Thoracic Aortic Aneurysm

Looking for the Area’s Most Advanced Care for Thoracic Aortic Aneurysm? Orange County Trusts Hoag.

At Hoag’s Jeffrey M. Carlton Heart and Vascular Institute, we’re changing the way cardiac conditions are treated in Southern California, with patient-focused care and the best tools and techniques available.

Need aortic aneurysm care in Orange County? Hoag’s Jeffrey M. Carlton Heart & Vascular Institute is a hub for advanced technology and world-class experts, treating the full range of conditions that can weaken or damage the aorta. That includes everything from high blood pressure and aortic valve disease to rare, connective tissue diseases like Marfan syndrome that affect the aorta.

Visit this link to learn more about Hoag’s Marfan Syndrome and Related Conditions Clinic, offering cutting edge diagnosis and treatment under the guidance of internationally recognized cardiovascular disease specialist focused on Marfan syndrome and connective tissue diseases, David Liang, M.D., Ph.D.

For more information about thoracic aortic aneurysm diagnosis and treatment, call 949-764-5314 or contact us online. Read on for what you need to know about thoracic aortic aneurysm, including causes, types, risk factors and more.

What is a Thoracic Aortic Aneurysm?

An aortic aneurysm is a medical condition in which the aorta – the body’s largest and most critical blood vessel, which runs from the heart to the lower abdomen – becomes abnormally enlarged and develops a significant bulge.

The portion of the aorta that runs through the chest is called the thoracic aorta. When an aortic aneurysm occurs in the thoracic aorta, it’s called a thoracic aortic aneurysm (TAA).

The portion of the aorta that runs through the abdomen is called the abdominal aorta. When an aortic aneurysm occurs in the abdominal aorta, it’s called an abdominal aortic aneurysm (AAA). 

Aortic aneurysms can be caused by a variety of factors that weaken the aorta, including smoking, high cholesterol and atherosclerosis, uncontrolled high blood pressure and certain genetic conditions like Marfan syndrome and Familial TAAD. Whatever the cause, that weakness can allow the walls of the thoracic aorta to stretch like a balloon due to the force of blood pressure and blood flow, creating a thoracic aortic aneurysm.

Having a thoracic aortic aneurysm can be very dangerous.

The aortic wall is made up of three layers. The innermost layer is called the intima, the middle layer is called the media and the outer layer is called the adventitia. In cases involving thoracic aortic dissection, an aneurysm or other damage causes a tear to develop in the inner wall of the thoracic aorta. This allows blood to rush between the layers of the aortic wall, forcing (or dissecting) the layers apart.

An aortic dissection is a medical emergency that requires immediate medical attention and surgical repair of the aortic wall. Symptoms of a ruptured thoracic aneurysm or dissected thoracic aorta may include sudden, severe back pain that may spread to the arms, neck, jaw or chest; difficulty breathing; low blood pressure; and severe shortness of breath that may lead to fainting or unconsciousness.

In some cases, an aortic aneurysm can grow so large that the aneurysm reaches a point that it bursts, causing what’s known as an aortic rupture. Experiencing a thoracic aortic aneurysm rupture can cause life-threatening bleeding and is fatal in many cases.

Acute Aortic Dissection vs. Chronic Aortic Dissection

Aortic dissections are classified as either acute or chronic. Whether an aortic aneurysm is considered chronic or acute depends on several factors, including symptoms and severity.

Acute Aortic Dissections

Acute aortic dissections are the more dangerous of the two. During an acute aortic dissection, symptoms are usually felt immediately after a tear in the aortic wall occurs, often including sudden, severe back or chest pain and shortness of breath. Even with emergency medical attention and surgical treatment to address the tear and repair the aorta, acute aortic dissections are often fatal.

Chronic Aortic Dissections

In some cases, however, the symptoms of an aortic dissection can go unnoticed for a long time. If a person survives the acute stage beyond two weeks, or if symptoms of an aortic dissection first become noticeable more than 14 days after the dissection first occurred, it’s considered a chronic aortic dissection.

Chronic aortic dissections are also often fatal. But because symptoms of a chronic aortic dissection develop more slowly, giving physicians time to act, they are usually more survivable than acute aortic dissections.

What Are the Different Types of Thoracic Aortic Aneurysm?

There are two types of aortic aneurysm: Type A aortic aneurysms and Type B aortic aneurysms. Which type of aortic aneurysm you have depends on where the initial tear occurs in the aorta.

To understand the difference between Type A and Type B aortic aneurysms, you need to know a little bit about the anatomy of the aorta.

Roughly as wide as a garden hose, a healthy aorta is a tough, flexible tube that runs from the heart to the lower abdomen. It is hooked at the top like a candy cane. The portion of the aorta that runs through the chest is called the thoracic aorta, while the abdominal aorta runs through the abdomen.

The portion of the thoracic aorta that lies closest to and connects to the heart is called the ascending aorta, because when it exits the heart, the aorta heads upward briefly through the chest.

The ascending aorta leads to the aortic arch, which is the curved or hooked portion of the aorta, before it turns and heads downward through the body.

The portion of the aorta that heads downward and away from the aortic arch is called the descending aorta.

Type A dissection vs. Type B dissection

• Type A aortic dissection is a tear that develops in the wall of the ascending aorta, near where the aorta is connected to the heart.
• Type B aortic dissection involves a tear in the wall of the descending aorta, occurring anywhere from the aortic arch to the abdomen.

What are the Symptoms of Thoracic Aortic Aneurysms?

In many cases, thoracic aortic aneurysms have no noticeable symptoms. Often, the first sign that a person has a thoracic aortic aneurysm is a fatal aneurysm rupture or aortic dissection.

In some cases, however, thoracic aortic aneurysms do cause symptoms as they grow. These symptoms may include:

• A recurring cough
• Wheezing when you breathe
• Trouble swallowing
• A hoarse or raspy voice due to pressure on the esophagus
• Unexplained back pain, or pain in the jaw or neck
• Shortness of breath
• Chest pain or discomfort

Need the experienced endovascular repair for a thoracic aortic aneurysm in Orange County? Visit this link to meet Hoag’s Aortic Program Team

Symptoms of a Dissected or Ruptured Aneurysm

An aortic dissection or ruptured aortic aneurysm is a life-threatening medical emergency. Even with immediate medical attention and surgical repair of the aortic wall, these conditions are often fatal. That makes it important to know the symptoms that indicate a rupture or dissection of the aorta.

Symptoms of a ruptured thoracic aneurysm or dissected thoracic aorta may include:

• Sudden, severe back pain that may spread to the arms, neck, jaw or chest
• Difficulty breathing
• Low blood pressure
• Severe shortness of breath that may lead to fainting or unconsciousness

What Can Cause a Thoracic Aortic Aneurysm?

There are several conditions and issues that can result in the aortic damage or weakness that can lead to the formation of a thoracic aortic aneurysm. These factors may include:

• High blood pressure, also called hypertension.
• Atherosclerosis, a condition involving the hardening of the arteries due to buildup of a waxy combination of fats and cellular waste called plaque on the walls of blood vessels.
• Certain genetic conditions can lead to Familial Thoracic Aortic Aneurysm and Dissection (Familial TAAD). Examples include Marfan syndrome, Vascular Ehlers-Danlos syndrome (VEDS), Loeys-Dietz syndrome (LDS), and other genetic aortic and vascular conditions. Hoag’s Marfan Syndrome and Related Conditions Clinic features world-class diagnosis, monitoring and care for these connective tissue disorders.
• Smoking tobacco
• Penetrating Aortic Ulcer: Usually caused by the buildup of plaque in the aorta due to atherosclerosis, a penetrating aortic ulcer occurs when plaque begins to wear down and penetrate the aorta’s inner lining. This can weaken that part of the aorta, putting a person at greater risk of an aortic aneurysm or dissection.
• Vasculitis, which is inflammation of the arteries. 
• Trauma to the chest, sometimes due a car accident or being hit very forcefully in the chest.
• Penetrative injuries that damage the aorta, due to issues like stabbings or gunshot wounds.
• Aortic Intramural Hematoma (IMH), which is a rare but potentially life-threatening condition in which blood leaks through the innermost layer of the aortic wall (the intima) and flows between the two outer layers, even though there’s no tear in the aortic wall.
• Certain infections: In rare cases, thoracic aortic aneurysms can occur due to an infection of the aortic wall — a condition called infected thoracic aortic aneurysm or ITAA. Infectious agents commonly involved in these cases include E. Coli, untreated Syphilis, Salmonella and Staphylococcus (Staph).
• Problems with the aortic valve: the aortic valve is a natural gate that regulates the flow of oxygenated blood from the main pumping chamber of the heart — the left ventricle — into the aorta. Having a damaged or diseased aortic valve can sometimes cause aortic weakening and a thoracic aortic aneurysm. For example, though the aortic valve is supposed to have three flaps or “cusps” to close the opening, some people are born with only two cusps — a congenital condition called bicuspid aortic valve. Those with a bicuspid aortic valve have an increased risk of developing a thoracic aneurysm.

For those in need of heart valve treatment in Orange County, Hoag’s Nancy and Bill Thompson Heart Valve Center is the area’s recognized leader in advanced valvular care.

What are the Risk Factors for Thoracic Aneurysm?

There are several medical conditions, lifestyle factors and other issues that can potentially increase your risk of developing a thoracic aortic aneurysm. These risk factors may include:

• Being Older
• Having certain genetic conditions that can impact the strength of connective tissues throughout the body, including Marfan syndrome and Loeys-Dietz syndrome
• Having a family history of aortic aneurysm, enlargement, rupture or dissection
• Having atherosclerosis, which is a condition in which the arteries harden due to the buildup of a substance called plaque on the artery walls
• Having high blood pressure, especially if it’s uncontrolled or poorly controlled
• Smoking tobacco
• Having a bicuspid aortic valve, which is a congenital (present at birth) condition in which the aortic valve — one of the four heart valves — has only two flaps or “cusps” instead of the usual three
• Being obese
• Chest trauma, such as experiencing a hard blow or penetrative injury to the chest
• Coarctation of the aorta, which is an abnormal narrowing of the aorta

Are There Any Ways to Reduce My Risk of Experiencing a Thoracic Aortic Aneurysm?

Because some issues that can cause thoracic aneurysms are beyond a person’s control, including certain genetically-inherited conditions or being born with a bicuspid aortic valve, there is no way to definitely prevent a person from experiencing a thoracic aortic aneurysm.

However, there are steps patients can potentially take to reduce the risk factors for conditions that can cause aortic aneurysm to occur, or to help prevent a catastrophic aortic dissection or rupture. These steps may include:

• Eat a heart-healthy diet that’s low in cholesterol and fat and includes lots of fruits and vegetables
• Get regular cardiovascular exercise, and take the steps necessary to maintain a healthy weight
• If you have any medical conditions that are known to have a high risk of causing an aortic aneurysm, including diabetes, high blood pressure, or genetic connective tissue diseases like Marfan syndrome, follow the instructions of your doctor exactly, including taking all prescribed medications
• Get regular medical checkups
• Don’t smoke tobacco, and if you do, quit now

Need Advanced Aortic Care in Orange County? There’s No Place Like Hoag.

Hoag’s Elaine and Robert Matranga Aortic Center is setting the standard of care for aortic disease in Orange County, with a team-based approach that puts you and your well-being first.

From long-term monitoring through active surveillance to cutting-edge imaging techniques like transesophageal echocardiogram, next-generation diagnosis to endoscopic techniques that can repair an aneurysm through small incisions, with less pain and shorter recovery times, there’s just no place like Hoag.

If you need aortic care in Huntington Beach, Irvine, Anaheim, Newport Beach, San Clemente, Tustin or other communities across Orange County, Hoag is here.

For more information about thoracic aortic aneurysm diagnosis and treatment, call 949-764-5314 or contact us online.