What are diseases of the aorta?
of the aorta
An aortic aneurysm is a swelling or bulging of
the aorta. Most aortic aneurysms are found in the
abdominal area of your aorta, which is known as an
abdominal aortic aneurysm - or AAA for short. Less
frequently, they can occur in your thorax (chest) -
in either your ascending (up high) or descending
(downwards) aorta. Anything that affects the elastic
fibers in the wall of your aorta may make it weaker
and more likely to bulge or swell.
Your risk of having an aneurysm increases as you
get older. Your risk is also higher if you smoke, have
high blood pressure, have coronary heart disease
or it is a condition that affects other people on your
family. (This means your brother, sister or a parent
has or has had an AAA.) Getting certain infections,
and inflammatory or autoimmune diseases such as
Marfans syndrome, may also increase your risk.
Most aortic aneurysms are found in people over
50 years and are 6 times more common in men
For men over the age of 65 years the NHS offer a
AAA screening service.
For more information visit
The aorta is the largest artery in your body that
leaves the left side of your heart and carries
oxygen-rich blood to all parts of your body.
Diseases of the aorta are very serious, and can
often be life-threatening.
If the wall of the aorta becomes weakened, it can:
• bulge or dilate – called an aortic aneurysm
• tear – called an aortic dissection
• split or burst – called an aortic rupture.
Small or moderate sized aortic aneurysms are
unlikely to cause you any symptoms, and so can be
difficult to detect. Larger aneurysms in your chest
may cause discomfort or pain in your chest or back.
Abdominal aortic aneurysms can put pressure on
your spine causing lower back or abdominal pain,
which can be severe and accompanied by feeling
lightheaded or fainting.
If you have an aortic aneurysm there is a risk
that it may begin to leak or even rupture (burst),
depending on its size. The bigger it is, the higher
the risk. If it grows more than around 5.5cm you
may need to have surgery to prevent it from
rupturing. A specialist will discuss which treatment
is best for you.
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surgery. This decision will depend on which type of
aortic dissection you have, Type A or Type B.
Type A occurs in the arch and proximal
descending aorta (the area from the left ventricle
to the aortic arch). The risk of rupture is high, and
usually requires surgery to repair the aorta and
possibly replace the aortic valve.
Type B occurs in the descending aorta. The risk of
rupture is less than for Type A, and doesn’t always
require immediate surgery. Doctors may be able
to keep the condition under control with the use
of blood pressure lowering medicines.
All people who have an aortic dissection (including
those treated surgically) have to take medication
to control their blood pressure, usually for the rest
of their lives. The medication helps reduce stress
on the aorta and usually consists of a beta-blocker
or calcium channel blocker plus another blood
pressure tablet such as an angiotensin-converting
enzyme (ACE) inhibitor.
Aortic dissection most often occurs because of a
tear or damage to the inner lining of the artery. This
can put extra pressure on the wall of the aorta and
may cause the wall to rupture. This is a potentially
dangerous condition that needs emergency
treatment. Aortic dissection is a rare condition –
and it is not an easy diagnosis to make. There are
two types of aortic dissection, Type A and Type
B. Each type is located in a different area and the
treatment and management of each is different.
Aortic dissection is caused by diseases that affect
the aortic wall. The most common of these is
atherosclerosis - the building up of fatty substances
in the artery lining. It can cause many different
symptoms, and the classic signs are a sudden onset
of severe pain across the chest, often felt in the
back or between the shoulder blades. It can also
cause pain in the jaw, face, abdomen, back or lower
extremities as well as shock, feeling cold, clammy
and sweaty, fainting and shortness of breath. If you
experience any of these symptoms you should call
999 for an ambulance. This is a life threatening
condition that needs immediate medical treatment.
If you have an aortic dissection you will be in a
intensive care unit to monitor your blood pressure,
heart rate and rhythm, breathing rate and oxygen
levels closely. Pain relief will be given to keep you
comfortable and medication to help control your
blood pressure and heart rate. Once your condition
is stable doctors will decide whether to recommend
surgery or to continue medication therapy without
The aorta is a very large blood vessel. If it ruptures
there is a massive amount of blood loss, and the
person can very quickly go into shock and die.
Ideally, an aortic aneurysm or dissection will be
repaired before it ruptures, but for many people they
simply don’t know they have any underlying disease.