Aortic disease

What is it?

The largest artery in the body, the aorta is the primary blood vessel. It's responsible for carrying oxygen-rich blood away from the heart, throughout the abdomen, and to all parts of the body. When affected by disease, the aorta can split (dissection) or dilate (aneurysm) and in either case, the rupture may have fatal results.

Types of aneurysms are classified by their location:

  • Abdominal aortic aneurysm: involves the lower part of the chest through abdominal area
  • Thoracic aneurysm: occurs in the chest
  • Thoracic abdominal aneurysm: involves both parts of the descending aorta 

Symptoms

Thoracic aortic aneurysm

  • Chest or back pain that continues to the jaw, neck or upper back
  • Persistent coughing
  • Hoarseness
  • Shortness of breath

Abdominal aortic aneurysm

  • Ongoing pain in the back, abdomen and/or groin
  • Pulsating enlargement or tender mass noticed by a doctor upon physical examination

When an aneurysm dissects or ruptures, symptoms may develop suddenly such as:

  • Severe sharp or tearing pain
  • Clammy skin
  • Fainting or dizziness
  • Nausea and vomiting
  • Rapid, weak heart rate
  • Low blood pressure

Risk factors

  • Family history of aortic aneurysm
  • Family history of peripheral vascular disease
  • Heart disease or atherosclerosis (hardening of the arteries)
  • Smoking
  • Advancing age
  • Gender; more men than women develop aortic disease
  • Genetic connective tissue disorder such as Marfan syndrome

Diagnosing aortic disease

  • Ultrasound 
  • CT scan
  • Angiogram
  • MRI

Treating aortic disease 

  • Observation of aneurysm using imaging such as ultrasound or MRI repeated over time to monitor for increasing size
  • Surgical repair
    • Endovascular aneurysm repair or endovascular stenting; a less invasive approach
    • Traditional open-chest surgery
  • Rupture or dissection requires emergent care