Aortic Aneurysm

The aorta is the body’s largest artery, carrying oxygen-rich blood from the heart to the body through smaller arteries. Beginning at the heart, the aorta leads upward, then curves into an arch and travels back down through the chest and abdomen to the pelvis.

An aneurysm happens when weakness in a section of artery wall causes it to bulge outward. If the weakened area continues to enlarge, it becomes thin and can burst, causing severe internal bleeding.

Types of aortic aneurysms

Aortic aneurysms are described according to where they develop along the aorta:

• Thoracic aortic aneurysms occur in the upper aorta, which rises from the heart and curves downward through the chest.
• Abdominal aortic aneurysms, the most common type, occur in the lower aorta from just below the chest to the pelvis.
• Thoracoabdominal aortic aneurysms develop in the chest and abdomen, in both the upper and lower sections of the aorta.

Aortic aneurysm complications

If left untreated, aortic aneurysms can lead to:

• Ruptured aneurysm, a life-threatening emergency that requires immediate medical care and is a leading cause of death in men
• Aortic dissection, one or more tears in the aorta’s wall
• Blood clots near the aneurysm that can break off and block blood flow elsewhere in the body

Aortic aneurysms can develop from several possible causes. The causes can vary depending on where the aneurysm occurs.

Causes common to all types of aneurysms:

• Hardening of the arteries (atherosclerosis): Cholesterol, fat and other substances build up inside artery walls, causing them to narrow and stiffen.
• High blood pressure: High blood pressure can damage and weaken the aorta's walls.
• Other health conditions: Infections in the aorta and certain diseases can cause inflammation in arteries, which weakens their walls.
• Trauma: Serious falls or car accidents can cause an aortic aneurysm.

Causes specific to thoracic aneurysms:

• Certain genetic conditions: Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome and Turner syndrome are connective tissue disorders that can weaken the aorta’s walls.
• Heart valve disorders: An abnormal or diseased aortic valve, which controls blood flow from the heart to the aorta, can increase the risk of thoracic aneurysm.

Risk factors for aortic aneurysms

Certain factors can increase your risk of an aortic aneurysm. These factors include:

• Age (typically 65 and older)
• Smoking
• Family history of aortic aneurysms

Because aortic aneurysms usually develop slowly over many years, you may not experience symptoms at first. Some aneurysms stay small, while others expand, sometimes quickly. As aortic aneurysms expand, the risk of rupture grows.

Symptoms specific to a thoracic aneurysm

Symptoms that occur with aneurysms in the upper aorta include:

• Chest pain or tenderness
• Upper back pain
• Cough or high-pitched breathing
• Hoarseness or swallowing problems
• Shortness of breath

Symptoms of abdominal and thoracoabdominal aneurysms

Aneurysms in the lower aorta have some different symptoms, such as:

• Constant, deep pain in your abdomen or side
• Back pain
• Pulsating sensation near your navel
• Lump in your abdomen

Symptoms of a ruptured aorta

Certain symptoms might mean that an aortic aneurysm has ruptured. Seek emergency medical care if you experience:

• Sudden, intense pain in your chest, abdomen or back
• Pain in your neck, jaw or arms
• Difficulty breathing
• Dizziness
• Rapid heart rate

If you have a small aneurysm, you may not experience noticeable symptoms. Often, your doctor finds an aortic aneurysm during a routine exam or on an imaging study for another condition.

At Henry Ford, our vascular team conducts a thorough evaluation to confirm a diagnosis of an aortic aneurysm. Learn more about our vascular testing and our process for aortic disease diagnosis.

If your parent or sibling had an aortic aneurysm, get a screening test. Henry Ford’s certified imaging technologists provide advanced imaging to check for aortic aneurysms.

At the Multidisciplinary Aorta Program, our vascular team has advanced training and years of experience. You’ll receive care from one of the few programs in Michigan offering the full range of options.

We treat people with all types of aortic aneurysms, using medications, monitoring, minimally invasive procedures and open surgery. Working closely with you, our vascular team uses the least invasive treatments that provide you with the longest-lasting results.

Lifestyle changes and medications for aortic aneurysm

The main treatment goal for an aortic aneurysm is to prevent a rupture or dissection. For a small, stable aneurysm, we typically begin your treatment with lifestyle changes and medications. Our vascular medicine and cardiologists offer conservative treatment options that include:

Recommendations for healthy lifestyle habits

You can help slow the condition’s progress and improve the way you feel with small changes toward a healthier lifestyle. Our vascular medicine specialists and cardiologists have years of experience helping people develop realistic goals to:

• Quit smoking
• Eat a more nutritious diet that’s low in cholesterol, saturated fats and sodium
• Stay physically active
• Maintain a healthy weight

You can work with us one-on-one, or we can refer you to Henry Ford programs such as:

• Tobacco Treatment Service, which includes options for individual coaching by phone and Freedom From Smoking® classes
• Henry Ford PREVENT Program, a medically supervised exercise program with individual and group options, nutrition classes and education on healthy habits

Medications for aortic aneurysm

Depending on your specific needs, our vascular medicine specialists and cardiologists prescribe medications such as:

• Blood thinners to prevent blood clots and reduce the risk of stroke
• Medications to lower blood pressure
• Statins to control high cholesterol

EVAR and other minimally invasive procedures for aortic aneurysm

Large (about 2 inches) or fast-growing aneurysms require either a minimally invasive procedure or open surgery for repair.

Our surgeons use catheters (thin, flexible tubes) and miniature instruments to provide minimally invasive procedures, using just a needle puncture or tiny incision. The procedures take an endovascular approach, meaning work is done inside blood vessels.

Read more about your endovascular options:

• Endovascular aneurysm repair (EVAR)
• Thoracic endovascular aneurysm repair (TEVAR)
• Fenestrated endovascular aneurysm repair (FEVAR)

Open surgery for aortic aneurysm

Some aortic aneurysms may need open surgery to repair. Learn more about aortic disease treatments using open surgery.

You’ll see our vascular medicine specialists and cardiologists for follow-up and long-term monitoring after surgery or a procedure. We make sure that your blood pressure is under control and adjust your medications as necessary.