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AORTIC ANEURYSM
Definition
An aneurysm is a localized sac or dilation formed at a weak point in the wall of the aorta.
Classification
Classification based on shape
 Saccular:- A saccular aneurysm projects from one side of the vessel only.
 Fusiform:- If an entire arterial segment becomes dilated, a fusiform aneurysm develops.
Classification based on site
 Thoracic aortic aneurysm: - Thoracic aortic aneurysms are found within the chest;
these are further classified as ascending, aortic arch, or descending aneurysms.
 Abdominal aortic aneurysm (AAA):- The most common form of aortic aneurysm,
involve that segment of the aorta within the abdominal cavity.
Causes
o Atherosclerosis, or hardening of the arteries, which weakens arterial walls.
o Hypertension (high blood pressure).
o Local injury to the artery.
o Congenital abnormality. A number of conditions, such as Marfan syndrome or bicuspid
aortic valves are present at birth and can cause weakness of the artery walls.
o Aging
Clinical manifestations
Thoracic Aortic aneurysms
 Most intact aortic aneurysms do not produce symptoms.
 In most cases, chest pain is the most prominent symptom.
 Dyspnea, the result of pressure of the sac against the trachea, a main bronchus, or the
lung itself.
 Cough
 Hoarseness
 Weakness or complete loss of the voice (aphonia), resulting from pressure against the left
recurrent laryngeal nerve;
 Dysphagia (difficulty in swallowing) due to impingement on the esophagus by the
aneurysm.
Abdominal aortic aneurysms
 Patient feels their heart is beating in abdomen.
  Patient feels an abdominal mass or abdominal throbbing.
 A bruit may be heard from the turbulent flow in the aneurysm.
Assessment and Diagnostic Findings
 History collection and physical examination
 Chest x-ray
 Transesophageal echocardiography,
 CT scanning
 ultrasonography
 Angiography 
 Magnetic resonance imaging (MRI)
Medical Management
 Controlling blood pressure
 Smoking cessation and correcting risk factors
Surgical management
o Repair of thoracic aneurysms using endovascular grafts implanted.
o Surgical repair of the aneurysm by resecting the vessel and sewing a bypass graft in
place.
Complications
 Rupture of aneurysms