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Overview
What is a thoracic aortic aneurysm?
An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. A thoracic aortic aneurysm (TAA) occurs in the part of the body’s largest artery (the aorta) that passes through the chest.
What are thoracic aortic aneurysm symptoms?
Aneurysms develop slowly over many years. Most people have no symptoms until the aneurysm begins to leak or expand. Symptoms often begin suddenly when:
- The aneurysm grows quickly
- The aneurysm tears open (called a rupture)
- Blood leaks along the wall of the aorta (aortic dissection)
If the aneurysm presses on nearby structures, the following symptoms may occur:
- Hoarseness
- Problems swallowing
- High-pitched breathing (stridor)
- Coughing (sometimes with blood)
- Swelling in the neck
Other symptoms may include:
- Chest or upper back pain
- Clammy skin
- Nausea and vomiting
- Rapid heart rate
- Sense of impending doom
What causes a thoracic aortic aneurysm?
The most common cause of a thoracic aortic aneurysm is hardening of the arteries (atherosclerosis). This condition is more common in people with:
- High cholesterol
- Long-term high blood pressure
- Who smoke
How to know if you're at risk of a thoracic aortic aneurysm
Other risk factors for a thoracic aneurysm include:
- Changes caused by age
- Connective tissue disorders such as Marfan or Ehlers-Danlos syndrome
- Inflammation of the aorta
- Severe chest injury from falls or motor vehicle accidents
How doctors diagnose aortic aneurysms
Often a physical exam is normal unless a rupture or leak has occurred. Most thoracic aortic aneurysms are found on imaging tests performed for other reasons. These tests include chest X-ray, echocardiogram, chest computed tomography (CT) scan or magnetic resonance imaging (MRI.) A chest CT scan shows the size of the aorta and the exact location of the aneurysm. An aortogram (a special set of X-ray images made when dye is injected into the aorta) can identify the aneurysm and any branches of the aorta that may be involved.
What are the treatment options for a thoracic aortic aneurysm?
There is a risk that the aneurysm may open (rupture) if you do not have surgery to repair it. The treatment depends on the size, location, and growth rate of the aneurysm. The aorta is made of three parts:
- The first part moves upward toward the head. It is called the ascending aorta.
- The middle part is curved. It is called the aortic arch.
- The last part moves downward, toward the feet. It is called the descending aorta.
Aneurysms of ascending aorta
For people with aneurysms of the ascending aorta or aortic arch:
- Small aneurysms are usually monitored with regular imaging and managed with medications to control blood pressure.
- Large aneurysms measuring 5 to 6 centimeters (approximately 2 inches) require surgical repair through open surgery or endovascular stent grafting.
Aneurysms of descending thoracic aorta
For people with aneurysms of the descending thoracic aorta:
- Small aneurysms are usually monitored with regular imaging and managed with medications to reduce stress on the aortic wall.
- Large aneurysms measuring larger than 6 centimeters (2.3 inches) require surgery or endovascular repair. Endovascular repair with stent grafting is often preferred because it is less invasive than open heart surgery.
Your care team will discuss all the risks and possible complications of all procedures or surgeries.
How to prevent a thoracic aortic aneurysm
While not all aneurysms can be prevented, certain measures can reduce the risk:
- Control blood pressure: Maintaining healthy blood pressure is crucial.
- Avoid smoking: Smoking can damage the blood vessels and increase aneurysm risk.
- Manage cholesterol levels: Reducing cholesterol can help prevent atherosclerosis.
- Regular monitoring: For those with a family history or certain genetics, regular check-ups and imaging can help catch aneurysms early.
What it's like to live with a thoracic aortic aneurysm
The outlook for individuals with a thoracic aortic aneurysm depends on several factors, including the aneurysm’s size, growth rate, location and the person’s overall health.
Small aneurysms that are monitored and managed with lifestyle changes and medication often have a good prognosis. Large aneurysms or those that rupture have a more serious outlook and require immediate medical intervention. With early detection and appropriate treatment, many individuals can manage the condition effectively and reduce the risk of complications.
Thoracic aortic aneurysm treatment near you
Cardiology services at Ballad Health
Our extensive network of highly trained cardiologists, surgeons and advanced practice providers are here to support you and help you navigate a heart-related diagnosis.
Learn more about heart and vascular services at Ballad Health.
CVA Heart Institute Learning Center
We understand that receiving a thoracic aortic aneurysm diagnosis can be overwhelming. Our goal is to alleviate your fears and help you to understand your condition.
We have an informational video library, education tools and heart-related FAQs so that you have the resources you need.
Heart care patient stories
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Read our patient stories
Our patients inspire us every day, and we’re honored when they trust us with their care. They tell their stories best, so we’ve gathered a few here to share with you.
Many of these patients received life-saving care for heart conditions when they weren’t experiencing any symptoms. These experiences have changed they way they look at their individual care and helped them see the importance of regular preventive screenings.