There are rarely any noticeable signs or symptoms associated with an aortic aneurysm [7]. Any symptoms that do occur only do so once the vessel walls are already enlarged. These symptoms are usually abdominal or back pain. As the nerve roots may become compressed, a person can experience leg pain and numbness. A hoarse voice is usually a common sign of an aortic aneurysm in the arch of the aorta because the laryngeal nerve is involved when the aortic aneurysm is located in this area.

If a patient is experiencing any of the vague symptoms and there is a history of aneurysms in the family, it mandatory to examine for an aortic aneurysm as early detection and treatment will lead to a better prognosis.

If an aortic aneurysm goes unnoticed and untreated it can increase in size at a variable rate. As the aneurysm grows in size, the likelihood of blood clots breaking off and causing embolism increases. This, however, does remain rare.

Usually, aneurysms are found during a patient’s normal physical examination. In order to confirm a diagnosis, a medical professional will use imaging which will confirm the presence of an aortic aneurysm and figure out the severity of the condition.

• Inflammation

  Moreover, inflammation and oxidative stress of the arterial wall were induced by endothelial dysfunction. Interestingly, there is a paradoxical differential correlation between diabetes and aneurysm formation in retinal capillaries and the aorta. [ncbi.nlm.nih.gov]

  But with too much saturated fat in one’s diet, fatty streaks start to appear, which can lead to inflammation, ulceration, and calcification. The walls of our aorta can weaken, start stretching, bulging out, ballooning under all that pressure. [nutritionfacts.org]

  […] tissues such as bones, cartilage, heart, and blood vessels, such as Marfan syndrome, Ehlers-Danlos syndrome, Turner's syndrome, and polycystic kidney disease Congenital syndromes: Bicuspid aortic valve or coarctation of the aorta Giant cell arteritis: Inflammation [stanfordhealthcare.org]

  To help diagnose an aortic aneurysm, your doctor may need to perform CT or ultrasound tests to find out whether your symptoms may be caused by other medical conditions, including: Appendicitis, inflammation of the appendix Cholecystitis, inflammation [nhlbi.nih.gov]

• Internal Bleeding

  Rupture of the bulge is a life-threatening emergency because of internal bleeding. [livestrong.com]

  This can develop into a potentially serious heath problem that can be fatal if the aneurysm bursts, causing massive internal bleeding. [medtronic.com]

  This ailment should be taken seriously as it can lead to a rupture of the vessel which will cause internal bleeding when left untreated. If a rupture does occur, it must be remedied quickly since the internal bleeding can lead to shock or death. [symptoma.com]

  An aneurysm can burst, creating serious internal bleeding. Aneurysms most often occur in the body's largest artery, the aorta. [health.harvard.edu]

  An aortic aneurysm can grow and rupture, causing internal bleeding, which can be life-threatening. Unfortunately, aortic aneurysms can develop without causing any symptoms, so patients at high risk for aortic disease should be screened regularly. [froedtert.com]

• Constitutional Symptom

  AAA may also present with constitutional symptoms as a result of the presence of an infected or inflamed aneurysm. disseminated intravascular coagulation (DIC). [lecturio.com]

• Cough

  shortness of breath Fainting Hoarseness Difficulty swallowing Coughing up blood Weight loss Chest pain Treatment Treatment includes surgery or stenting. [cancercarewny.com]

  Symptoms of a thoracic aortic aneurysm (affecting upper part of aorta in chest): Pain in the jaw, neck, upper back or chest Coughing, hoarseness or difficulty breathing Learn more about thoracic aortic aneurysm Symptoms of an abdominal aortic aneurysm [my.clevelandclinic.org]

  The symptoms of an aortic aneurysm can sometimes include chest or back pain, shortness of breath, coughing, and difficulty swallowing. [health.uconn.edu]

  Depending on the size, location and progression rate of dilatation/dissection, patients may be asymptomatic or may present dyspnea, cough, jaw, neck, chest or back pain, head, neck or upper limb edema, difficulty swallowing, voice hoarseness, pale skin [orpha.net]

• Abdominal Pain

  KEYWORDS: Abdominal aortic aneurysm; Abdominal pain; Appendicitis; Elderly; Mesenteric ischemia [ncbi.nlm.nih.gov]

  Non-abdominal causes of abdominal pain Failing to consider extra-abdominal causes in the patient presenting with abdominal pain is a frequent pitfall. Several life-threatening illnesses can present with abdominal pain only. [doi.org]

  Intense back or abdominal pain Rapid pulse Nausea and vomiting Excessive sweating Shock Abdominal Aortic Aneurysm Test Screening FAQ Wear a comfortable, loose-fitting, two-piece outfit Fast for four hours prior to your screening Make sure the meal you [lifelinescreening.com]

  Prednisolone + cyclophosphamide Good [ 11 ] 67-year old man presented with abdominal pain and shock Superior pancreatico-duodenal artery Open repair of ruptured artery Died from multi-organ failure [ 4 ] 50-year old woman presented with abdominal pain [casesjournal.biomedcentral.com]

• Nausea

  The larger an aneurysm grows, the more likely it will burst or rupture, causing intense abdominal or back pain, dizziness, nausea or shortness of breath. [radiologyinfo.org]

  You may have nausea and vomiting. You may have a rapid heart rate and clammy skin. You may pass out, and you may go into shock. A ruptured aorta is a medical emergency that is often fatal. Behandling A small aortic aneurysm may not need treatment. [capitalcardiology.com]

  Intense back or abdominal pain Rapid pulse Nausea and vomiting Excessive sweating Shock Abdominal Aortic Aneurysm Test Screening FAQ Wear a comfortable, loose-fitting, two-piece outfit Fast for four hours prior to your screening Make sure the meal you [lifelinescreening.com]

  When an aneurysm ruptures, you experience pain, dizziness, nausea, vomiting, clammy skin, rapid heart rate, shock or plunging blood pressure. This is a medical emergency. [heart.memorialhermann.org]

• Abdominal Mass

  masses noted that imaging studies are important in diagnosing the cause of a pulsatile abdominal mass and, if an AAA is found, in determining its size and involvement of abdominal branches. [emedicine.com]

  An AAA rupture can present with abdominal pain, back pain, syncope, or vomiting*. On examination they will typically be haemodynamically compromised, with a pulsatile abdominal mass and tenderness. [teachmesurgery.com]

  Pain and a pulsatile mass are associated with larger abdominal aortic aneurysm. [azcentral.com]

  ACR Appropriateness Criteria for pulsatile abdominal mass, suspected abdominal aortic aneurysm. Available at: https://acsearch.acr.org/docs/69414/Narrative. Updated 2016. Last reviewed February 2018 by EBSCO Medical Review Board Michael J. [cancercarewny.com]

  Abdominal aortic aneurysm should be suspected in the presence of an unusual, strong pulsatile upper abdominal mass. [lecturio.com]

• Dysphagia

  Esophageal compression causes dysphagia. Superior vena cava compression causes superior vena cava syndrome. Vascular sequences 1. Aortic regurgitation AR may occur as a consequence of aortic root dilatation with subsequent distortion of the annulus. [lecturio.com]

  Dysphagia is due to compression on the esophagus and esophageal rupture can cause significant hematemesis. Emboli may involve distally to renal, visceral, or lower extremities. Aneurysm rupture presents with severe pain, hypotension, and shock. [clinicaladvisor.com]

  When thoracic aortic aneurysms are large, patients may suffer a local mass effect, such as compression of the trachea or mainstem bronchus (causing cough, dyspnea, wheezing, or recurrent pneumonitis), compression of the esophagus (causing dysphagia), [circ.ahajournals.org]

• Hematemesis

  At the 15th month of his discharge, the patient was readmitted to the emergency room of our clinic suffering from hematemesis. [trdizin.gov.tr]

  That might happen if the aneurysm erodes into the trachea nearby or hematemesis, that's vomiting up blood. That might occur if the aneurysm erodes into the esophagus also nearby, so we don't want these things to happen to us. [khanacademy.org]

  Dysphagia is due to compression on the esophagus and esophageal rupture can cause significant hematemesis. Emboli may involve distally to renal, visceral, or lower extremities. Aneurysm rupture presents with severe pain, hypotension, and shock. [clinicaladvisor.com]

• Heart Disease

  CONTINUE SCROLLING OR CLICK HERE FOR RELATED SLIDESHOW QUESTION In the U.S., 1 in every 4 deaths is caused by heart disease. See Answer [medicinenet.com]

  Newly diagnosed with heart disease? Download the free iHeart Touch iPad app to learn more about it BEFORE your next doctor visit: http://tinyurl.com/7adoref ANH12061 [youtube.com]

  This bodes well for patients, since research shows a high correlation between volumes and positive outcomes, especially with complex congenital heart disease. [med.umich.edu]

  disease, which is most frequently congenital. [semanticscholar.org]

• Chest Pain

  Chest Pain Accreditation On June 16, 2005, Good Samaritan was given official Chest Pain Center designation by the Society of Chest Pain Centers and recognized for offering state-of-the-art heart care to its patients. [chihealthgoodsamaritan.org]

  Introduction Chest pain is a common and challenging clinical problem. Three important life-threatening causes of chest pain are aortic dissection (AD), pulmonary embolism (PE), and acute coronary syndrome [1]. [ncbi.nlm.nih.gov]

  Though most people with aortic arch aneurysm don’t notice symptoms, some may experience a dull chest pain, shortness of breath, and a hoarse voice. [nyulangone.org]

  Symptoms of a thoracic aortic aneurysm (affecting upper part of aorta in chest): Pain in the jaw, neck, upper back or chest Coughing, hoarseness or difficulty breathing Learn more about thoracic aortic aneurysm Symptoms of an abdominal aortic aneurysm [my.clevelandclinic.org]

• Hypotension

  Around 50% patients present with the ‘classic triad’ of ruptured AAA (flank or back pain, hypotension, and a pulsatile abdominal mass). *20% of AAA ruptures will rupture anteriorly into the peritoneal cavity (which are associated with a very poor prognosis [teachmesurgery.com]

  Significant blood loss results in low blood pressure, also called hypotension, which causes lightheadedness/dizziness, nausea or vomiting, blurred vision, and confusion. [spine-health.com]

  Hypotensive Hemostasis in Patients Presenting with Ruptured Aortic Aneurysm. In: Ruptured Abdominal Aortic Aneurysm. Starnes BW, Mehta M, Veith FJ. Springer 2017:141-9. IMPROVE Trial Investigators. [revistaangiologia.es]

  The bleeding usually leads to a hypovolemic shock with hypotension, tachycardia, cyanosis, and altered mental status. [westchestermedicalcenter.org]

  The classic presentation of ruptured AAA is hypotension, abdominal pain, and a pulsatile abdominal mass. While classic, this combination is found in less than half of cases [ 12 ]. [doi.org]

• Thrombosis

  […] blood test, biochemical, immunological, hemostatic parameters) in preoperative, intraoperative and postoperative period with Aneurizma abdominalne aorte, hirurgija, hemostaza; abdominal aortic aneurysms, open reconstruction, EVAR, bleeding, hemostasis, thrombosis [nardus.mpn.gov.rs]

  The researchers say their findings -- which are published in the American Heart Association scientific journal Atherosclerosis Thrombosis and Vascular Biology -- lay the foundations for further investigations into ways of raising HDL cholesterol as a [sciencedaily.com]

  Thrombosis of the femorofemoral graft occurred in 1 case during the immediate postoperative period due to insufficient inflow from a residual stenosis of the endograft (primary patency 97.5%). [ncbi.nlm.nih.gov]

  Plaque rupture can occlude the SMA, leading to acute SMA thrombosis. Figure 1 CT angiogram demonstrating stenosis of the superior mesenteric artery. [doi.org]

  American College of chest physicians antithrombotic therapy and prevention of thrombosis panel. [revistaangiologia.es]

• Sweating

  Intense back or abdominal pain Rapid pulse Nausea and vomiting Excessive sweating Shock Abdominal Aortic Aneurysm Test Screening FAQ Wear a comfortable, loose-fitting, two-piece outfit Fast for four hours prior to your screening Make sure the meal you [lifelinescreening.com]

  If an aneurysm expands rapidly, tears, or leaks, the following symptoms may develop suddenly: intense and persistent abdominal or back pain that may radiate to the buttocks and legs sweating and clamminess dizziness nausea and vomiting rapid heart rate [radiologyinfo.org]

  Internal bleeding caused by a ruptured aneurysm can lead to shock, which includes symptoms such as a sudden and rapid heartbeat, shallow breathing, clammy skin and cold sweats, general weakness, and confusion, agitations or anxiety, and losing consciousness [spine-health.com]

  These include increased sweating, dizziness, rapid breathing, and a fast heart rate. Some people report that they experience an unusual feeling of fullness after only eating a minimal amount of food. Nausea and vomiting commonly occur as well. [docdoc.com.sg]

• Increased Sweating

  These include increased sweating, dizziness, rapid breathing, and a fast heart rate. Some people report that they experience an unusual feeling of fullness after only eating a minimal amount of food. Nausea and vomiting commonly occur as well. [docdoc.com.sg]

  Besides pain, increased sweating, a fast heart rate, rapid breathing, dizziness, and shock may occur. [emedicinehealth.com]

• Back Pain

  See Lower Back Pain Symptoms When an abdominal aortic aneurysm does produce symptoms, the pain and discomfort are usually severe and immediately noticeable. [spine-health.com]

  A patient presenting with severe back pain, vague abdominal pain, weight loss and decline in general health, was diagnosed with a contained-rupture of a suprarenal mycotic aortic aneurysm, as a complication of spondylodiscitis. [ncbi.nlm.nih.gov]

  An AAA rupture can present with abdominal pain, back pain, syncope, or vomiting*. On examination they will typically be haemodynamically compromised, with a pulsatile abdominal mass and tenderness. [teachmesurgery.com]

  The aneurysm can cause low back pain due to the constant aortic pounding on the vertebral plate which is imbued with a rich supply of periosteal pain fibers. The AP lumbar x-ray may also show an aneurysm. [dynamicchiropractic.com]

  If you have an enlarging abdominal aortic aneurysm, you might notice: Deep, constant pain in your abdomen or on the side of your abdomen Back pain A pulse near your bellybutton When to see a doctor If you have pain, especially if pain is sudden and severe [mayoclinic.org]

• Confusion

  Significant blood loss results in low blood pressure, also called hypotension, which causes lightheadedness/dizziness, nausea or vomiting, blurred vision, and confusion. [spine-health.com]

  However, if you do have symptoms, they will depend on the location and size of the aneurysm and may include: Can be confused with the signs and symptoms of a heart attack Sudden onset of severe chest, neck, back, or abdomen pain that has a ripping, stabbing [hoag.org]

  This should not be confused with a psoas muscle spasm, which will generally angulate the spine to the side of spasm. Fifteen percent of abdominal aortic aneurysms are not visible on x-ray. [dynamicchiropractic.com]

  Other symptoms that require emergency medical care are: Loss of consciousness Numbness or tingling sensation Weakness Confusion Light-headedness Who to See & Types of Treatment Available Patients who are considered at higher risk of developing aortic [docdoc.com.sg]

• Altered Mental Status

  The bleeding usually leads to a hypovolemic shock with hypotension, tachycardia, cyanosis, and altered mental status. [westchestermedicalcenter.org]

  Patients with a ruptured AAA may present in frank shock, as evidenced by cyanosis, mottling, altered mental status, tachycardia, and hypotension. [emedicine.com]

• Paresthesia

  A 58-year-old Japanese man with an unremarkable medical history presented with a 3-day history of mild weakness in both legs, and experienced paraplegia and paresthesia a day before admission. [ncbi.nlm.nih.gov]

  Aortic dissections usually cause severe, sudden chest or back pain, and may also result in unusually pale skin (pallor), a very faint pulse, numbness or tingling (paresthesias) in one or more limbs, or paralysis. [ghr.nlm.nih.gov]

The best way to diagnose an abdominal aortic aneurysm is through an abdominal aortic ultrasound [8]. This is usually done after there is a suspicion of an aneurysm after a normal physical examination occurs and a family history is examined. If a thoracic aortic aneurysm is suspected, a chest X-ray should be done. The early detection of an aortic aneurysm is important as treatment for the condition can prevent ruptures from occurring. Early detection and treatment will also lower the chances of related mortality.

Once an aortic aneurysm is diagnosed, there are a number of treatment options available [9]:

• Risk factor reduction and control (eg. cessation of smoking, blood pressure control)
• Stent grafting
• Surgery to place a synthetic arterial graft in the affected area

In general, the prognosis for an aortic aneurysm of any kind is positive [6]. Once an aneurysm is properly treated, the chances of death related to one are as low as 10 percent. In the cases where surgery is required mortality increases, but only to around 30 percent. 

The exact etiology of an aortic aneurysm is usually not known. There are various lifestyle factors that are associated with aneurysms [3]. A family history of aneurysm can also increase the chances of one occurring. Other risk factors that can be associated with aneurysms are:

• Atherosclerosis (present in 95 percent of aortic aneurysms)
• Congenital disorders (eg. Marfan syndrome, Ehlers-Danlos syndrome Type 4)
• Smoking
• Hypertension 
• Infection (eg. untreated syphilis) 
• Trauma
• Complications from other conditions

In the United States, the likelihood of an abdominal aortic aneurysm occurring can range from as small as three in 100,000 up to 117 in the same amount of people [4]. On an international scale there is a chance of abdominal aortic aneurysm ranging from 4.8 to 13 occurrences in 100,000 people annually. The incidence of thoracic aortic aneurysms is estimated to be 6:100,000 person-years.

While an aneurysm can occur at any point in a person’s life, the possibility increases once a person passes the age of 50 for males and after the age of 60 for women. The likelihood of an aneurysm peaks around the age of 80 for everyone.

It is unclear if there are any inciting factors that cause aortic aneurysms but, it is obvious that there has to be a defect in collagen and elastin, probably the most important structural proteins, in order for an aortic aneurysm to develop [5]. This process and degeneration of the media cause weakening of the vessel wall and dilation. Heredity and hemodynamic factors also seems to play an important role in the occurrence of aortic aneurysms.

Lifestyle changes can lower a person’s chance of suffering from an aortic aneurysm. A low-cholesterol diet void of saturated fats can reduce atherosclerosis, therefore lowering the risk of aortic aneurysms [10]. High blood pressure should also be controlled, if present, or prevented if it’s likely to occur.

If there is a family history of aortic aneurysms, a person should be aware of their health and remain on the lookout for the usual signs and symptoms of the condition. By being aware of their own health an aortic aneurysm can be diagnosed early and the chances of a positive prognosis icreased. If a person is considered to be high risk, periodic screenings should be done.

When the aorta becomes dilated to more than 1.5 times its average size, the condition is defined as an aortic aneurysm [1]. There are different etiologies for this disorder, but an aortic aneurysm results in dilatation in all layers of the vessel wall no matter the cause. A person suffering from this ailment can experience pain which is usually a precursor to a rupture. This aortic rupture will cause internal bleeding and should be treated immediately. In individuals who do not receive timely treatment, it can cause shock or even death.

There are four different aortic aneurysms that are designated by location [2]:

• Aortic root aneurysm – located in Valsalva sinus.
• Thoracic aortic aneurysm – located within the chest and broken up into ascending, aortic arch and descending aneurysms.
• Abdominal aortic aneurysm (AAA) – the most common aneurysm located in the aortal segment of the abdominal cavity.
• Thoracoabdominal aortic aneurysm – located in the thoracic and abdominal aorta. 

An aortic aneurysm is defined as a bulge in the aortic walls. The aorta is the largest artery in the body which goes down into the chest and the abdominal region. The aorta then splits into two blood vessels, one for each leg. The bulge occurs due to weaknesses within the walls.

This ailment should be taken seriously as it can lead to a rupture of the vessel which will cause internal bleeding when left untreated. If a rupture does occur, it must be remedied quickly since the internal bleeding can lead to shock or death.

When an aortic aneurysm is caught early it can be treated through medications like beta blockers. More severe cases may need surgery to properly remedy the aneurysm.

1. Johnston KW, Rutherford RB, Tilson MD, Shah DM, Hollier L, Stanley JC. Suggested standards for reporting on arterial aneurysms. Subcommittee on Reporting Standards for Arterial Aneurysms, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery. Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 1991 13 (3): 452–8.
2. Saratzis A, Bown MJ.The genetic basis for aortic aneurysmal disease. Heart. 2014 Jun;100(12):916-22.
3. Nazari S, Salvi S, Visconti E, et al. Descending aorta substitution with expandable ends prosthesis. Case report. J Cardiovasc Surg (Torino) 1999 40 (3): 417–20.
4. Cinà C, Abouzahr L, Arena G, Laganà A, Devereaux P, Farrokhyar F. Cerebrospinal fluid drainage to prevent paraplegia during thoracic and thoracoabdominal aortic aneurysm surgery: a systematic review and meta-analysis. Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 2004 40 (1): 36–44.
5. Gopaldas RR, Huh J, Dao TK, et al. Superior nationwide outcomes of endovascular versus open repair for isolated descending thoracic aortic aneurysm in 11,669 patients. J. Thorac. Cardiovasc. Surg. 2010 140 (5): 1001–10.
6. Crawford ES, Cohen ES. Aortic aneurysm: a multifocal disease. Presidential address. Arch Surg 1982; 117:1393.
7. Pressler V, McNamara JJ. Aneurysm of the thoracic aorta. Review of 260 cases. J Thorac Cardiovasc Surg 1985; 89:50.
8. Bickerstaff LK, Pairolero PC, Hollier LH, et al. Thoracic aortic aneurysms: a population-based study. Surgery 1982; 92:1103.
9. Itani Y, Watanabe S, Masuda Y, et al. Measurement of aortic diameters and detection of asymptomatic aortic aneurysms in a mass screening program using a mobile helical computed tomography unit. Heart Vessels 2002; 16:42.
10. Isselbacher EM. Thoracic and abdominal aortic aneurysms. Circulation 2005; 111:816.