Has the main blood vessel in your chest bloated like a balloon? (Thoracic Aortic Aneurysm) - Let's talk about this!

The main, largest blood vessel that carries blood throughout our body is the aorta, or aorta. Think of it like the main water pipe that brings water to our house. What happens if one of the walls of this pipe weakens in one place and starts to bulge under the pressure of the water? That's what a Thoracic Aortic Aneurysm is. What happens in this case is that the wall of a section of the aorta that runs through our chest weakens and bulges like a balloon under the pressure of the blood. Today, we'll talk about this condition, which often occurs without any symptoms, inside the body.

What exactly is Thoracic Aortic Aneurysm?

Simply put, this is a swelling or bulge (aneurysm) in the aorta, the large artery that runs through our chest (thorax). This aorta is like a tube. But when an aneurysm forms, the shape of that tube changes, and one place bulges out like a balloon. Usually, doctors call this condition an aneurysm when that part of the artery becomes at least 50% wider than its normal width.

This type of aneurysm can form anywhere in our aorta. But it most commonly occurs in the abdomen. We call it an Abdominal Aortic Aneurysm. But about one in four aneurysms that form occurs in the chest. We call it a Thoracic Aortic Aneurysm.

If you have a small aneurysm like this, it may not need much treatment. While you are taking medication to control things like high blood pressure, your doctor will scan you regularly to see if it is getting bigger. But if the aneurysm is large, or growing rapidly, surgery may be necessary before serious, life-threatening complications develop.

How common is this condition?

According to statistics, this condition affects between 6 and 10 people in every 100,000. However, the real number may be higher. This is because many people do not show any symptoms and live without even knowing that they have this condition. About 20% of diagnosed patients have family members who also have it, meaning it may be hereditary.

What are the symptoms of this?

The biggest danger of this condition is that most of the time there are no symptoms. However, sometimes, when the aneurysm grows large and presses on surrounding organs, some symptoms may appear.

Emergency symptoms that occur if an aneurysm ruptures (ruptures) or dissection (dissection)

This is the most dangerous stage of the disease. The wall of an aneurysm can weaken and suddenly burst (rupture) or tear through two layers of the wall (dissection). This is a very sudden, life-threatening condition. These symptoms usually appear suddenly and very severely.

Why does something like this happen?

The walls of our arteries are normally strong and flexible. They should be able to contract and stretch under the pressure of the blood that comes in with each heartbeat. But if these walls become weak, they can't handle the pressure and start to bulge.

The main cause of this is a condition called Atherosclerosis . Simply put, fatty substances like cholesterol are deposited inside the blood vessels (we call this plaque), gradually thickening and weakening the walls of the vessels. Just like rust builds up inside an old water pipe. This weakens the walls of the vessels and increases the chance of developing an aneurysm.

What are the factors that increase the risk?

In addition to atherosclerosis, anything that weakens the walls of the aorta increases the risk of developing an aneurysm.

How do doctors find this?

Most of the time, this is discovered by accident. We call it an "incidental diagnosis." That is, when a chest X-ray is done for some other reason, the doctor may notice that the middle part of the chest (mediastinum) is wider than normal. That's when an aneurysm is suspected.

If such suspicion arises, the doctor will order tests such as these to confirm it:

• Computed tomography (CT) angiogram: This can produce very clear three-dimensional images of the aorta.
• Echocardiogram (echo): An ultrasound scan to look at the function of the heart and the first part of the aorta.
• Magnetic resonance angiogram (MRA): A test similar to a CT scan, but without the use of radiation.
• Abdominal ultrasound: People with a thoracic aneurysm may also have an abdominal aneurysm, so check that as well.

What are the treatments available?

The only definitive treatment for a thoracic aortic aneurysm is surgery. However, when and what type of surgery is performed depends on the size of the aneurysm, its location, how fast it is growing, and your overall health.

When is surgery necessary?

If the aneurysm is small, the doctor may decide to wait without surgery. We call this "watchful waiting." This means that they will scan the aneurysm every 6 to 12 months to see if it is getting bigger, and they will give you medication to control your blood pressure.

But,

• If the aneurysm is 2 inches (about 5.5 centimeters) or larger,
• If the aneurysm is growing faster than 0.5 cm per year ,
• If the aneurysm is causing symptoms ,

Surgery is usually recommended because the larger the aneurysm, the greater the risk of it bursting.

Main types of surgeries

There are several main types of surgery currently used.

1. Traditional open surgery: An incision is made in the middle of the chest, the weakened part of the aorta with the aneurysm is removed, and a graft is implanted in its place.

2. Thoracic endovascular aortic repair (TEVAR): This is a minimally invasive procedure. A small incision is made in the groin, and a stent graft is inserted through the incision using a catheter to the aneurysm and secured from the inside.

3. Aortic root replacement: This surgery is performed if the aneurysm is located at the root of the aorta, which connects to the heart. It may also be necessary to replace the heart valve.

Your doctor will determine which treatment method is best for you.

Can't this be prevented from happening?

There is no way to 100% prevent the development of an aneurysm. However, controlling the main cause, atherosclerosis, can greatly reduce the risk.

• Control your blood pressure and cholesterol levels by taking the medications your doctor prescribes.
• Adopt a heart-healthy eating pattern, such as the Mediterranean Diet.
• Quit smoking and all tobacco products completely.
• Exercise. Engage in moderate physical activity, such as walking, for at least 150 minutes a week. But talk to your doctor before starting a new exercise program.
• Have an annual medical checkup.

If you have this condition, how do you take care of yourself?

If your doctor tells you that you have a thoracic aortic aneurysm, don't panic. He or she will give you advice on how to take care of yourself while you live with it.

• Avoid things like weight lifting and high-intensity interval training (HIIT). These can put unnecessary pressure on the aorta. Ask your doctor what exercises are right for you.
• Avoid tobacco use completely.
• Reduce salt in food.
• Take the medicine prescribed by the doctor exactly and on time.
• Avoid drugs that increase heart rate (cocaine, amphetamines) and some herbs.
• Stay in regular contact with your doctor. If you develop any new symptoms or experience any side effects from your medication, let them know immediately.