Aortic aneurysms, often called the “silent killer,” are raising increasing concerns among American doctors. This condition affects about 1% of Americans and develops quietly, potentially becoming fatal if undetected. Most patients show no symptoms until it becomes an emergency, making screening and awareness critical. An aortic aneurysm is a balloon-like bulge in the wall of the aorta, the body’s largest artery, which carries blood from the heart to the rest of the body. These bulges form due to weakness in the vessel wall and can rupture suddenly, causing catastrophic internal bleeding.

There are two main types:
– Thoracic aortic aneurysm (TAA): occurs in the chest.
– Abdominal aortic aneurysm (AAA): occurs in the abdomen, especially below the kidneys, and is the most common.

Most aneurysms develop silently without symptoms until they worsen or rupture. When symptoms appear, they often include pain or other signs. Rupture is often fatal, with only about 20% survival.

Risk factors include age over 65, male gender (men are four times more likely to develop abdominal aortic aneurysms than women), smoking (current or former), and some congenital conditions like bicuspid aortic valve.

Screening with a one-time ultrasound is recommended for men aged 65 to 75 who have smoked. Men in this age group who never smoked should discuss screening with their doctor. There is insufficient evidence to recommend routine screening for women.

Abdominal ultrasound is the first-line test for aortic aneurysm. CT scans or echocardiograms provide precise measurements or are used if rupture is suspected.

Symptoms, when they appear, include pain and other signs. Small, stable aneurysms may only require monitoring. Treatment depends on size—surgery is considered when the aneurysm reaches 4.8-5.6 cm or grows rapidly—and symptoms such as pain, leakage, or rupture require immediate intervention.

Surgeons evaluate risk factors and comorbidities before deciding on surgery. Lifestyle choices play a crucial role in prevention; proactive measures can significantly reduce the risk of aneurysm complications.