Thoracic Aortic Aneurysm

Syllabus: General Studies Paper 3

The American football writer Grant Wahl died last week after a catastrophic tear in a major blood vessel leading out of his heart. The autopsy found that Wahl had an “ascending thoracic aortic aneurysm”, a weakening of the blood vessel that often goes undetected. 

About Thoracic Aortic Aneurysm

• As the aneurysm grows, it may produce a cough, shortness of breath or chest pain.
• An aneurysm is a localised weakening of the wall of a blood vessel, which causes the vessel to bulge in that area — as a result of which the vessel may widen to more than 50 per cent of its usual diameter. Aneurysms are more commonly seen in arteries than in veins.
• The aorta is the main artery that carries oxygenated blood from the heart to the rest of the body; it is also the body’s largest blood vessel.
• An aortic aneurysm is a weakening and bulging in a portion of the aorta; “thoracic” refers to that section of the blood vessel that passes through the chest. 
• According to a note by Johns Hopkins Medicine, aneurysms occur more often in the portion of the aorta that runs through the abdomen rather than the chest (causing what is called “abdominal aortic aneurysm”).
• An aneurysm increases in size over time, and the wall of the blood vessel gets progressively weaker in that area. 
• The vessel may ultimately burst or separate, triggering a bleeding rush that can be life-threatening, and potentially lethal.

Causes and symptoms

• Among the possible causes of thoracic aortic aneurysm, the Johns Hopkins note lists 
• Degenerative disease that causes breakdown of the aortic wall tissue; 
• Genetic disorders
• Family history
• Vasculitis, or inflammation of the arteries
• Atherosclerosis, or the build-up of plaque on the walls of the artery. In rare cases, an infection can also trigger an aneurysm.
• Wahl had Marfan syndrome, a genetic disorder that increases the risk of this type of aneurysm. 
• He was tall and thin and had long arms, all of which can be signs of the syndrome.
• The US Centers for Disease Control and Prevention (CDC) page on Marfan syndrome describes it as a genetic condition that affects connective tissue and can damage the blood vessels and cause aneurysms of the aorta. 
• The syndrome presents in around 1 in 5,000 individuals and is caused by a mutation in the FBN1 gene that limits the body’s ability to make the proteins needed to build connective tissue, according to the CDC.

Treatment

• Treatment may include monitoring the size and rate of growth of the bulge through an MRI or CT, and managing risk factors or a surgery.

Question: What is the Thoracic Aortic Aneurysm? What are its symptoms and causes.