The aorta is the main blood vessel that leads blood away from the heart to the body. The thoracic aorta is the part of this blood vessel that runs through the chest. A thoracic aneurysm is a bulging, weakened area in the wall of the thoracic aorta. Over time, the blood vessel balloons, weakens, and is at risk for bursting (rupture) or separating (dissection). This can be a life-threatening disease if not discovered early. Different problems can cause thoracic aortic aneurysms, from genetic disorders to atherosclerosis to degenerative disease that causes the breakdown of the tissue of the aorta.
Thoracic aortic aneurysms may not cause symptoms. When symptoms do occur, they may be related to location, size, and how fast the aneurysm is growing. Sudden, severe pain associated with a thoracic aneurysm may be a sign of a life-threatening medical emergency. Symptoms of a thoracic aneurysm may include:
Treatment depends on the size of the aneurysm. If the aneurysm is less than 5 cm (or 2 inches) and not growing rapidly, your doctor will probably recommend a repeat ultrasound every 6 to 12 months. If the aneurysm is 5.5 cm or larger, or if it is expanding rapidly, surgery to repair the aneurysm is generally recommended because there’s a higher risk for rupture.
An aortic dissection starts with a tear in the inner layer of the aortic wall of the thoracic aorta and can lead to a rupture. This requires immediate attention. The most common symptom of an acute aortic dissection is sudden and severe chest or upper back pain, sometimes described as “ripping” or “tearing.” The pain may move from one place to another. When a diagnosis of aortic dissection is confirmed, immediate surgery or stenting is usually performed.