Thoracic Aneurysm Clinical Presentation

Updated: Feb 05, 2020
  • Author: Bret P Nelson, MD; Chief Editor: Erik D Schraga, MD  more...
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Presentation

History and Physical Examination

History

Patients with thoracic aortic aneurysm (TAA) may be asymptomatic. Forty percent may be found incidentally during workup for other processes. Symptoms vary according to the size, location, and interval changes in the aneurysm. Chest, back, and abdominal pain are common symptoms in patients who are symptomatic. Note the following:

  • Aortic root dilatation may lead to symptoms of congestive heart failure (CHF) due to aortic insufficiency.

  • Hoarseness may signify vagus or recurrent laryngeal nerve compression.

  • Wheezing, dyspnea, or cough suggests tracheal compression. Hemoptysis may be a sign of aneurysmal erosion into the trachea.

  • Dysphagia, hematochezia, or hematemesis may be caused by esophageal compression or aortoesophageal fistula.

Physical examination

The physical examination findings are usually normal. Note the following:

  • Ruptured thoracic aneurysm typically causes hypotension, tachycardia, and shock.

  • An early diastolic murmur may be heard in patients with aortic root dilatation causing aortic insufficiency.