Aortic Aneurysm/Dissection

UW Health Heart, Vascular and Thoracic doctors treat aortic aneurysms - an abnormal bulge in the aorta - and aortic dissection, when the outer layers of the aortic wall separate.

Both aortic aneurysm and aortic dissection often occur in patients with Marfan Syndrome, wherein the walls of the aorta are weaker than normal.

Treating Aortic Aneurysm/Dissection

• Aortic Aneurysm/Dissection Treatment
• What to Expect After Adult Congenital Cardiac Surgery

Concerns and Symptoms

Mild aortic enlargement may not cause any noticeable symptoms at first. An enlarged aorta, however, may allow blood to leak back into the heart, due to aortic valve insufficiency. This can cause shortness of breath and a pounding heartbeat.

More severe aortic enlargement can further weaken the aortic wall, causing the aneurysm to enlarge or dissect.

Symptoms of an aortic aneurysm include:

• Upper back pain
• Coughing and wheezing
• Difficulty swallowing
• Swelling in the neck or arms 

Symptoms of an aortic dissection usually appear suddenly. They include:

• Severe, stabbing pain in the center of the chest, abdomen, or back
• Decreased ability to move an arm, leg, or other part of the body
• Rapid pulse
• Sweating
• Dizziness
• Shortness of breath

Monitoring Patients with Marfan Syndrome

For patients with Marfan Syndrome, it is extremely important to monitor the aorta for signs of progressive enlargement and/or an aneurysm. Using ultrasound, computed tomography (CT) scans or magnetic resonance imaging (MRI), surgeons can determine the size of a developing aortic aneurysm.

If the aortic diameter expands rapidly or reaches a critical size (usually about 4.5 to 5 cm), planned surgical repair is recommended. If surgery is performed early, before a rupture or dissection, hospital survival rates are much higher. In addition, performing surgery early increases long-term life expectancy, because there are fewer residual complications associated with aortic dissection (false lumen).

However, if an aneurysm ruptures or a dissection tears, it can cause life-threatening internal bleeding. Even with emergency surgery, the risk of mortality is up to 10 times higher.