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Aortic aneurysm

4-minute read

An aneurysm is a bulge or weakness in a blood vessel. When this happens in the aorta (one of main blood vessels in the body), it’s called an aortic aneurysm. Small aortic aneurysms don’t need to be treated, but larger ones will need surgery in case they burst.

Types of aortic aneurysm

The aorta is a blood vessel about the thickness of a garden hose that carries blood from the heart through the centre of the chest and into the abdomen.

Aortic aneurysms can happen anywhere along the length of the aorta, but they are most common in the lower part. This is called an abdominal aortic aneurysm. When they happen in the upper part of the aorta, in the chest, it is called a thoracic aortic aneurysm.

The bulge in the aorta happens when part of the blood vessel grows weak and expands under pressure. Aneurysms usually start small and then grow bigger as the pressure increases. They usually grow very slowly.

Sometimes aneurysms burst and cause bleeding inside the body. Because the aorta is such a large blood vessel, this can be very dangerous and is often fatal.

illustration comparing a normal aorta with a ruptured aorta
Aortic aneurisms greater than 5.5cm usually require surgery to reduce the risk of rupture

Aortic aneurysm symptoms

Aortic aneurysms usually don't have any symptoms until they burst. Signs of a possible aortic aneurysm in the chest include:

  • pain in the chest or back
  • difficulty swallowing
  • difficulty breathing
  • coughing or being hoarse

If the aneurysm is in the abdomen, signs can include:

  • pain in the back
  • a deep pain on the side of the abdomen
  • a throbbing feeling near the belly button

Aortic aneurysm diagnosis

There is no screening in Australia for aortic aneurysms. Often they are found when people see their doctor for something else, such as prostate problems or gallstones.

Your doctor might suggest you have an ultrasound scan if you are at high risk of an aortic aneurysm, for example if you are a man aged over 60, a smoker, have high blood pressure, have hardening of the arteries, or if you have a brother or father who had had an aortic aneurysm.

Most people with an aortic aneurysm will have a CT scan or MRI scan so the doctor can look at it in more detail.

Aortic aneurysm treatment

Small aneurysms less than 5.5 cm across usually do not need treatment. You will need to see your doctor and have ultrasound scans regularly to keep an eye on the aneurysm.

Aneurysms larger than 5.5 cm across will probably need surgery because they are more likely to burst. You might also need surgery if the aneurysm is smaller but growing quickly or causing other problems.

Until recently, the only treatment for an aortic aneurysm was open surgery, a major operation that replaces the faulty part of the aorta with an artificial blood vessel. Patients usually stay in hospital for 7 to 10 days and will spend some time in intensive care.

Some people may be able to have a stent inserted into the aneurysm through small cuts in the groin to strengthen the wall of the aorta. This is called endovascular surgery. It is not suitable for all types of aortic aneurysm. Another possibility is to repair the aortic aneurysm via keyhole surgery.

You may also be given medicines to lower the risk of the aneurysm bursting.

Aortic aneurysm prevention

It is not possible to prevent an aortic aneurysm, but it is possible to stop it from growing. If you have an aortic aneurysm, you should stop smoking and follow your doctor’s advice for keeping your blood pressure down and treating hardening of the arteries.

When to seek help

If you have an aortic aneurysm that bursts, you need to go straight to hospital. Symptoms of a burst aortic aneurysm include:

  • chest pain
  • a pulsating in your abdomen
  • severe pain in your back, side or abdomen
  • feeling nauseas or vomiting
  • becoming sweaty and dizzy

Where to seek more information

The Australian and New Zealand Society for Vascular Surgery provides patient information on aortic aneurysm.

If you want help quitting smoking, call the Quitline on 13 7848.

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Last reviewed: June 2020

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