Thoracic aortic aneurysm overview
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Thoracic aortic aneurysm Microchapters |
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Differentiating Thoracic Aortic Aneurysm from other Diseases |
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Diagnosis |
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Treatment |
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Special Scenarios |
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Case Studies |
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Thoracic aortic aneurysm overview On the Web |
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Directions to Hospitals Treating Thoracic aortic aneurysm overview |
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Risk calculators and risk factors for Thoracic aortic aneurysm overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Editor-in-Chief: Amjad AlMahameed, MD, MPH, RPVI, FACP. Beth Israel Deaconess Medical Center and Harvard Medical School. Boston, USA
Overview
A Thoracic aortic aneurysms (TAA) is defined as an expansion or dilation of the aorta greater than 4.5 cm. Thoracic aortic aneurysms (TAAs) encompass all aneurysms the aorta between the aortic root and the crura of the diaphragm. The aortic root and the ascending thoracic aorta are the most common sites of TAAs (60%), followed by the descending thoracic aorta (40%). Involvement of the aortic arch and/or extension of a TAA into the abdominal aorta (AA) (so called thoracoabdominal aneurysms) are relatively uncommon subsets (each encountered in 10% of cases or less).
Overview
Two of the most common causes of thoracic aorta aneurysm are Marfan's syndrome and atherosclerosis. In some centers, a prior history of dissection with aneurysmal dilation is the most common cause of surgical repair.
Causes
- Marfan's Syndrome
- Atherosclerosis
- Previous injury to the aorta such as an aortic dissection is the most common cause of aortic aneurysm repair in some institutions
Causes in Alphabetical Order
- Ankylosing spondylitis
- Atherosclerosis
- Bacterial infection, often following valvular endocarditis
- Behcet's disease
- Bicuspid aortic valve with post-stenotic dilation due to turbulence
- Ehlers-Danlos syndrome
- Familial thoracic aortic aneurysms and dissections
- Giant cell arteritis
- Loeys-Dietz syndrome
- Marfan's syndrome
- Previous injury to the aorta such as an aortic dissection
- Syphilis
- Takayasu's arteritis
- Traumatic - Sudden deceleration
- Turner's syndrome
Differentiation of Thoracic Aortic Aneurysm from Other Disorders
Thoracic aortic aneurysms are often asymptomatic and as a result can be easily missed. If chest pain is present, it is critical to differentiate a thoracic aortic aneurysm with dissection from other potential life-threatening diseases which include the following:
- Abdominal aortic aneurysms [1]
- Acute myocardial infarction [2]
- Congestive heart failure
- Aortic regurgitation
- Blunt chest trauma
- Hypertensive emergency
- Hemothorax
- Pneumothorax
- Pericarditis
- Pulmonary embolism
- Cardiac tamponade
- Superior vena cava syndrome
Risk factors
Hypertension and cigarette smoking are the most important risk factors, though the importance of genetic factors in the development of thoracic aortic aneurysm (such as familial thoracic aortic aneurysm; familial aortic dissection) has been increasingly recognized. Approximately 10% of patients may have other family members who have aortic aneurysms. It is also important to note that individuals with a history of aneurysms in other parts of the body have a higher chance of developing a thoracic aortic aneurysm.[3]
Specific thoracic aortic aneurysm risk factors include:
- Smoking or chewing tobacco
- High blood pressure
- Bicuspid aortic valves
- Atherosclerosis (buildup of plaque in the arteries that can damage the lining)
- Gender
- Aortic aneurysms are three time more prevalent in males versus females
- Race
- Aortic aneurysms are more frequent in Caucasian individuals versus other races
- Individuals who have a family history of aortic aneurysms have a much higher risk of rupture and tend to develop aneurysms at a younger age
- Chronic obstructive pulmonary disease
- Previous repair of a thoracic aorta aneurysm
- Turners syndrome
References
- ↑ Larsson E, Vishnevskaya L, Kalin B, Granath F, Swedenborg J, Hultgren R (2011). "High frequency of thoracic aneurysms in patients with abdominal aortic aneurysms". Annals of Surgery. 253 (1): 180–4. doi:10.1097/SLA.0b013e3181d96498. PMID 20571364. Unknown parameter
|month=ignored (help) - ↑ Schubert H (2003). "Thoracic aortic dissection: distinguishing it from acute myocardial infarction". Canadian Family Physician Médecin De Famille Canadien. 49: 583–5. PMC 2214223. PMID 12790268. Unknown parameter
|month=ignored (help) - ↑ Thoracic Aortic Disease - Northwestern Memorial Hospital. Thoracic Aortic Aneurysm