding Sources
Searching Images
diagram of thoracic and abdominal aortic aneurysm anatomy
An aortic aneurysm is an abnormal, persistent widening of the aorta, the body’s largest artery. It may occur in the:
- Abdominal aorta: abdominal aortic aneurysm, or AAA
- Thoracic aorta: thoracic aortic aneurysm, or TAA
- Both regions: thoracoabdominal aneurysm
A true aneurysm involves all three layers of the vessel wall. It can be fusiform (circumferential widening) or saccular (a localized outpouching). Harrison’s Principles of Internal Medicine, 22e, p. 2208-2209.
Why it matters
Most aneurysms grow silently, but enlargement can lead to:
- Rupture, causing internal bleeding and shock
- Dissection, a tear within the aortic wall
- Blood clot formation with emboli traveling to the legs or other organs
Risk factors
Common risk factors include older age, smoking, high blood pressure, atherosclerosis, high cholesterol, male sex, and family history. Thoracic aneurysms may also be associated with inherited connective-tissue disorders such as Marfan syndrome, Loeys-Dietz syndrome, and vascular Ehlers-Danlos syndrome. Harrison’s Principles of Internal Medicine, 22e, p. 2209.
Symptoms
Often there are no symptoms. Possible symptoms depend on location:
- AAA: pulsating abdominal sensation, abdominal or back pain
- TAA: chest, upper-back, or interscapular pain; occasionally hoarseness or difficulty swallowing
Call emergency services immediately for sudden severe chest, back, or abdominal pain, fainting, sweating, weakness, or low blood pressure. A ruptured AAA may not show the classic triad of pain, hypotension, and a pulsatile mass. Rosen’s Emergency Medicine, Key Concepts.
Diagnosis and treatment
- Ultrasound is commonly used to screen and monitor AAA.
- CT angiography or MRI/MRA defines anatomy and guides treatment.
- Small, stable aneurysms are monitored while blood pressure, smoking, and cardiovascular risk are addressed.
- Larger, rapidly enlarging, symptomatic, or leaking aneurysms may need open surgical repair or endovascular repair.
The Society for Vascular Surgery recommends ultrasound as the preferred modality for AAA screening and surveillance, including one-time screening in people aged 65 or older with a history of tobacco use and in first-degree relatives of people with AAA. See the SVS patient guidance.
A recent systematic review also reaffirmed associations of AAA with smoking, hypertension, male sex, and other factors (PMID 40982438).
This is a shared conversation. Sign in to Orris to start your own chat.