What is an aortic ulcer?
Sometimes called a penetrating aortic ulcer, this irregularity of the aortic wall is caused by the formation of plaque from atherosclerosis. The plaque wears down the inner lining of the aorta, which is the largest blood vessel in the body and branches off from the heart. As the plaque erodes the artery wall in the chest, it puts you at risk for a thoracic aortic aneurysm or aortic dissection.
Symptoms of an aortic ulcer
An aortic ulcer is difficult to describe because the symptoms — chest and back pain — are common with many other conditions. Your doctor may suspect an aortic ulcer if you have:
- Family history of aortic dissection or aneurysm
- Connective tissue-related genetic conditions, including Marfan syndrome or Ehlers-Danlos syndrome
- Bicuspid aortic valve disease
- Coronary artery disease (heart disease), which can lead to atherosclerosis
- High blood pressure
Diagnosing an aortic ulcer
If you visit your doctor complaining of chest or back pain that is unusual or difficult to describe, they may recommend you undergo cardiovascular imaging tests such as:
- CT scan
- MRI scan
Treatment at Penn Medicine
The team of cardiologists, cardiac surgeons, and vascular surgeons at the Aorta Center lead and advance the field of aortic disease management. Your doctor’s goal is to prevent an aortic ulcer from developing into an aortic aneurysm or dissection. To accomplish this, he or she will likely use:
- Active surveillance: Sometimes called "watchful waiting," this is regular monitoring of the ulcer using the same imaging tests used for diagnosis.
- Medications: Your doctor may prescribe medicines to control coronary artery disease.
Your doctor may determine you need surgery to prevent the ulcer from worsening. Surgical options may include:
- Thoracic endovascular aortic repair (TEVAR) to repair the damaged part of the aorta by threading a synthetic reinforced graft (tube) into the aorta through a catheter inserted in a leg artery
- Hybrid aorta surgery, which uses a combination of endovascular (catheter-based) surgery and open surgery to repair the aorta wall
- Aorta surgery to repair the ulcerated area with a graft using open-heart surgery
- Valve-sparing aortic root replacement, which is a specialized operation that spares the valve when the ulcer occurs where the aorta meets the heart