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Thoracic Aortic Aneurysm (TAA)

Thoracic Aortic Aneurysm is abnormal widening of an artery. A weakened wall of an artery is stretched as the blood is pumped through it often creating an egg-shaped ballooning. A thoracic aortic aneurysm (thoracic aortic aneurysm) is the swelling or ballooning of the thoracic aorta. The aorta is the main artery that carries oxygen filled blood from the heart to all parts of the body. In the thorax (chest), once leaving the heart, blood travels upward through the ascending aorta turning into the aortic arch and branching into the innominate, carotid and subclavian arteries. These branch vessels carry blood to the heart muscle, arms, shoulders, chest, neck, face, and head (including brain). Once past the aortic arch, the aorta turns downward turning into the descending aorta and carries blood to the intercostal arteries, spinal arteries, and ultimately other lower organs and areas of the body

Thoracic aortic aneurysms are serious because they can burst or rupture causing severe internal bleeding, which can rapidly lead to shock or death. Researchers believe that atherosclerosis, (hardening of the arteries), causes thoracic aortic aneurysms.

Risk Factors

  1. Smoking
  2. High blood pressure
  3. High cholesterol
  4. Obesity
  5. Marfan’s syndrome
  6. Syphillis

These risk factors will lead to weakening of the aorta. Continuous blood pressure against this weakened area can result in the ballooning (enlarging and thinning) of the aorta.

Symptoms

Many people do not experience any symptoms of a thoracic aortic aneurysm.  When symptoms do occur, pain is most commonly experienced. This can occur in the chest or back area, shoulders, neck and abdomen. Some patients describe the pain as anything from mild to severe, or a tenderness in the mid or upper chest, back or shoulders. Again, many people may not experience any of these symptoms, yet still be found to have a thoracic aortic aneurysm. Your doctor may discover a thoracic aortic aneurysm during a routine physical exam. Most often, aneurysms are found during a medical test such as a CT (Computed Tomography or CAT scan), MRI (Magnetic Resonance Imaging Scan) or cardiac catheterization (angiogram) procedure.

What will happen if your aneurysm is left untreated?

While the thoracic aorta’s diameter, normally ranges from l to 1.5 inches (2 - 4 cm), an aneurysm can cause it to grow to several times its normal size. This condition, if not treated, could result in a rupture (bursting) of the aorta leading to internal bleeding. The risk of rupture increases with aneurysm size and high blood pressure.

Diagnostic Tests

  1. Chest X-ray
  2. Echocardiography
  3. Magnetic Resonance Imaging (MRI)
  4. Computed tomography Scan(CT)
  5. Angiography

Treatment:

Medical management: is the first choice for treatment, including reducing blood pressure and minimizing other risk factors. Medical management usually includes keeping your blood pressure under control, quitting smoking and reducing cholesterol in your diet. If an aneurysm is small it will be monitored with CT or MRI every six months. Blood pressure will also be monitored and medicated as necessary.

If the aneurysm is large and causing symptoms, it must be treated immediately. Options include surgical repair  or endovascular stenting repair.

 

 

 

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