Thyroid & Adrenal
The most common presenting symptoms in patients with an ascending thoracic aneurysm.
|A||Anterior chest pain|
|B||Posterior chest pain|
|C||Aortic value insufficiency|
a. The majority of the thoracic aneurysm are asymptomatic until significant enlargement has occurred,
b. Pain frequently occur in anterior chest .
c. Still, majority of the patients are accidently discovered during chest x-ray examination.
d. The most common symptoms in patients with ascending aortic aneurysms is anterior chest discomfort.
e. The pain is frequently pericardial in location, but may radiate to the neck and jaw, mimicking angina.
f. The thoracic aneurysms are classified in five groups:1.Ascending aorta 2. Transverse aortic arch 3. Traumatic usually occurring distal to left subclavian artery 4. Descending thoracic aorta 5. Thoracoabdominal.
g. Aneurysm of ascending aorta, transverse aortic arch can cause symptoms related to compression of SVC, the pulmonary artery, the airway or the sternum.
h. Expansion of the distal aortic arch can stretch the recurrent laryngeal nerve, resulting in left cord paralysis hoarseness.
i. When the aneurysm is largest in the region of aortic hiatus, middle back and epigastric pain may occur.
j. Thoracoabdominal aortic aneurysm can cause duodenal obstruction or upon bowel wall erosion, gastrointestinal bleeding.
k. Jaundice due to compression of liver or porta hepatis is uncommon.
l. The most common causes of thoracic aneurysm are atherosclerosis, aortic dissection , collagen degenerative disease.
m. Aneurysm of the ascending aorta are most frequent representing over 40% of the total aneurysms.