A thoracic aortic aneurysm is a weakening of the upper aorta, which is the large blood vessel that sends blood to the rest of the body. The condition is sometimes called thoracic aneurysm and aortic dissection (TAAD) due to the possibility of an aneurysm causing a tear within the artery wall that can lead to life-threatening bleeding. Thoracic aortic aneurysms may be small and grow slowly, or they can be large and fast growing. Large ones are more likely to rupture.
Aneurysms can appear anywhere on the thoracic aorta. Several factors can contribute to its formation, including hardened arteries, various genetic and medical conditions, untreated infections, issues with the aortic valve, and traumatic injury. Patients with a bicuspid aortic valve, a connective tissue disease like Marfan syndrome, or a family history of aortic aneurysm are more likely to encounter the condition and should consider regular exams and screenings.
Patients with a slow growing thoracic aortic aneurysm may go for years without any symptoms. As it grows, they are likely to experience:
Some people may notice nothing amiss unless a tear or rupture appears. When this happens, common symptoms include difficulty breathing, a sudden sharp pain in the upper back, and pain in the neck, chest, arms, or jaw.
Hardening of the artery walls is one cause of thoracic aortic aneurysms and this occurs as people get older and plaque begins to build up along the artery walls. High blood pressure and high cholesterol contribute to the hardening of arteries, which, in turn, makes the individual more susceptible to experiencing a thoracic aortic aneurysm.
The condition can also be prompted through genetics. Marfan syndrome affects the body’s connective tissue and, as such, can cause the weakening of the aorta wall that can lead to an aneurysm.
Ehlers-Danlos and Loeys-Dietz syndromes can also have the same effect on the body, creating weaker connective tissue that may ultimately lead to an aneurysm.
Other conditions may cause the emergence of a thoracic aortic aneurysm, such as the inflammation seen in giant cell arteritis and Takayasu arteritis. Heart conditions in which there is a faulty aortic valve may increase the development of an aneurysm. Subjects born with a bicuspid aortic valve, as opposed to those born with three valves, are especially at risk.
In rare circumstances, an untreated infection or a traumatic injury can also lead to a thoracic aortic aneurysm.
How a thoracic aortic aneurysm is treated depends on its size and how quickly it is growing. Large and fast growing aneurysms will likely need surgery to repair the damaged blood vessel. Small aneurysms that are not likely to rupture are typically treated with blood pressure medications to lessen the stress placed on the aortic wall. If surgery is not done, routine ultrasounds are recommended to monitor whether the aneurysm is getting any bigger.
While genetic conditions can’t be prevented, other conditions that make a thoracic aortic aneurysm more likely can be reduced. Smoking will contribute to the hardening of the artery walls, as will a poor diet. In conjunction with eating healthier, blood pressure and cholesterol levels should be monitored regularly. Additionally, regular exercise will provide greater blood circulation and reduce the risk of plaque building up in the arteries.
Injuries from falls and traffic accidents have also resulted in the development of a thoracic aortic aneurysm, so following safety rules can also help reduce the risk.
While it is possible to be genetically predisposed to experience a thoracic aortic aneurysm, there are steps every person can take to reduce risks. In general, living a healthy lifestyle has been shown to greatly increase the chance that a thoracic aortic aneurysm will never occur.