U01.07.037 Aortic aneurysm

An aortic aneurysm is a localized pathologic dilation of the aorta, which can lead to severe complications. If left untreated, it may cause abdominal and/or back pain, signaling potential rupture, dissection, or leakage. Below are details regarding different types of aortic aneurysms and their associated risk factors and presentations.

Types of Aortic Aneurysms

1. Abdominal Aortic Aneurysm (AAA)

Pathophysiology: Most commonly associated with atherosclerosis, particularly in the infrarenal region (distal to the origin of the renal arteries).
Risk Factors:
- History of tobacco use
- Advanced age
- Male sex
- Family history of aneurysms
Clinical Presentation:
- Abdominal pain
- Pulsatile abdominal mass
Imaging Findings:
- The image below shows a dilated, calcified aortic wall with a partial crescent-shaped non-opacification of the aorta due to a flap/clot (arrows point to the outer dilated calcified aortic wall).

Feature	Description
Common Location	Infrarenal (distal to renal arteries)
Key Imaging Findings	Pulsatile mass, calcified aortic wall with partial clot/flap
Risk Factors	Tobacco use, male sex, advanced age, family history

2. Thoracic Aortic Aneurysm (TAA)

Pathophysiology: Often associated with cystic medial degeneration of the aortic wall, leading to its dilation.
Risk Factors:
- Hypertension
- Bicuspid aortic valve
- Connective tissue disorders (e.g., Marfan syndrome)
- Syphilis (especially tertiary syphilis, which causes obliterative endarteritis of the vasa vasorum)
Clinical Presentation:
- Chest pain
- Shortness of breath
Complications:
- Aortic valve regurgitation due to aortic root dilation

Feature	Description
Common Location	Thoracic aorta
Key Imaging Findings	Aortic root dilation, possible valve regurgitation
Risk Factors	Hypertension, bicuspid aortic valve, connective tissue disorders, tertiary syphilis

Key Takeaways

AAA is most common in the abdominal region and linked to atherosclerosis, with risk factors including smoking, older age, male sex, and family history.
TAA is more common in the chest and associated with cystic medial degeneration, hypertension, Marfan syndrome, and syphilis.
Both aneurysms can lead to life-threatening events such as rupture or dissection if not detected and managed promptly. Regular imaging and early detection are essential for managing these conditions.

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