Aortic Aneurysm

An aortic aneurysm is a bulge that develops in a weakened part of the aorta, the large blood vessel that carries blood away from the heart. The wall of the artery stretches and balloons outward. Aneurysms can occur in the chest (thoracic) or the abdomen (abdominal). They often grow slowly and may go unnoticed, but a large or rapidly enlarging aneurysm can be dangerous.

Aortic aneurysms are more common in older adults, particularly men over the age of 65 and people who smoke or have smoked. They can also affect women and younger people, especially those with certain inherited conditions affecting blood vessels. Many aneurysms are found unexpectedly during scans done for other reasons, as they frequently cause no symptoms.

Most aortic aneurysms cause no symptoms and are found by chance. When symptoms occur, they may include a pulsing feeling in the abdomen, or pain in the abdomen, chest, or back. A sudden, severe, tearing pain may signal that an aneurysm has burst or split, which is a life-threatening emergency. If this happens, contact local emergency services immediately.

Aneurysms develop when the wall of the aorta weakens. Key risk factors include smoking, high blood pressure, older age, and a build-up of fatty deposits in the arteries. A family history of aneurysms and certain inherited conditions affecting connective tissue also increase risk. Being male raises the likelihood of an abdominal aortic aneurysm, though women can be affected too.

Aortic aneurysms are usually found using imaging tests. An ultrasound scan is commonly used to check the abdomen and is also the basis of screening programmes in some regions. CT and MRI scans give detailed pictures of the aorta and are used to measure an aneurysm precisely. Because many cause no symptoms, screening and incidental scan findings play an important role in detection.

Treatment depends on the aneurysm's size, location, and rate of growth. Small aneurysms are often monitored with regular scans, alongside steps to control blood pressure and stop smoking. Larger aneurysms, or those growing quickly, may be repaired to reduce the risk of rupture, either through open surgical repair or minimally invasive endovascular aneurysm repair (EVAR/TEVAR) using a stent graft. The approach is decided for each individual.

While not all aneurysms can be prevented, risk can be lowered by not smoking, keeping blood pressure under control, eating a healthy diet, staying active, and managing cholesterol. These habits help keep artery walls healthier. People with a family history or risk factors may be offered screening, which allows aneurysms to be found and monitored before they cause problems.