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.

• Cough

  Symptoms of aortic aneurysm may be related to the location, size and growth rate of the aneurysm and can include: Pain in the chest, neck, and/or back Swelling of the head, neck, and arms Coughing, wheezing, or shortness of breath Coughing up blood Symptoms [marfan.org]

  […] of breath Fainting Hoarseness Difficulty swallowing Coughing up blood Weight loss Chest pain Diagnosis & Treatment Diagnosis The doctor will ask about your symptoms and medical history. [semc.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]

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

• 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]

  Article continues below Symptoms of abdominal aortic rupture can include some combination of the following: Abdominal pain. A stabbing pain may be felt deep in the abdomen between the sternum and the bellybutton. [spine-health.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]

  If the AAA starts to leak or ruptures, you may have any of the following: Sudden pain in your abdomen, groin, back, legs, or buttocks Nausea and vomiting A lump or swelling in your abdomen Stiff abdominal muscles Numbness or tingling in your legs Pale [drugs.com]

  […] pressure that interferes with the function of vital organs like the brain and kidneys and is marked by: Clammy, sweaty skin Light-headedness Rapid heart rate Ruptured abdominal aneurysms can cause: Sudden, severe pain in your lower abdomen and back Nausea [medstarheartinstitute.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]

• 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]

• 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]

  Still, you might have: Back pain A deep pain on the side of your abdomen A throbbing sensation near your navel If the aneurysm ruptures, you might feel sick to your stomach, or suddenly develop an intense pain in your back or abdomen. [webmd.com]

• 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.

• Pleural Adhesions

  Nevertheless, open repair of thoracoabdominal aortic aneurysms is still relevant in complex cases, including combined chronic aortic dissection, congenital aortic abnormalities such as aberrant right subclavian artery, and dense pleural adhesions after [ncbi.nlm.nih.gov]

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.

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2. Saratzis A, Bown MJ.The genetic basis for aortic aneurysmal disease. Heart. 2014 Jun;100(12):916-22.
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