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Diagnosis & Treatment

Aortic Aneurysm

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Diagnosis & Tests

Diagnosis & Tests

At NewYork-Presbyterian, we use the most advanced imaging to monitor and diagnose aortic disease. Since these conditions are often “silent,” they are frequently discovered during tests for other health issues.

How We Find Aortic Aneurysms and Dissections

Your doctor may catch signs of an aortic aneurysm during a regular exam or tests for other reasons. If you are at high risk of developing the disease, your doctor may recommend regular screenings for aortic aneurysms. Unfortunately, many aortic aneurysms may not be diagnosed until after they have ruptured or developed an aortic dissection, as they do not cause symptoms beforehand.

If you are presenting with signs or symptoms of an aortic aneurysm, your doctor will first review your medical history and family history. Your physician may conduct one or more imaging tests to diagnose or confirm aortic aneurysms. These tests can help determine where an aneurysm is located, how severe it is, how quickly it is growing, and other important details about your condition.

Imaging tests that may be used to diagnose aortic aneurysms include:

  • Echocardiogram: An ultrasound of the heart to view the ascending aorta.
  • Computed tomography (CT) scan: The gold standard for measuring the size and location of an aneurysm as well as for surgical or endovascular planning.
  • Magnetic resonance imaging (MRI): High-resolution imaging without radiation.
  • Abdominal ultrasound: Used for screening and monitoring an abdominal aortic aneurysm.

Management & Treatment

Management & Treatment

How are aortic aneurysms and dissections treated?

Treatment depends on the size and growth rate of the aneurysm and the severity of the dissection. At NewYork-Presbyterian, our world-renowned multidisciplinary aortic team creates a care plan customized to your specific situation, ranging from “watchful waiting” to emergency surgery.

Monitoring and Medication

If an aneurysm is small and not growing quickly, your doctor may recommend:

  • Regular monitoring: Scheduled CT, MRI, or ultrasound scans to track changes.
  • Blood pressure management: Medications like beta-blockers to reduce the stress on the aortic wall.
  • Cholesterol control: Statins to help maintain the health of the blood vessels.
  • Smoking cessation: Quitting smoking has many health benefits including slowing aneurysm growth.
  • Lifestyle modification: Avoiding heavy lifting while continuing modest exercise is recommended.

Surgery and Endovascular Repair

If the risk of rupture is high, aortic aneurysm surgery or aortic dissection treatment is necessary.

  • Endovascular repair (EVAR/TEVAR): A minimally invasive procedure where a stent-graft is inserted through small incisions in the groin to reinforce the aorta.
  • Branched or Fenestrated (BEVAR/FEVAR): A minimally invasive method of repairing complex aneurysms, which includes branches or stents to major blood vessels supplying organs.
  • Open surgery: The damaged section of the aorta is replaced with a synthetic tube (graft). This is often required for complex cases or Type A dissections. It may also be preferred for younger, healthier patients, those with aortic infection, or connective tissue disorders. A minimally invasive open repair may be considered for selected patients.

Living With Aortic Disease

Living With Aortic Disease

Receiving a diagnosis can be overwhelming, but many patients live long, full lives with proper management. Our team provides the support you need to manage your heart health confidently.

Follow-Up, Lifestyle, and Family Screening

  • Follow-Up: Lifelong monitoring is essential to ensure grafts are working and no new aneurysms form.
  • Lifestyle: Quitting smoking and maintaining a heart-healthy diet are vital. Regular cardiovascular exercise is recommended; however, very heavy lifting should be avoided.
  • Family screening: If you are diagnosed, your first-degree relatives (parents, siblings, children) should be screened, as aortic disease can be inherited.

When to Call 911 or Your Doctor

  • Call 911: For sudden, severe pain (chest, back, or abdomen) or signs of shock.
  • Call your doctor: If you notice new, persistent back or abdominal pain, or if you feel a new pulsating sensation in your belly.

FAQs

FAQs

An aortic aneurysm is a weak spot that bulges out like a balloon. An aortic dissection is a tear in the inner lining of the artery wall. While they are different, both conditions weaken the aorta and require expert medical attention.

In most cases, doctors recommend surgery based on size and location, however surgery is recommended when the aneurysm reaches to 5.0 to 5.5 centimeters (about 2 inches). Your care team may suggest surgery sooner if the aneurysm is growing quickly,if you have certain genetic risk factors, or for other medical reasons.

Yes. About 1 in 5 people with a thoracic aneurysm have a close family member with the same condition. If you are diagnosed, it is recommended that your parents, siblings, and children also be screened.

Yes. Most people return to their usual jobs and activities. To stay healthy, you will need to keep your blood pressure under control and come in for regular "check-up" scans to monitor your heart and vessels.

Pregnancy increases the strain on your heart and aorta. If you have a history of aortic disease, it is very important to speak with your cardiologist and a high-risk pregnancy specialist before you try to conceive to ensure a safe plan for you and your baby.

Why Choose the NewYork-Presbyterian Aortic Center

Why Choose the NewYork-Presbyterian Aortic Center

When you choose NewYork-Presbyterian, you gain access to one of the nation's most experienced teams of cardiac and vascular surgeons.

  • Multidisciplinary expertise: We bring together surgeons, cardiologists, and geneticists to treat every aspect of your condition.
  • Innovative technology: We utilize the latest in minimally invasive endovascular techniques, often resulting in shorter hospital stays and faster recoveries.
  • Comprehensive genetics program: We offer specialized screening for families to identify and manage inherited aortic risks early.
  • Emergency readiness: Our “Aortic Alert” system ensures that patients with life-threatening dissections receive immediate, life-saving intervention 24/7.
 

This content has been reviewed by the following medical editors.

Virendra I. Patel, MD, MPH, Thomas O'Donnell, MD