Aortic Aneurysm: What Are the Different Types?
 The heart is one of the main essential organs in our body, and it pumps blood all across the body with the help of the Aorta artery. Aorta is the core artery of the body that supports the supply of oxygen-rich blood in our circulatory system. In human beings, it passes from over the heart and is provided with oxygenated blood from the left ventricle, which passes through the aortic valve into the aorta, which further delivers it all across the body.
The aorta is tough and durable. Yet, its walls can get weak and swell over. This condition is known as Aortic Aneurysm. This can cause leakage; known as endoleaks, which in turn may cause spillage of blood inside the body.
Some of the aortic aneurysms erupt, while some of them don’t, and the others alter the blood flow from the organs and tissues. This can lead to problems like heart attack, stroke, damage of Kidneys and sometimes even fatality.
Aortic Aneurysms
Aortic aneurysms can be found in two regions: in the upper body or chest and the lower body or abdomen. The Aortic Aneurysms in the upper body are known as thoracic aortic aneurysm and which occurs in the lower body is known as an abdominal aortic aneurysm.
Thoracic Aortic Aneurysm
This Aortic aneurysm takes place in the Thorax as the Thoracic Aorta is a part of the aorta in the chest region.
Symptoms
 Most people having thoracic aortic aneurysms rarely show early signs. But when the aneurysm starts getting bigger and starts putting pressure on the organs which surround it, the symptoms begin to show up. The symptoms may include:
- Chest pain
- Back pain
- Cough
- Breathing problem
- Hoarseness
- Trouble or pain while swallowing
- Trouble swallowing,
- Pain while swallowing.
If an aortic aneurysm ruptures, or bursts, there is severe and sudden pain, a life-threatening descent in that blood pressure, and immeasurable shock. Without instant action, it can be fatal.
Causes
The Thoracic aortic aneurysm might be affected by different types of Diseases depending on their location, which are as follows:
Ascending thoracic aneurysm
Ascending thoracic aortic aneurysm occurs in the chest area in the Ascending thoracic aorta. The causes are as follows:
- Cystic medial degeneration, which is the breakdown of the aortic wall’s tissues and is the most common cause of a thoracic aortic aneurysm.
- Genetic disorders such as Marfan syndrome, Ehlers-Danlos, and Loeys-Dietz, which affect the body’s connective tissue that gives support to the blood vessels. It may also result in the enlarging of the aorta.
- Family Medical history of having a Thoracic aortic aneurysm without any Marfan Syndrome incidence.
- Atherosclerosis is caused when plaques build up in the inner lining of the artery, which further hardens it. This is quite a rare cause for a thoracic aortic aneurysm.
Aortic arch thoracic aneurysm
As the name suggests, the aortic arch thoracic aneurysm is formed on the aortic arch, in the artery that lies between the ascending and descending aorta, and results in the weakening and bulging of its wall. It further may lead to the following conditions-
- Takayasu’s arteritis –this is a kind of vasculitis that causes arteries to inflate.
- Atherosclerosis, the building up of plaque inside the arteries
- Continuation of the descending or/and ascending aortic aneurysm
Descending thoracic aortic aneurysm
Descending thoracic aortic aneurysm takes place in the Descending thoracic aorta. Atherosclerosis is mostly linked with descending thoracic aneurysms and believed to be essential in the aneurysmal disease.
The danger factors that might lead to atherosclerosis are as follows:
- Age
- Gender
- Family history
- Genetic factors
- Hyperlipidemia
- Hypertension
- Smoking
- Diabetes
Forms
The form of an aneurysm can be defined as being either fusiform or saccular, and it helps in identifying the condition between True or False aneurysms. True aneurysms can be described as abnormal dilations of an artery due to its weakened vessel wall, and false aneurysms are external hematomas (Blood collected outside blood vessels) that are in persistent communication with an artery that is leaking. Their types are as follows:
- Fusiform-shaped aneurysm: Swells or inflates out from all the sides of the aorta, and this is a common form.
- Saccular-shaped aneurysm: This aneurysm inflates out from only one side of the aorta
- Pseudoaneurysm (or false aneurysm): Enlargement due to trauma or surgery, due to some accidental cut or tears.
Abdominal aortic aneurysm:
An abdominal aortic aneurysm is caused due to a swelling in the lower section of the aorta that runs from the heart through the centre of the chest and abdomen.
Symptoms
- Back pain
- Abdominal pain
- An Aching feel near the navel
- If the aneurysm ruptures, one might feel a sudden abdominal pain on the back part of the abdomen along with vomit, sweat, and dizziness.
Causes
The causes are mostly unknown, but here are the few underlying reasons that may support its causing:
- Atherosclerosis
- Smoking
- High blood pressure
- Genetic disposition
- Family history
Any ailment such as Aortic Aneurysm can be best treated if diagnosed at an early stage. It can possibly be detected during a routine exam sometimes. If the bulge caused is not too large, it can be monitored for its growth so that it doesn’t create major complications going further, but, if it is large, one might require surgery.
Dr. Mohd Maqbool Sohil | Consultant – Cardiology Adult | Narayana Multispeciality Hospital, Ahmedabad