Thoracic aortic aneurysm

The aorta is the main artery supplying oxygen-rich blood to every part of your body. It starts in the lower left heart chamber (left ventricle), goes up toward the brain, then curves down and extends into the abdomen.

When the aorta wall is weakened or damaged, it can begin to balloon outward in the damaged area, causing an abnormal bulge (aneurysm). Blood can pool in the aneurysm, causing it to rupture, or the aorta wall can tear (aortic dissection). Cardiac specialists at Penn Medicine’s Aorta Center can diagnose and treat aneurysms quickly, providing expert care for even the most urgent and complex cases.

There are three types of aortic aneurysms. At Penn Medicine, we have specialists who provide focused treatment for each of these conditions.

• Thoracic aortic aneurysms occur in the parts of the aorta that are in the chest cavity like the aortic root, where the aorta connects to the heart. Penn Medicine’s cardiac surgeons provide care for aneurysms that occur in the chest.
• Thoracoabdominal aortic aneurysms are found in the area that extends from the chest to the abdomen. Cardiac surgeons work collaboratively with vascular surgeons to manage these aneurysms.
• Abdominal aortic aneurysms occur in the part of the aorta that is below the diaphragm. If you have this type of aneurysm, our vascular surgery and endovascular therapy team will provide your care.

Because aortic aneurysms develop slowly over years, doctors discover most of them before they tear open or leak blood. Your medical provider may discover a thoracic aortic aneurysm when they order imaging tests for another reason. Most people don’t experience symptoms when aneurysms are small.

A large or rapidly expanding aneurysm that tears (dissects) or leaks blood may be accompanied by symptoms including:

• Pain: This can include sudden, severe, or constant jaw, neck, chest, or back pain that isn’t relieved by movement or pain medicines.
• Difficulty breathing: You may have difficulty catching your breath or have frequent fits of coughing. Some people have a hoarse voice that has no obvious explanation.
• Rapid heart rate: You may notice your heart is beating rapidly and that you have clammy skin.

Plaque formation in the artery (atherosclerosis) can weaken the walls of your aorta over time, making it more likely for aneurysms to develop. This is the most common cause of thoracic aortic aneurysms.

Other factors may contribute to the risk of developing thoracic aortic aneurysms. They include:

• A family history of aortic aneurysms
• Genetic conditions like Marfan syndrome or Ehlers-Danlos syndrome
• Bicuspid aortic valve (BAV) disease
• High cholesterol
• High blood pressure
• Smoking
• Older age

Penn Medicine’s Aorta Center is a high-volume hub, offering diagnostic and treatment options for even the most rare aortic conditions, including thoracic aortic aneurysms. With advanced imaging tools, the latest noninvasive procedures, and sophisticated open surgical techniques, we’ll identify and deliver the right treatment for you.

Our care doesn’t stop after treatment. We monitor your progress and work alongside a team of collaborative specialists including cardiac surgeons, vascular surgeons, geneticists, and imaging experts to provide ongoing care. Our goal is to help you achieve better health now while giving you the tools to stay well into the future.