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An aortic aneurysm is an enlargement (dilatation) of the aorta to greater than 1.5 times normal size. [1] Typically, there are no symptoms except when the aneurysm dissects or ruptures , which causes sudden, severe pain in the abdomen and lower back.
A thoracic aorta diameter greater than 3.5 cm is generally considered dilated, whereas a diameter greater than 4.5 cm is generally considered to be a thoracic aortic aneurysm. [4] Still, the average diameter in the population varies by for example age and sex.
Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left (< 5%) coronary sinus. [1] These aneurysms may not cause any symptoms but if large can cause shortness of breath, palpitations or blackouts. Aortic sinus aneurysms can burst or rupture into adjacent cardiac chambers, which can lead to heart failure if untreated.
A thoracic aortic aneurysm is an aortic aneurysm that presents primarily in the thorax. A thoracic aortic aneurysm is the "ballooning" of the upper aspect of the aorta, above the diaphragm. Untreated or unrecognized they can be fatal due to dissection or "popping" of the aneurysm leading to nearly instant death.
A true aneurysm is one that involves all three layers of the wall of an artery (intima, media and adventitia).True aneurysms include atherosclerotic, syphilitic, and congenital aneurysms, as well as ventricular aneurysms that follow transmural myocardial infarctions (aneurysms that involve all layers of the attenuated wall of the heart are also considered true aneurysms).
The thoracic aorta is a continuation of the descending aorta and becomes the abdominal aorta when it passes through the diaphragm. The initial part of the aorta , the ascending aorta , rises out of the left ventricle, from which it is separated by the aortic valve .
Name Triad Disease Abdominal aortic aneurysm rupture Triad: hypotension, pulsatile abdominal mass, flank pain: Abdominal aortic aneurysm: Achalasia Triad: increased lower esophageal sphincter (LES) tone, decreased LES relaxation, aperistalsis
However, a different mechanism is involved when the ascending aorta proximal to the isthmus is torn. When there is a rapid deceleration the heart is pushed to the left posterior chest. This causes a sudden increase in intra-aortic pressure and can cause aortic rupture. This is known as the water hammer effect. [9]
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