Thoracic aortic aneurysm history and symptoms

Editor-in-Chief: Amjad AlMahameed, MD, MPH, RPVI, FACP. Beth Israel Deaconess Medical Center and Harvard Medical School. Boston, USA

Diagnosis
Most TAAs are asymptomatic and diagnosed incidentally on imaging studies. Common clues to the possibility of TAA include widening of the mediastinum on chest X-ray, dilated aortic root on transthoracic echocardiography, and enlarged ascending aorta or aortic arch by transesophageal echocardiography.

CT angiography is the imaging modality of choice for TAAs but MRA is also an excellent test. Once diagnosd, serial CTA (or MRA) are recommended every 6-12 months based on the initial aneurysm size, its etiology (Marfan's vs not), type (dissecting vs not), and patient's health status (pregnant vs not).

When symptomatic, patients presents with complaints related to compression of adjacent structures. These include dysphagia (compression of the esophygus), dyspnea and chronic cough (airway), or hoarseness (recurrent laryngeal nerve).

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