Aortic Aneurysm Explained: What You Need to Know

Why Should I Care About Aortic Aneurysms if I Feel Fine?

Many health issues develop without early warning signs such as pain or visible symptoms. As we tend to respond only when something feels undeniably “wrong,” it’s quite natural that such conditions go unnoticed. Aortic aneurysms challenge this way of thinking and can pose a serious threat, particularly for individuals with certain risk factors. The absence of symptoms does not equal the absence of disease. Aneurysms often develop without warning signs, and many people don’t know they have one until it’s discovered during an unrelated scan or until a serious complication occurs.

This is what makes aortic aneurysms important to understand. While they may remain stable for years, they can also grow silently and become life-threatening if they rupture. The good news is that when identified early, aneurysms can often be monitored or treated safely.

This blog is designed to give you a clear, easy-to-understand overview of aortic aneurysms, including what they are, who is at risk, how they’re detected, and what can be done about them.

What Is the Aorta and Why Is It So Important?

To understand an aortic aneurysm, it helps to first understand the aorta itself.

The aorta is the largest artery in the human body. It begins at the heart and carries oxygen-rich blood to the rest of the body, supplying vital organs like the brain, kidneys, and legs. Every heartbeat sends blood through the aorta under high pressure, making it one of the most-worked blood vessels in the body.

A simple way to think of the aorta is as the main highway of your circulatory system. Smaller roads (arteries) branch off from it to deliver blood to different destinations. If there’s a problem on this main highway, like a weak spot or blockage, it can affect every other branch.

The strength of the aorta‘s wall is critical because it handles such a large volume of blood at high pressure. Problems like aneurysms can develop when that wall weakens.

What Is an Aortic Aneurysm, and How Does It Develop?

An aortic aneurysm is a weakened area in the wall of the aorta that causes it to bulge or balloon outward.

The danger lies in what happens as the bulge grows larger. As the bulge grows, the aortic wall becomes even thinner and weaker. If the aneurysm grows too large or expands too quickly, two life-threatening events can occur:

• Dissection: The layers of the aortic wall tear apart.
• Rupture: The wall bursts completely, causing massive internal bleeding

Both scenarios are medical emergencies requiring immediate treatment. Without rapid intervention, a ruptured aortic aneurysm is often fatal. Even with emergency surgery, survival is uncertain.

How Do Aneurysms Form?

Aortic aneurysms don't appear overnight. They typically develop slowly over many years as the blood vessel wall sustains ongoing damage. The most common causes include:

• High blood pressure: Constant force against weakened vessel walls accelerates the damage
• Smoking: Damages the elastic fibers that give your arteries strength and flexibility
• Cholesterol buildup: Creates inflammation and weakens the arterial structure
• Genetic factors: Some people inherit conditions that affect the strength of their connective tissue

The critical issue is that most aneurysms produce no symptoms whatsoever as they grow. You can't feel them developing. There's no pain to warn you. This is precisely why screening is so important for people with risk factors. It's the only way to catch an aneurysm before it becomes an emergency.

Are There Different Types of Aortic Aneurysms? Where Do They Occur?

Yes. Aortic aneurysms are classified based on where they occur along the aorta. The two main types are:

Thoracic Aortic Aneurysm (TAA)
These occur in the part of the aorta that runs through the chest (thorax). Depending on their exact location, they may affect blood flow to the heart, brain, or upper body.

Thoracic aneurysms are less common than abdominal ones but can be more complex because of their proximity to the heart and major blood vessels.

Abdominal Aortic Aneurysm (AAA)
These occur in the lower part of the aorta, in the abdomen. This is the most common type of aortic aneurysm.

Abdominal aortic aneurysms often grow slowly and without symptoms, which is why screening is especially important in people with risk factors.

Am I at Risk for an Aortic Aneurysm?

Some people are more likely to develop an aortic aneurysm than others. Common risk factors include:

• Age: Risk increases after age 60
• Smoking: One of the strongest risk factors
• High blood pressure: Constant pressure weakens artery walls over time
• Family history: Aneurysms can run in families
• Atherosclerosis: Buildup of plaque in the arteries
• Male sex: Men are more commonly affected, especially by abdominal aneurysms

Having one or even several risk factors does not mean you will definitely develop an aneurysm but it does mean screening and monitoring become more important.

What Are the Warning Signs? Can an Aneurysm Really Have No Symptoms?

Yes, many aortic aneurysms are completely silent, especially when they are small. That’s why they are often discovered incidentally during imaging tests done for other reasons, such as back pain, kidney problems, or routine health evaluations.

When symptoms do occur, they may vary depending on the type:

Symptoms of Thoracic Aortic Aneurysm

• Chest or upper back pain
• Shortness of breath
• Hoarseness or difficulty swallowing
• Coughing without another clear cause

Symptoms of Abdominal Aortic Aneurysm

• Deep, persistent abdominal or back pain
• A pulsating sensation near the belly button
• Pain that spreads to the lower back or legs

A sudden, severe pain, especially if accompanied by dizziness or fainting, can signal a rupture and requires immediate emergency care.

How Are Aortic Aneurysms Diagnosed?

Aortic aneurysms are usually diagnosed through imaging tests, not blood tests or routine physical exams.

Common methods include:

• Ultrasound: Often used to screen for abdominal aortic aneurysms
• CT scan: Provides detailed images and accurate size measurements
• MRI: Useful in certain patients and for long-term monitoring

Many aneurysms are found by chance, during scans performed for unrelated health concerns. This incidental detection often allows doctors to intervene before serious complications develop.

What Are the Treatment Options if an Aneurysm Is Found?

Treatment depends on several factors, including the size of the aneurysm, how fast it’s growing, its location, and the patient’s overall health.

Monitoring (Watchful Waiting)
Small aneurysms that aren’t growing quickly may not need immediate intervention. Instead, doctors may recommend:

• Regular imaging tests
• Blood pressure control
• Lifestyle modifications

Interventional Treatment
If an aneurysm reaches a certain size or grows rapidly, repair may be recommended.

• Open surgery: Replacing the weakened section with a synthetic graft
• Endovascular repair (EVAR and FEVAR): A minimally invasive approach using a stent-graft placed inside the aorta through small incisions

Your care team will help determine the safest and most effective option for your situation.

Can Aortic Aneurysms Be Prevented or Managed Long-Term?

While not all aneurysms can be prevented, risk can be reduced and progression slowed with healthy habits:

• Control blood pressure
• Quit smoking
• Maintain a heart-healthy diet
• Stay physically active (as advised by your doctor)
• Keep regular follow-up appointments

For people with known aneurysms, long-term management and monitoring can make a significant difference in outcomes.

What Should I Do Next If I’m Concerned?

If you have risk factors or unexplained symptoms, the next step is simple: talk to your doctor. A discussion may lead to screening, reassurance, or early intervention.

Being proactive means being informed and safe.

When Should I Get Screened or Speak to a Specialist?

You should consider screening or a specialist consultation if you:

• Are over 60 with a history of smoking
• Have a family history of aneurysms
• Have long-standing high blood pressure
• Have been diagnosed with atherosclerosis

Early detection saves lives, and screening is often quick and non-invasive.

Why Choose RIVEA Vascular Institute?

RIVEA is co-founded and led by Dr. Karthik Mikkineni, U.S.-trained Chief Vascular Specialist, whose advanced expertise in EVAR and Fenestrated EVAR (FEVAR) strengthens RIVEA’s position as a centre of excellence for minimally invasive aortic care. The vascular department is also supported by Dr. Syed Mohammed Ali Ahmed. He is particularly renowned for his work in aortic aneurysm and occlusive disease, offering both open and endovascular solutions tailored to each patient’s condition.

What sets RIVEA apart:

• Advanced Aortic Expertise: Comprehensive care for abdominal aortic aneurysms using EVAR and FEVAR, even in complex anatomies
• Minimally Invasive Focus: Endovascular-first approach for faster recovery, shorter hospital stays, and reduced surgical risk
• Next-Generation Technology: High-resolution imaging and precision-guided interventions for safer outcomes
• Dual Skill Advantage: Expertise in both open and endovascular surgery ensures the right treatment
• Collaborative, Personalized Care: Every treatment plan is tailored through multidisciplinary consultation

Aortic aneurysms may be silent, but understanding your risk and taking timely action can prevent life-threatening emergencies.