An aortic aneurysm is a bulge in your aorta, the largest artery in your body

Your aorta carries blood directly from your heart to the rest of your body. An aortic aneurysm happens when the wall of this artery becomes weak and balloons outward, like a bulge in an old tire. The bulge itself does not hurt and does not always cause symptoms, which is why many people do not know they have one until a doctor finds it during imaging for another reason.

The danger is that the bulge can tear or rupture. If that happens, you lose blood very quickly inside your body, and this is a medical emergency. Most aortic aneurysms grow slowly over years, but some grow faster than others. Doctors watch them with regular ultrasounds or CT scans to see if they are getting bigger.

Key Takeaways

  • An aortic aneurysm is a weakened, bulging section of your aorta that usually has no symptoms until it ruptures.
  • The two main types are thoracic (in the chest) and abdominal (in the belly), and they have different risk factors and growth patterns.
  • Doctors find most aneurysms by accident during imaging for other conditions, or when screening people at high risk.
  • Treatment depends on the size and location of the aneurysm, and ranges from watching it with regular scans to surgery.
  • A ruptured aortic aneurysm is life-threatening and requires emergency surgery.

Where the aneurysm forms: thoracic versus abdominal

The location of the aneurysm matters because it affects your symptoms, how fast it grows, and what treatment you need. A thoracic aortic aneurysm forms in the chest, in the part of the aorta closest to your heart. An abdominal aortic aneurysm forms lower down, in the belly.

Thoracic aneurysms are often linked to connective tissue disorders (conditions that affect how your body builds and repairs tissue), high blood pressure, or injury to the chest. Abdominal aneurysms are more common in older men who smoke or have high blood pressure. The two types also grow at different speeds—abdominal aneurysms tend to grow more slowly, while thoracic ones can enlarge faster.

Why the aorta wall weakens

Several things can damage the wall of your aorta over time. High blood pressure puts constant stress on the artery walls and is one of the most common causes. Smoking damages the tissue in artery walls and makes aneurysms more likely to form and grow. Atherosclerosis—the buildup of plaque inside arteries—can weaken the wall from the inside.

Some people are born with conditions that affect connective tissue, such as Marfan syndrome or Ehlers-Danlos syndrome, which make the aorta wall naturally weaker. Age also plays a role; aneurysms are more common as you get older. In rare cases, an infection or inflammation of the aorta can lead to an aneurysm.

How doctors find an aortic aneurysm

Most aortic aneurysms are found by accident. You might have a CT scan or ultrasound for back pain, chest pain, or another reason, and the radiologist spots the bulge. Because aneurysms usually cause no symptoms, screening is important for people at higher risk.

Men over 65 who have ever smoked are offered one-time ultrasound screening in many healthcare systems. If you have a family history of aortic aneurysm, high blood pressure, or a connective tissue disorder, your doctor may recommend screening even if you have no symptoms. Once an aneurysm is found, you will have follow-up imaging—usually ultrasound or CT—to measure it and watch whether it is growing.

What size matters: when doctors recommend treatment

The size of the aneurysm is the main factor in deciding whether to watch it or treat it. Doctors measure the width of the bulge in millimeters. For abdominal aneurysms, surgery is usually recommended when the aneurysm reaches 5.5 centimeters (about 2.2 inches) across, or if it is growing faster than 0.5 centimeters per year. For thoracic aneurysms, the threshold is often lower, around 5 to 5.5 centimeters, depending on your body size and other risk factors.

If your aneurysm is smaller, your doctor will schedule regular imaging—often every 6 to 12 months—to track its growth. During this time, controlling your blood pressure and quitting smoking (if you smoke) are critical to slow the growth. You should also avoid heavy lifting and strenuous exercise, as these can raise blood pressure and stress the weakened artery.

Treatment options: surgery and less invasive approaches

When an aneurysm reaches the size where rupture risk becomes serious, or if it is growing very quickly, surgery is recommended. The traditional approach is open surgery, in which the surgeon opens your chest or abdomen, removes the weakened section of aorta, and replaces it with a synthetic graft (a tube made of artificial material).

A newer, less invasive option is endovascular repair. In this procedure, the surgeon makes a small cut in your groin and threads a catheter (a thin tube) up to the aneurysm. A stent graft—a metal mesh tube covered with fabric—is placed inside the aorta to reinforce the weak spot and redirect blood flow away from the bulge. This approach has a shorter recovery time than open surgery, though it requires more frequent follow-up imaging.

Your surgeon will recommend one approach or the other based on the location and shape of your aneurysm, your age, and your overall health. Both procedures carry risks, and your doctor will discuss these with you in detail.

What a ruptured aortic aneurysm means

If an aneurysm ruptures, blood spills into your chest or abdomen very quickly. This is a life-threatening emergency. Signs include sudden, severe chest or back pain, feeling faint or losing consciousness, and shortness of breath. If you experience these symptoms, call 911 immediately.

A ruptured aortic aneurysm requires emergency surgery to stop the bleeding and repair the aorta. Survival depends on how quickly you reach the hospital and how quickly surgeons can operate. This is why finding and monitoring aneurysms before they rupture is so important—it gives you the chance to have planned surgery when you are stable, rather than emergency surgery when you are in shock.

Living with an aortic aneurysm

If you have been diagnosed with an aortic aneurysm that does not yet need surgery, your main job is to slow its growth and keep your follow-up appointments. Control your blood pressure by taking medications as prescribed and limiting salt in your diet. If you smoke, quitting is one of the most important things you can do.

Avoid sudden heavy exertion, straining, and activities that spike your blood pressure. Talk to your doctor before starting an exercise program; gentle, steady activity is usually safe, but high-intensity workouts may not be. Keep a list of your imaging results and measurements so you and your doctor can track changes over time. If you have a family history of aortic aneurysm, your relatives may benefit from screening as well.

Frequently Asked Questions

Can you feel an aortic aneurysm?

Most aortic aneurysms cause no symptoms at all, which is why they are often found by accident. Some people with a thoracic aneurysm may feel chest or back pain, or have a hoarse voice if the aneurysm presses on a nerve. Abdominal aneurysms rarely cause pain unless they are about to rupture.

Is an aortic aneurysm hereditary?

Aneurysms themselves are not inherited, but the conditions that make them more likely can run in families. If you have a relative with an aortic aneurysm, or if you have a genetic connective tissue disorder, your risk is higher. Talk to your doctor about whether screening is right for you.

How often do aortic aneurysms rupture?

The risk of rupture depends on the size and location of the aneurysm. Smaller aneurysms rupture rarely, but the risk increases as the aneurysm grows. This is why doctors recommend surgery when aneurysms reach a certain size—to prevent rupture before it happens.

Can you exercise with an aortic aneurysm?

Light to moderate exercise is usually safe, but you should avoid sudden heavy lifting, straining, and high-intensity workouts that spike your blood pressure. Ask your doctor what activities are safe for you based on the size and location of your aneurysm.

What happens after aortic aneurysm surgery?

After open surgery, recovery takes 6 to 12 weeks. After endovascular repair, recovery is faster—usually 1 to 2 weeks. Either way, you will need regular follow-up imaging to make sure the repair is holding and to check for new aneurysms elsewhere in the aorta.