Thoracic Aortic Aneurysm

Eastern Vascular Society

GOAL: Identify and Quantify TAA

DIFFERENTIAL DIAGNOSIS -
These are usually diagnosed serendipitously on chest x-ray or CT Scan obtained for other reasons

PERTINENT HISTORY -
History of back pain?
History of cardiopulmonary disease?
History of myocardial infarction?
Any family history?

PHYSICAL FINDINGS -
Any findings suggestive of Marfan?s Syndrome
Intraabdominal mass or evidence of infrarenal abdominal aortic aneurysm
Any difference in pulses one side of the body to the other upper or lower extremities to suggest aortic dissection.

INITIAL LABORATORY INVESTIGATIONS -
Bilateral arm blood pressures
CT Scan of the chest
RPR to rule out syphilis

MANAGEMENT ALGORITHM - ASYMPTOMATIC THORACIC AORTIC ANEURYSM
If no symptoms - aorta < 5 cm in diameter, repeat CT Scan in one year
If symptoms or aortic aneurysm > 5 cm in size - refer to vascular surgeon with cardiac risk evaluation (see infrarenal abdominal aortic aneurysm)