Thoracic Aortic Aneurysm: A Clinical Review

Cardiol Clin. 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003.


Thoracic aortic aneurysms are common. Most thoracic aortic aneurysms are degenerative. However, some are associated with connective tissue disorders, bicuspid aortic valves, or familial/genetic predisposition. Most are asymptomatic, discovered incidentally on imaging. Aortic diameter is the best predictor of the natural history and risk of complications. Treating hypertension and smoking cessation can slow their growth. Surveillance imaging and referral for prophylactic aortic repair based on absolute aneurysm diameter is the primary means to decrease mortality from thoracic aortic aneurysm. We provide a practical evidence-based summary of the pathophysiology, risk factors, associated genetic syndromes, and clinical management of thoracic aortic aneurysms.

Keywords: Bicuspid aortic valve; Loeys-Dietz syndrome; Marfan syndrome; Thoracic aortic aneurysm; Thoracic aortic dissection; Vascular Ehlers-Danlos syndrome.

Publication types

  • Review

MeSH terms

  • Aortic Aneurysm, Thoracic* / diagnosis
  • Aortic Aneurysm, Thoracic* / epidemiology
  • Aortic Aneurysm, Thoracic* / etiology
  • Aortic Dissection*
  • Bicuspid Aortic Valve Disease*
  • Genetic Predisposition to Disease
  • Humans
  • Marfan Syndrome*