What are the symptoms of an aortic aneurysm?

Dr. William J. Quinones Baldrich, MD
Vascular Surgeon

Most aortic aneurysms cause no symptoms. They are frequently discovered by the patient undergoing imaging for some other reason. Depending on the location of the aneurysm, the patient may experience chest, abdominal and/or back pain. Other symptoms may include early fullness with small meals due to compression of the intestine by the aneurysm. Compression of the ureter, the tube that carries urine from the kidney to the bladder, can lead to flank pain. Clots can break off from an aneurysm leading to blockage of arteries and a sudden onset of pain either in the abdomen or in the lower extremities. Rupture is the most feared complication of an aortic aneurysm. Symptoms of aortic aneurysm rupture include sudden onset of chest, abdominal or back pain, often with a drop in blood pressure leading to shock. On occasion, the rupture is contained, allowing for the emergency transfer of the patient to a hospital where treatment can be promptly administered.

Most people with thoracic or abdominal aortic aneurysms have no symptoms and are discovered while the person is having an x-ray study for another reason or on physical exam. Some people complain of vague pain in the chest or abdomen and they may have a persistent cough and hoarseness. Large abdominal aneurysms can result in a pulsing feeling in the abdomen or chest.

When an aneurysm ruptures, the internal bleeding can cause intense back, abdominal, or chest pain. People with a ruptured aneurysm may also experience signs of shock such as shaking, dizziness, fainting, sweating, rapid heartbeat, and sudden weakness.

Aortic aneurysms develop slowly over time and almost never have any symptoms. If an aneurysm is near the skin, it may be a visible, painful and throbbing mass.

People with aortic aneurysms most commonly do not have any defining symptoms, but they often have non-specific chest pain. Pain that is unusual in the chest should warrant a workup to check heart arteries and also to rule out an aneurysm. A very large aneurysm can also cause symptoms if it interacts with nearby organs, such as the lungs (causing shortness of breath), esophagus (causing difficulty swallowing), or even a stroke in some cases.

An aortic aneurysm  is an enlargement or dilation of the aorta. The aorta is the largest artery in the body. It begins at the heart and curves to run along the spine and provides blood flow to all major organs in the body. An aneurysm causes stretching and thinning of the layers of the artery and this thinning can result ultimately in a rupture, which is a life threatening event. Aneurysms may occur anywhere in the aorta; however they are most commonly seen in the lower aorta in the abdomen.  Most  people do not have any symptoms with an aortic aneurysm, but may notice a throbbing or pulsing area above the belly button. Rarely, the aneurysm may have some inflammation around it that causes the area to be tender or painful. When these aneurysms become very large, they may produce some back discomfort due to pressure near the spine. If they do burst, they usually produce severe pain and sweating and patients are acutely aware that something is wrong. Finally aneurysms often contain  sand-like deposits inside the artery due to the currents that are produced as they enlarge. Occasionally these particles can dislodge and go downstream to produce symptoms such as blue areas on the toes.

One kind of aneurysm is a dissecting aneurysm, which results from a tear in the layers of the artery wall. This tear happens suddenly and patients usually have pain that is severe. This type of problem requires immediate attention in the hospital.

Dr. David W. Drucker, MD
Cardiologist (Heart Specialist)

Most of the time, aneurysms are completely and totally asymptomatic. 70 to 75 percent or more of the time people have no symptoms at all. If you do have symptoms from an aneurysm, it may be an indication that you need urgent evaluation and treatment. There's a big difference between an asymptomatic aneurysm and a symptomatic aneurysm. If it's a symptomatic aneurysm, the aneurysm itself may be at high risk for rupture. If so, it needs to be treated as soon as possible.

Common symptoms include severe abdominal or back discomfort, nausea and sweating. Someone can also pass out. We call that syncope because the aneurysm fully or partially bursts and the person loses blood volume into their abdomen. A medical emergency may also occur where people lose consciousness and need to be resuscitated.

If you have an aneurysm, make sure you know the signs of an aneurysm that’s bursting. Often times, you may notice advanced symptoms like back and abdominal pain, and with symptoms like those, it’s important you seek medical attention. When they burst, it can be life threatening, but if you pay attention to the symptoms, you can get medical therapy in time. It’s important to know that a leaking aneurysm or a symptomatic aneurysm is a major medical emergency, and isn’t something that can wait. 9-1-1 needs to be called in that case, or at the very minimum, the person needs to get to the hospital quickly.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.