Thoracic aortic aneurysm: How to counsel, when to refer

Frank Cikach; Milind Y Desai; Eric E Roselli; Vidyasagar Kalahasti

doi:10.3949/ccjm.85a.17039

Thoracic aortic aneurysm: How to counsel, when to refer

Cleve Clin J Med. 2018 Jun;85(6):481-492. doi: 10.3949/ccjm.85a.17039.

Authors

Frank Cikach¹, Milind Y Desai^{2

3}, Eric E Roselli^{4

5}, Vidyasagar Kalahasti^{6

7}

Affiliations

¹ Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
² Haslam Family Endowed Chair in Cardiovascular Medicine, Department of Cardiovascular Medicine, Medical Director, Aorta Center, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
³ Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
⁴ Chief, Adult Cardiac Surgery, Surgical Director, Aorta Center, Director, Heart and Vascular Condition Centers, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
⁵ Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
⁶ Director, Marfan and Other Connective Tissue Disorders Clinic, Aorta Center, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. [email protected].
⁷ Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.

PMID: 29883307
DOI: 10.3949/ccjm.85a.17039

Abstract

Thoracic aortic aneurysm (TAA) is usually clinically silent and progresses slowly until a tipping point is reached, after which the aortic diameter can expand more rapidly and the condition can potentially end in aortic dissection or rupture. Causes include bicuspid aortic valve and genetic syndromes (Marfan, Loeys-Dietz, and Ehlers-Danlos syndromes) and familial associations, but many cases are idiopathic. Clinicians should therefore be alert for clues on chest imaging, and consider screening in first-degree relatives of patients known to have aortic disease. Early referral to a cardiologist specializing in aortic disease is key.

Publication types

Review

MeSH terms

Aortic Aneurysm, Thoracic / diagnosis*
Counseling / methods*
Humans
Referral and Consultation*