Symptoms:

Aneurysms develop slowly over many years. Most patients have no symptoms until the aneurysm begins to leak or expand. Chest or back pain may mean sudden widening or leakage of the aneurysm.

Symptoms often begin suddenly when:

• The aneurysm grows quickly
• The aneurysm tears open (called a rupture)
• Blood leaks along the wall of the aorta (aortic dissection)

If the aneurysm presses on nearby structures, the following symptoms may occur:

• Hoarseness
• Swallowing problems
• High-pitched breathing (stridor)
• Swelling in the neck

Other symptoms may include:

• Chest or back pain
• Clammy skin
• Nausea and vomiting
• Rapid heart rate
• Low blood pressure

Signs and tests:

The physical examination is often normal unless a rupture or leak has occurred.

Most thoracic aortic aneurysms are detected by tests performed for other reasons, usually a chest x-ray, echocardiogram, or a chest CT scan. A chest CT scan shows the size of the aorta and the exact location of the aneurysm.

An aortogram (a special set of x-ray images made when dye is injected into the aorta) can identify the aneurysm and any branches of the aorta that may be involved.