Thoracic Aortic Aneurysm – Symptoms and Causes

ByJanis Updated

Overview

A thoracic aortic aneurysm occurs when the main artery in the chest (aorta) weakens and widens. This weakening can create a bulge in the vessel wall. When this bulge becomes significant, doctors classify it as an aneurysm.

These aneurysms require different treatment approaches based on several factors:

  • Size of the aneurysm
  • Rate of growth
  • Underlying cause

Treatment options range from regular monitoring with health checkups to emergency surgical intervention in severe cases. Thoracic aortic aneurysms are less common than their abdominal counterparts, which form in the lower section of the aorta.

Potential Complications:

  • Aortic rupture (complete tear of the vessel wall)
  • Aortic dissection (dangerous tear between layers of the vessel wall)

Both complications can be life-threatening and may lead to sudden death if not treated promptly.

Signs of Thoracic Aortic Aneurysms

Thoracic aortic aneurysms often grow slowly and without clear warning signs. Many remain small and cause no problems. Others expand over time, though growth rates vary from person to person.

When symptoms do appear, they may include:

  • Pain in the back
  • Coughing
  • Voice changes (weakness or scratchiness)
  • Breathing difficulties
  • Chest pain or tenderness

If an aneurysm ruptures or dissects (tears), more severe symptoms appear suddenly:

Urgent Warning Signs Description
Back Pain Sharp and sudden in the upper back, often spreading downward
Chest Pain May extend to jaw, neck or arms
Breathing Problems Severe shortness of breath
Blood Pressure Drop Can cause dizziness or fainting
Loss of Consciousness May occur suddenly
Swallowing Difficulty Can develop when the aneurysm presses on the esophagus

When Medical Help Is Needed

Since most aortic aneurysms don’t cause symptoms until they become dangerous, knowing when to get help is critical.

If you experience sudden, severe chest or back pain, breathing problems, or fainting, call 911 immediately. These could signal an aneurysm rupture or dissection, which is a life-threatening emergency requiring immediate medical treatment.

Causes

The main artery of the body, called the aorta, can develop bulges known as aneurysms in various locations. These may form in the chest area (thoracic aortic aneurysms) or between the chest and belly regions (thoracoabdominal aneurysms).

Thoracic aneurysms can be either round or tube-shaped and may appear anywhere in the chest portion of the aorta.

Several factors can lead to the development of thoracic aortic aneurysms:

  • Artery Hardening: Plaque builds up on artery walls (atherosclerosis), making them less flexible. This weakening can cause the arteries to widen, especially with high blood pressure or high cholesterol. Older adults face higher risks.

  • Genetic factors: Younger people with aortic aneurysms often have inherited conditions. Marfan syndrome weakens the body’s connective tissue, including aortic walls. Other genetic conditions linked to aortic problems include:

    • Vascular Ehlers-Danlos syndrome
    • Loeys-Dietz syndrome
    • Turner syndrome

  • Blood Vessel Inflammation: Conditions like giant cell arteritis and Takayasu arteritis can increase aneurysm risk.

  • Aortic Valve Abnormalities: Being born with a two-flap aortic valve instead of the normal three flaps raises the risk of thoracic aneurysms.

  • Untreated Infections: Though rare, infections like syphilis or salmonella can sometimes lead to thoracic aortic aneurysms.

  • Physical Trauma: In rare cases, injuries from falls or vehicle accidents may cause these aneurysms.

Blood Vessel Emergencies

When the wall of the aorta tears, this creates a condition called aortic dissection. This serious problem allows blood to flow between the layers of the aortic wall.

Sometimes the bleeding extends completely outside the aorta, which is called an aortic rupture.

Aortic dissection represents a potentially life-threatening emergency. The severity depends on the location of the tear in the aorta.

Proper treatment of aortic aneurysms is crucial to prevent dissection. Even when dissection occurs, surgery remains an option, though the risk of complications increases significantly.

Risk Factors

Several factors can increase your chance of developing a thoracic aortic aneurysm:

  • Age: People 65 and older face higher risk as blood vessels naturally weaken over time.
  • Tobacco Use: Smoking significantly damages blood vessels and greatly increases aneurysm risk.
  • High Blood Pressure: The constant force of elevated blood pressure weakens arterial walls over time.
  • Plaque Buildup: Fat deposits in arteries (atherosclerosis) can damage vessel linings, especially in older adults.
  • Family History: Having a close relative with an aortic aneurysm raises your risk and may lead to earlier onset.
  • Genetic Conditions: These inherited disorders significantly increase the chance of developing an aneurysm and the risk of rupture or dissection:
    • Marfan syndrome
    • Loeys-Dietz syndrome
    • Vascular Ehlers-Danlos syndrome
  • Bicuspid Aortic Valve:This heart valve abnormality (having two valve flaps instead of the normal three) often occurs alongside aortic weaknesses.

Some risks like smoking and blood pressure can be controlled, while others like genetics cannot.

Complications

Thoracic aortic aneurysms can lead to serious health problems. The most dangerous complications include tears or ruptures in the aorta’s wall. Small aneurysms that grow slowly might never rupture, but larger ones carry higher risks.

Possible complications include:

  • Internal Bleeding: When an aneurysm ruptures, it causes life-threatening bleeding inside the body. This requires immediate emergency surgery to prevent death.

  • Blood Clots: These can form inside the aneurysm area. If a clot breaks free, it may travel to other parts of the body and block blood flow to important organs.

  • Stroke: If blood flow to the brain is blocked, a stroke can occur. Signs include:

    • Weakness on one side of the body
    • Inability to move one side of the body
    • Speech difficulties

The risk of these complications typically increases with the size of the aneurysm.

Ways to Prevent Aneurysms

Keeping your blood vessels healthy plays a key role in preventing aneurysms. Health experts suggest several heart-healthy habits:

  • Stop tobacco use – don’t smoke or use any tobacco products
  • Monitor health numbers – keep blood pressure and cholesterol under control
  • Stay active – exercise regularly
  • Eat well – reduce fat and cholesterol in your diet

While no specific medicines prevent aortic aneurysms, medications can treat related conditions like high blood pressure and cholesterol.

Testing and Family Risk Factors

Thoracic aortic aneurysms often run in families. Your doctor might suggest screening if you have a close relative with Marfan syndrome or another condition linked to these aneurysms.

Screening involves regular imaging tests. Usually, an echocardiogram is used to check for aneurysms. If your heart ultrasound shows an enlarged aorta or an aneurysm, doctors typically perform another imaging test within 6-12 months to monitor any growth.

If you have a family history of aortic aneurysms, genetic testing might be recommended. This is particularly important if you’re thinking about becoming pregnant.


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Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.