An aortic root aneurysm is a bulge in the first section of the aorta, where the artery joins the heart and aortic valve. Treatment for an aortic root aneurysm can help prevent serious complications.
The aorta is the main artery that transports blood away from the heart to supply the rest of the body. An aneurysm is a balloon-like bulge in the walls of a blood vessel.
An aortic root aneurysm is a bulge in the aortic root, which is where the aorta joins the heart.
This article looks at the symptoms, causes, diagnosis, and treatment of an aortic root aneurysm.
An aortic root aneurysm is a bulging of the aorta, in the area where the aorta and heart connect through the aortic valve.
The aortic valve opens to let blood flow from the heart to the aorta and closes to prevent blood from flowing back toward the heart.
If an aortic root aneurysm continues to expand, it
Diagnosing and treating an aortic root aneurysm in its early stages can help prevent serious complications.
In most cases, an aortic aneurysm does not cause any symptoms.
Large aneurysms can compress nearby structures, leading to the
- difficulty swallowing
- chest pain or pressure
- back pain
- shortness of breath
An aortic root dissection or rupture may cause the following symptoms:
- sudden, severe chest or back pain
- low blood pressure, which may cause blurry vision, dizziness, or confusion
- fainting
- weak pulse
- nausea
- vomiting
- sweating
- shortness of breath
- leg pain
If there is any concern for aortic emergency, a person should call 911 or your local emergency number.
Is it a heart attack?
Heart attacks occur when there is a lack of blood supply to the heart. Symptoms include:
- chest pain, pressure, or tightness
- pain that may spread to arms, neck, jaw, or back
- nausea and vomiting
- sweaty or clammy skin
- heartburn or indigestion
- shortness of breath
- coughing or wheezing
- lightheadedness or dizziness
- anxiety that can feel similar to a panic attack
If someone has these symptoms:
- Dial 911 or the number of the nearest emergency department.
- Stay with them until the emergency services arrive.
If a person stops breathing before emergency services arrive, perform manual chest compressions:
- Lock fingers together and place the base of hands in the center of the chest.
- Position shoulders over hands and lock elbows.
- Press hard and fast, at a rate of 100 to 120 compressions per minute, to a depth of 2 inches.
- Continue these movements until the person starts to breathe or move.
- If needed, swap over with someone else without pausing compressions.
Use an automated external defibrillator (AED) available in many public places:
- An AED provides a shock that may restart the heart.
- Follow the instructions on the defibrillator or listen to the guided instructions.
The walls of the aorta are usually strong enough to withstand normal blood pressure.
Certain health conditions, such as high blood pressure or genetic conditions,
Medical professionals also link certain aortic valve problems, like bicuspid aortic valve, with aortic root aneurysm.
One of the
Atherosclerosis, which is a thickening of the arteries due to plaque buildup, is also a leading cause. Other conditions that experts associate with an aortic root aneurysm include:
- connective tissue disorders, such as Ehlers-Danlos syndrome and Loeys Dietz syndrome
- aortic valve stenosis, a narrowing of the aortic valve
- bicuspid aortic valve, a heart abnormality present at birth
- inflammatory diseases of the arteries, such as Takayasu arteritis and Behçet’s disease
- bacterial infections
- trauma
- long-term high blood pressure
- infective endocarditis, inflammation of the heart lining and valves
Risk factors for an aortic root aneurysm
- being over the age of 50 years
- being male, which may increase the risk by 2 to 4 times
- arteritis, an inflammation of the artery walls
- smoking
- genetic predisposition
- high blood pressure, especially if not well-controlled
- high cholesterol
- large body size
An aortic root aneurysm may not cause symptoms, so doctors may identify it through imaging scans for another condition.
An aortic root aneurysm can cause the aortic valve to leak, causing a heart murmur. A doctor may listen to the heart and check for unusual signs.
Medical tests to diagnose an aortic root aneurysm include:
- CT angiography (CTA), which uses an intravenous contrast dye with a CT scan to show images of the blood vessels
- MR angiography (MRA), which is an MRI scan with intravenous contrast dye, usually gadolinium, to show images of the blood vessels
- echocardiography, which uses an ultrasound to create an image of the heart and aorta
If a doctor suspects a complication of an aortic root aneurysm, such as aortic dissection, they will work to diagnose the condition as quickly as possible. Doctors may check for the following signs:
- new heart murmur
- weak pulse
- difference in blood pressure between each arm
A doctor may take a CT scan of the chest to check for an aortic dissection or rupture.
In some cases, an aortic aneurysm can be an inherited condition. If people have an aortic aneurysm, first-degree relatives
Treatment of aortic aneurysm
Surgery is reserved for situations when the risk of complications outweighs the risk of the procedure, such as for larger-size aneurysms.
Smaller aneurysms can be monitored over time with imaging to look at the rate of growth and size of the aneurysm. A fast-growing or large aneurysm may require surgery.
Certain medications may help reduce the aneurysm and delay progression, particularly in people with high blood pressure. These may include:
- β-receptor blockers
- angiotensin converting enzyme inhibitors
- angiotensin receptor blockers
Although medications may slow down the rate at which the aorta is expanding, aortic root replacement surgery is the main treatment for aortic root aneurysm.
In aortic root replacement, a surgeon may replace the aortic valve with an artificial valve and use a graft or tube to replace the section of the damaged aorta. If the aortic valve functions well, a surgeon will implant a graft but leave the valve in place.
While surgery is currently the main treatment, experts are investigating endovascular approaches for treating aortic root aneurysms.
Endovascular surgery is a minimally invasive procedure in which a surgeon inserts a catheter through a small incision to carry out the surgery.
Lifestyle factors are also important in managing an aortic root aneurysm and include:
- monitoring and controlling blood pressure, such as taking any prescribed blood pressure medications
- maintaining a moderate weight
- getting at least 30 minutes of brisk exercise daily
- consulting a doctor about a suitable exercise program
- taking any prescribed medication to reduce plaque in the arteries, such as aspirin or statins
What is the life expectancy of someone with an aortic aneurysm?
Aortic aneurysms
However, treatment for an aortic aneurysm can lead to excellent outcomes and allow people to live a long, healthy life.
According to a
People who underwent surgery had the same outcomes compared to people of the same sex assigned at birth in the general population.
When does aortic root aneurysm need surgery?
Although medications may help slow the progression of aortic root aneurysm, surgery is recommended when an aneurysm is
A cardiologist or cardiac surgeon can advise on an individual treatment plan based on risks and benefits in particular circumstances.
Although other treatments can help slow the progression of an aortic root aneurysm, surgery is the main treatment option.
An aortic root aneurysm is a bulge in the first section of the aorta, where the artery connects to the heart and aortic valve.
An aortic root aneurysm may not cause any symptoms. It is important to recognize any symptoms of aortic dissection or rupture, as these can be life threatening without prompt treatment.
Doctors may manage an aortic root aneurysm with medications to slow the progression of the aneurysm, but surgery is the main treatment option.
Aortic root replacement is a procedure that replaces the damaged section of the aorta with a graft and sometimes also replaces the aortic valve. Outcomes are excellent when performed at experienced centers.