Aortic aneurysm, dissection and rupture

Aortic aneurysm treatment

The treatment you receive will depend on a few factors, such as the size of the aneurysm and the location. A CT scan can be requested to assess the aneurysm.

If you have an aortic aneurysm, there’s a risk that it may begin to leak or even burst. The bigger the aneurysm is, the higher the risk of rupture (or bursting). If it grows more than around 5.5cm you may need to have surgery to prevent it from bursting. A specialist will discuss which treatment is best for you.

• Learn more about the treatments for a thoracic aortic aneurysm and an abdominal aortic aneurysm.

Aortic rupture

Aortic rupture is a significant tear in all the layers of the aorta wall where there is large aneurysm, causing blood to leak out from the aorta. This can lead to severe blood loss, stopping blood being pumped around the body and is life threatening.

Ideally an aortic aneurysm will be repaired before a rupture can occur.

Aortic dissection

Aortic dissection is when the weakened wall of the aorta tears, causing blood to leak between the layers that make up the wall of your aorta. This can happen suddenly or slowly over time. If you have an aortic aneurysm, you’re at higher risk of this happening.

The symptoms of aortic dissection include:

• a sudden, severe pain across the chest, often felt in the back or between the shoulder blades
• pain in the jaw, face, abdomen, back or lower extremities (these include hip, thigh, knee, lower leg (or shin), ankle, and foot)
• feeling cold, clammy and sweaty
• fainting and shortness of breath.

If you experience any of these symptoms you should phone 999 immediately as aortic dissection is a medical emergency and needs urgent treatment.

Aortic dissection causes

Certain risk factors increase the chance of aortic dissection. High blood pressure is one of the most common and can weaken the wall of the aorta over time, making it more likely to tear under pressure. Others risk factors include atherosclerosis and aortic coarctation (narrowing of part of the aorta, present at birth).

Conditions that weaken the aorta wall, like an aneurysm, can make aortic dissection more likely too. Some people are born with conditions that cause the aorta wall to weaken.

These conditions are uncommon and include:

• Marfan syndrome
• Turner syndrome
• Ehlers-Danlos syndrome
• Loeys-Dietz syndrome
• bicuspid aortic valve.

Aortic dissection diagnosis

Diagnosing aortic dissection can be difficult because the symptoms are similar to many other health conditions.

To find out if you have a dissection, your doctor may use:

• CT scan. X-rays and a computer are used to create detailed images of the inside of the chest.
• Magnetic resonance angiogram (MRA). This creates images of your blood vessels.
• Transoesophageal echocardiogram (TOE). A probe is guided through the throat to create pictures of the heart.

Aortic dissection treatment

There are two types of aortic dissection, Type A and Type B. Each type is in a different area and the treatment and management of each is different.

• Type A dissection is a tear in the curved part of the aorta that leaves the heart (also known as the ascending aorta). The risk is high, and usually requires surgery to repair the aorta and possibly replace the aortic valve
• Type B dissection is a tear in the lower, descending part of the aorta and can involve the abdominal aorta. The risk is less than for Type A and does not always require immediate surgery. Doctors may be able to keep the condition under control with blood pressure lowering medicines.

People diagnosed with aortic dissection (including those treated surgically) will have to take medicines to control their blood pressure, usually for the rest of their lives. The medicines help reduce stress on the aorta.