Editor’s note: This article originally ran July 1, 2022, and was updated July 22, 2025.
Being diagnosed with an aortic aneurysm is frightening. It’s natural to worry about what it means for your health and your future. But take heart: Though this is a serious diagnosis and aortic aneurysms can be fatal, with careful monitoring and treatment your doctor can help you manage an aortic aneurysm and avoid a life-threatening rupture.
We talked to UNC Health vascular surgeon Mark Farber, MD, to learn more about what an aortic aneurysm is and how your healthcare team can care for an aortic aneurysm before it ruptures.
What is an aortic aneurysm?
The aorta is the main artery in the body that moves blood and oxygen from the heart to other areas, such as the brain, muscles and organs. Shaped liked a candy cane, the aorta has thick walls and is more than an inch wide in some places. An aortic aneurysm is a weakened or bulging area in the wall of the aorta.
“An aortic aneurysm is defined as greater than 50 percent enlargement of the aorta relative to its normal size,” Dr. Farber says.
This may occur anywhere along the aorta, including in the abdomen (abdominal aortic aneurysm) or chest (thoracic aneurysm). Aneurysms tend to develop over time. The bulging itself is not fatal, but if it bursts, it can cause life-threatening internal bleeding.
The aorta can weaken in response to risk factors such as high blood pressure and smoking, Dr. Farber says. The aorta starts to dilate, or get larger, increasing the tension on the wall of the aorta. This tension “increases the likelihood of catastrophic events like bursting of the aorta, rupture or a condition called aortic dissection,” he says.
While uncommon, an aortic dissection can cause blood to get in between the layers of the aorta, which causes narrowing and results in decreased blood flow to organs. When this happens, it is harder for blood to provide the necessary oxygen to these areas of the body. The separation of the aortic layers can weaken the artery, which can cause the aneurysm to enlarge and rupture.
What are risk factors for an aortic aneurysm?
While doctors can’t pinpoint exactly what causes someone’s aorta to dilate, there are certain risk factors including:
- High blood pressure
- High cholesterol
- Smoking
- Family history of aortic aneurysms
Aortic aneurysms are more common in men, people 65 and older and those with certain hereditary conditions including Marfan syndrome, Ehlers-Danlos syndrome and Loeys-Dietz syndrome.
How are aortic aneurysms detected?
In many cases, people do not know they have an aortic aneurysm because the aneurysm usually doesn’t cause any symptoms. It might be discovered during an imaging test for something else—maybe you have a persistent cough and have a chest X-ray, which shows signs of a widening of the aorta, and then a CT scan reveals the aneurysm.
If aortic aneurysms run in your family, your doctor may screen you to check for one. Symptoms usually do not occur until an aneurysm bursts.
Symptoms of a ruptured aneurysm are sudden and can include:
- Dizziness
- Rapid heart rate
- Sudden, severe chest, stomach or back pain
The symptoms of an aortic aneurysm can also be confused with those of a heart attack. Both are emergencies. Seek immediate medical attention if you experience any of these warning signs. Call 911 or go straight to an emergency department.
How are aortic aneurysms treated?
If you have an aortic aneurysm, the goal is to keep it from bursting. Getting your blood pressure and cholesterol levels under control and quitting smoking are very helpful.
There is no medical treatment to shrink or decrease the size of the aneurysm.
“While there are numerous clinical trials for this, currently there is nothing that has been conclusively shown to change the course of the disease once it starts,” Dr. Farber says.
If you have an unruptured aortic aneurysm, your doctor will monitor your condition closely through regular screenings to see if it grows.
“They typically grow very slowly over many years,” Dr. Farber says. “If it’s rapidly growing, then we’d consider a procedure to fix it. We can replace the artery or put a lining on the inside of the artery to strengthen it.”
Sometimes, this repair is done through traditional open surgery, but increasingly, there are options for a minimally invasive procedure, shortening your time in the hospital and typical recovery time.
If you know that you might need surgery for an aortic aneurysm, Dr. Farber says it’s important to seek out a specialist in aortic care or visit a medical center with an aortic center. The UNC Health Aortic Network is made up of a multidisciplinary team of specialists who care for patients with aortic diseases such as aortic aneurysms. It also offers aortic aneurysm screening to high-risk patients 65 and older.
“The benefit of the UNC Health Aortic Network is that we have the latest up-to-date options available,” Dr. Farber says. “We can tailor the treatment and the device to your aneurysm, with better outcomes.”
If you have been diagnosed with an aortic aneurysm—a bulge in the body’s main artery—you should be monitored regularly. Talk to your doctor about referring you to the UNC Health Aortic Network or to a specialist who can monitor you. Need a doctor? Find one near you.