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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. [2] [3] The etiology remains an area of active research.
The size cut off for aortic aneurysm is crucial to its treatment. A thoracic aorta greater than 4.5 cm is generally defined as aneurysmal, while a size greater than 5.5 cm is the distinction for treatment, which can be either endovascular or surgical, with the former reserved for pathology at the descending aorta.
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.
Aortic unfolding is an abnormality visible on a chest X-ray, that shows widening of the mediastinum which may mimic the appearance of a thoracic aortic aneurysm. [ 1 ] With aging, the ascending portion of the thoracic aorta increases in length by approximately 12% per decade, whereas the diameter increases by just 3% per decade.
Inferior vena cava size as estimate of central venous pressure; Aortic root size for thoracic ascending aortic aneurysm; Pericardial effusion size; All function dysfunction is graded on a scale (normal, trace, mild, moderate, or severe) based on various criteria.
The aorta normally has three small pouches that sit directly above the aortic valve (the sinuses of Valsalva), and an aneurysm of one of these sinuses is a thin-walled swelling. Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left (< 5%) coronary sinus. [ 1 ]
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The aortic wall dilatation at the commissural level causes the cusps to effectively shorten and prevent them from converging during systole, which results in aortic valve incompetence. The arch is typically spared from the aneurysmal process, though it may involve the entire ascending aorta. The ectatic aorta may experience dissections.
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