Thoracic aortic aneurysms are often discovered during a routine physical exam or on x-ray and the patient may not have any symptoms. According to the Journal of Cardiovascular Nursing, patients who do have symptoms will most often complain of chest, back or flank pain. These symptoms are similar to other disease processes and will require further workup by a physician.
Aorta
The aorta is the largest artery in the body. The aorta starts in the left ventricle of the heart, ascends upward and then arches over heading down through the chest into the abdomen. The aorta is divided anatomically into the thoracic and the abdominal components. Aneurysms will be named based upon what section of the aorta they are located in: thoracic aortic aneurysm or abdominal aortic aneurysm.
Aneurysm
An aneurysm is a weakening in the wall of the artery and causes a balloon-like bulge. As pressure is increased on the weakened area there is a potential the aneurysm could rupture. The larger the weakened area is, the greater the risk of rupture. The rupture of an aneurysm can cause serious bleeding into the body and even death.
Causes
There are several causes for thoracic aortic aneurysms as described by the "Journal of Cardiovascular Nursing." Atherosclerosis, a build-up of waxy plaque on blood vessels and it's associated risk factors are associated with thoracic aortic aneurysms. The associated risk factors include high blood pressure, high cholesterol and smoking. Genetic factors, such as Marfan syndrome and vascular disorders are also associated with aneurysms.
Signs / Symptoms
The "Clinical Practice of Emergency Medicine" indicates that a thoracic aortic aneurysm is insidious in onset, meaning it is more dangerous than what appears evident. The patient with an impending rupture of the aneurysm may complain of deep, throbbing chest or back pain. A sudden escalation of pain and a low blood pressure are signs of a rupture and should not be ignored.
Management
Depending on the size of the aneurysm and if no symptoms are present, a patient may be managed medically, not requiring surgery. The patient with a thoracic aortic aneurysm will need close management of their blood pressure in addition to periodic Computerized Tomography (CT) scans which will watch the growth of the aneurysm.
Surgical management will be necessary depending on the size, rate of growth or the unexpected rupture of the aneurysm. Surgical interventions may include the placement of a graft or repair using a stent.
References
- "Journal of Cardiovascular Nursing"; Thoracic Aortic Aneurysms: Deborah Klein; Vol 20, No 4, pp 245-250, 2005
- "Clinial Practice of Emergency Medicine"; Lippincott Williams & Wilkins; 2010
