You’re unlikely to have any symptoms of a thoracic aortic aneurysm unless it bursts or the aorta lining tears. However, if it starts to expand and push on surrounding tissue or nerves in your chest, a thoracic aortic aneurysm can cause:
- chest pain
- back pain
- difficulty breathing
- difficulty swallowing
These symptoms aren’t always caused by a thoracic aortic aneurysm. If you’re worried about any of them or if you have chest pain, contact your GP.
If a tear appears in one of the layers of the aorta wall, you may feel a severe, sharp pain in your chest. This is sometimes confused with a heart attack.
If a thoracic aortic aneurysm ruptures, this is extremely serious and usually fatal.
You probably won’t have any symptoms of a thoracic aortic aneurysm. If it’s expanding quickly, you may have some chest pain. An aortic aneurysm is usually discovered during tests for chest pain or tests you’re having for another reason.
If your GP suspects that you have a thoracic aortic aneurysm, you may have other tests in hospital, which may include the following.
- A CT or MRI scan can provide images of your thoracic aorta. They are very useful for finding the exact position of the aneurysm.
- A chest X-ray may show a widening of your aorta.
- A transthoracic echocardiography is a test in which an ultrasound sensor is placed over your chest. This can show an image of your heart and thoracic aorta.
- A transoesophageal echocardiography test. This involves passing a small ultrasound sensor into your oesophagus or gullet (the food pipe that goes from your mouth to your stomach).
Your treatment for a thoracic aortic aneurysm will depend on your symptoms and the size of your aneurysm.
If you have a small aneurysm, you won’t usually have surgery but you will need regular ultrasound checks to see if your aneurysm is growing. It’s also important to manage your condition by changing your lifestyle and treating the cause of the aneurysm, such as high blood pressure.
Your doctor will advise you to have surgery if your aneurysm is:
- larger than 5.5cm
- expanding quickly
- causing pain or other symptoms, such as difficulty breathing
Or if you have Marfan syndrome or a family history of aneurysms.
You will need to have emergency surgery if your aneurysm ruptures or leaks.
There are two main types of operation for a thoracic aortic aneurysm.
Open surgery for aortic aneurysm involves your surgeon opening your chest to reach your aorta. They will then insert a graft into the weak area of your aorta. The graft may be synthetic and made out of a knitted or woven material. Blood will flow through the graft inside your aorta instead of through the aneurysm. This prevents the aneurysm getting bigger.
Endovascular stent graft replacement
Endovascular aneurysm repair (EVAR) involves your surgeon feeding a stent through the femoral arteries in your groin. The stent will go up through your aorta to the area of the aneurysm. A stent is a tube covered with synthetic graft material. Your surgeon will use X-ray images to guide the placement of the stent.
The graft material will bond with the arterial wall and blood will flow through the stent instead of the weakened aneurysm. Stents aren’t suitable for everyone. It depends on the location of the aneurysm and other factors. Ask your doctor for more information.
A thoracic aneurysm develops when the wall of your aorta weakens, which causes it to bulge. Doctors don’t know exactly why the aorta weakens in some people. Some people with a thoracic aneurysm have atherosclerosis. This is a process in which fatty deposits build up on the inside of your arteries and weaken the artery walls.
You’re more likely to develop an aneurysm if you:
If the aneurysm ruptures it may cause severe internal bleeding. This will be fatal without emergency surgery to repair it. The chance of an aneurysm rupturing depends on its size and location in your aorta. If your aneurysm is greater than 5.5cm wide, the chances of rupture are high. The risk increases with increasing size.
If your thoracic aneurysm ruptures you will get severe pain in your chest. If you have this symptom, you must seek urgent medical attention.
Complications of a thoracic aortic aneurysm can include the following.
- Heart failure. If the aneurysm happens near your heart it may cause the aortic valve to leak. This can cause blood to flow back into your heart (aortic regurgitation), stopping your heart pumping effectively and causing heart failure.
- Aortic dissection. The inner lining of your aorta can tear and blood will enter into the wall of the aorta. If this happens, you may feel sudden and severe chest and back pain.
You can take steps to reduce your risk of developing an aneurysm by:
- not smoking
- keeping your blood pressure and cholesterol well controlled
- exercising regularly
- maintaining a healthy weight
- eating a healthy diet
If you have a family history of arterial disease you should have regular check-ups so that your GP can advise you how to prevent problems.
What is Marfan syndrome?
Marfan syndrome is a condition that affects the way your body produces the fibres that make up the connective tissue in your body. For example, between your joints and organs.
People with Marfan syndrome have a defect in a gene that controls the production of connective tissue in their body. The connective tissue holds your joints and organs in place and helps control how your body grows. Because connective tissue is found throughout your body, the effects of Marfan syndrome can be widespread, and involve your heart, lungs, skeleton, skin and eyes.
About one in 5,000 people have Marfan syndrome. People can inherit the condition, meaning that they get it from a parent who also has the syndrome.
If you have Marfan syndrome, you’re more at risk of getting an aortic aneurysm because the elastic tissue of your aorta isn’t produced correctly. This makes your aorta weaker so it can widen more easily.
What are the risks of open surgery versus endovascular aneurysm repair (EVAR) for treating thoracic aortic aneurysm?
Endovascular aneurysm repair (EVAR) may have fewer risks during and straight after the operation than open surgery. However, there isn’t enough research to know which type of operation is better in the long term. EVAR isn’t suitable for everyone.
Like all major surgical procedures, surgery to repair a thoracic aortic aneurysm carries a risk of complications. These include paralysis, bleeding and stroke. The risk of these complications depends on your specific circumstances.
EVAR reduces the risk of complications during and straight after the procedure. However, there are additional problems that can happen after EVAR that don’t happen after open surgery. People who have this operation need to have more regular check-ups than those who have open surgery.
There isn’t enough research to know which type of operation is better in the long term. Talk to your doctor or surgeon for more advice.
How long does it take to recover from open surgery for thoracic aortic aneurysm?
You can expect to be in hospital for around a week. A full recovery usually takes at least six weeks.
People respond to surgery differently. Many factors, including your age and general state of health, will affect how quickly you recover from the procedure. If you smoke, it will slow down your recovery. Talk to your surgeon for more information.
- Thoracic aortic aneurysm. Patient UK Professional Reference. www.patient.co.uk, published 13 June 2012
- Thoracic aortic aneurysm. eMedicine. www.emedicine.medscape.com, published 19 November 2014
- Hole JR, Koos KA. Human anatomy. Dubuque, Iowa: Wm C Brown; 1994:25–26
- Thoracic aortic aneurysm. Patient UK Professional Reference. www.patient.co.uk, published 16 May 2012
- Simon C, Everitt H, van Dorp F and Burkes M. Oxford handbook of general practice. 4th ed. Oxford: Oxford University Press; 2014
- Ruptured abdominal aortic aneurysm. Patient UK Professional Reference. www.patient.co.uk, published 16 May 2012
- Echocardiogram. British Heart Foundation. www.bhf.org.uk/heart-health/tests/echocardiogram, accessed 25 February 2015
- NHS Abdominal Aortic Aneurysm Screening Programme. Care Pathway. aaa.screening.nhs.uk, accessed 25 January 2015
- Endovascular stent-graft placement in thoracic aortic aneurysms and dissections. National Institute for Health and Care Excellence (NICE), 2005. www.nice.org.uk
- Ramrakha P, Hill J. Oxford handbook of cardiology. 2nd ed. Oxford: Oxford University Press, 2012. doi:10.1093/med/9780199643219.001.0001
- CVD risk assessment and management. Risk Factors for CVD. NICE Clinical Knowledge Summaries. www.cks.nice.org.uk, published September 2014
- Marfan syndrome. Patient UK Professional Reference. www.patient.co.uk, published 10 December 2013
- Abraha I, Romagnoli C, Montedori A, Cirocchi R. Thoracic stent graft versus surgery for thoracic aneurysm. Cochrane Database of Systematic Reviews 2013, Issue 9. doi:10.1002/14651858.CD006796.pub3
- Open AAA repair. The Circulation Foundation. www.circulationfoundation.org.uk, accessed 3 May 2015
We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.
Let us know what you think using our short feedback form Ask us a question
Reviewed by Dylan Merkett, Bupa Health Content Team, June 2015.
Let us know what you think using our short feedback form Ask us a question
About our health information
At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.
Information StandardWe are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
HONcodeThis site complies with the HONcode standard for trustworthy health information.
What our readers say about us
But don't just take our word for it; here's some feedback from our readers.
“Simple and easy to use website - not alarming, just helpful.”
“It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.”
“Good information, easy to find, trustworthy.”
Our core principles
All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.
In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.
We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.
We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.
Here are just a few of the ways in which the quality of our information has been recognised.
The Information Standard certification scheme
You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.
It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.
Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.
Plain English Campaign
Our website is approved by the Plain English Campaign and carries their Crystal Mark for clear information. In 2010, we won the award for best website.
Website approved by Plain English Campaign.
British Medical Association (BMA) patient information awards
We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.
If you have any feedback on our health information, we would love to hear from you. Please contact us via email: firstname.lastname@example.org. Or you can write to us:
Health Content Team
15-19 Bloomsbury Way