The descending aorta is the portion of aorta that extends downward from the arch of the aorta. This part of the aorta runs through the back next to the spine and into the abdomen (stomach area). A descending aortic aneurysm is a medical condition characterized by an abnormal and potentially dangerous enlargement or bulging of the descending aorta.
It means that this segment of the aorta has weakened and expanded beyond its normal size. If left untreated, an descending aortic aneurysm can continue to grow, potentially leading to serious and life-threatening complications such as rupture, dissection, and compression of nearby structures.
Causes
There are many potential causes of a descending aortic aneurysm, including:
- Genetics and family history of aneurysms
- Connective tissue disorders, such as Marfans syndrome, Vascular Ehlers-Danlos syndrome, and Loeys-Dietz syndrome
- High blood pressure
- Smoking (leading to injury of the wall of the aorta)
- Age
- Atherosclerosis (hardening of the arteries)
- Bicuspid aortic valve, a congenital heart condition
- Infections affecting the aorta
- Trauma or injury to the aorta
Symptoms
Descending aortic aneurysms often have no symptoms. Some possible aneurysm symptoms are:
- Dull chest pain, back pain, or abdominal pain
- Chest pain, back pain, or abdominal pain during exercise
- Shortness of breath
Symptoms of a dissected or ruptured descending aortic aneurysm include:
- Sharp chest pain, back pain, or abdominal pain
- Extreme shortness of breath
- Trouble swallowing
- Fainting/loss of consciousness
- Hoarseness
- Difficulty swallowing
- Coughing or wheezing
Diagnosis
Descending aortic aneurysms are typically diagnosed using the following imaging tests:
- Echocardiogram (ultrasound of the heart): An echocardiogram uses sound waves to create a picture of the heart and blood vessels.
- Computed tomography (CT) scans use X-rays and computer technology to produce detailed images of the aorta.
- Magnetic resonance angiography (MRA) scans are a type of MRI that looks specifically at the body’s blood vessels.
Treatment Options
Monitoring and Medical Management of a Descending Aortic Aneurysm
Medical management of a descending aortic aneurysm involves regular monitoring of the aneurysm’s size and shape and taking steps to prevent it from growing or rupturing. Monitoring typically involves regular imaging tests, such as CT scans, MRA, or ultrasound, to track the size and shape of the aneurysm. The frequency of these tests will be determined by your doctor based on the size and rate of growth of the aneurysm.
Medical management of a descending aortic aneurysm also involves managing underlying health conditions, such as high blood pressure or smoking, that can contribute to aneurysm growth. If appropriate, your healthcare provider may prescribe medications such as beta-blockers or angiotensin receptor blockers. It is essential to modify your risk for rupture by controlling high cholesterol and high blood pressure, and avoiding tobacco use. In some cases, surgical intervention may be necessary to repair or remove the aneurysm.
It is important to follow your provider’s recommendations and attend all scheduled appointments and tests to ensure proper monitoring and management of a descending aortic aneurysm.
Open surgical repair of Descending Aortic Aneurysm
This procedure involves replacing the weakened or aneurysmal segment of the descending aorta with a synthetic graft to restore normal blood flow. An open repair includes an incision that is located under your shoulder blade, around the side of your rib cage, to just under the breast. The incision site may vary depending on the size, location, as well as individual factors. This incision site will allow the surgeon to see the aorta directly to repair the aneurysm.
Thoracic Endovascular Aortic Repair (TEVAR)
- A TEVAR is a minimally invasive procedure. The surgeon reaches the aorta by placing a small, hollow tube (catheter) through a blood vessel in the groin. They use the catheter to place a small mesh device (stent) that repairs the diseased portion of the aorta and restores proper blood flow.
Genetic Counseling for Descending Aortic Aneurysmst
Certified genetic counselors are healthcare professionals with specialized training in genetics and counseling. They are available to discuss the potential role of genetics in the development of aortic aneurysms. The genetic counselor will review your personal and family medical history and may perform genetic testing to identify any potential genetic mutations that increase the risk of developing aortic aneurysms. If a mutation is found, the genetic counselor will discuss the implications for you and your family members, including the risks of inheriting the condition and the potential for future generations to be affected. They will also provide information about available screening and monitoring options and the importance of regular check-ups.
Genetic counselors work with you and your family to discuss:
- The inheritance pattern, including the role of genetic and environmental factors.
- The potential risks for the individual and their family members, including the likelihood of developing the condition and the potential impact on their health and daily life.
- The available genetic testing options, including the benefits, limitations, and results of genetic testing for a thoracic aortic aneurysm.
- The management options for an aortic aneurysm, including medical, surgical, and lifestyle interventions.
- The psychological and emotional impact of an aortic aneurysm and the importance of support and resources for individuals and families affected by the condition.
Make an Appointment
To request an appointment or to get more information, please call 734-936-9010 and a team member will get back to you within two business days.