Thoracic Aortic Aneurysm: A Clinical Review

Ethan M Senser; Shantum Misra; Stanislav Henkin

doi:10.1016/j.ccl.2021.06.003

Thoracic Aortic Aneurysm: A Clinical Review

Cardiol Clin. 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003.

Authors

Ethan M Senser¹, Shantum Misra², Stanislav Henkin³

Affiliations

¹ Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
² Department of Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
³ Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA. Electronic address: Stanislav.henkin@hitchcock.org.

PMID: 34686263
DOI: 10.1016/j.ccl.2021.06.003

Abstract

Thoracic aortic aneurysms are common. Most thoracic aortic aneurysms are degenerative. However, some are associated with connective tissue disorders, bicuspid aortic valves, or familial/genetic predisposition. Most are asymptomatic, discovered incidentally on imaging. Aortic diameter is the best predictor of the natural history and risk of complications. Treating hypertension and smoking cessation can slow their growth. Surveillance imaging and referral for prophylactic aortic repair based on absolute aneurysm diameter is the primary means to decrease mortality from thoracic aortic aneurysm. We provide a practical evidence-based summary of the pathophysiology, risk factors, associated genetic syndromes, and clinical management of thoracic aortic aneurysms.

Keywords: Bicuspid aortic valve; Loeys-Dietz syndrome; Marfan syndrome; Thoracic aortic aneurysm; Thoracic aortic dissection; Vascular Ehlers-Danlos syndrome.

Publication types

Review

MeSH terms

Aortic Aneurysm, Thoracic* / diagnosis
Aortic Aneurysm, Thoracic* / epidemiology
Aortic Aneurysm, Thoracic* / etiology
Aortic Dissection*
Bicuspid Aortic Valve Disease*
Genetic Predisposition to Disease
Humans
Marfan Syndrome*