A short story: what would you do?
Follow Ben to learn the warning signs and what to do. Turn on your sound for the narration.
What can go wrong with the aorta
The aorta carries blood from the heart through the chest (the thoracic aorta) and down into the belly (the abdominal aorta). [Ref: AHA Aorta Health]
Aneurysm
A weak part of the wall bulges outward. It usually grows slowly and silently. The bigger it gets, the higher the risk of a tear or rupture. [Ref: AHA Aorta Health] [Ref: ESC 2024 PAAD]
Dissection
Blood forces its way between the layers of the aortic wall and splits them apart. This is an emergency. [Ref: AHA Aorta Health]
Rupture
The wall bursts and blood escapes. This is life-threatening and needs emergency surgery. [Ref: AHA Aorta Health]
How common are aortic aneurysms?
About 1 in 100 adults aged 30 to 79 worldwide has an abdominal aortic aneurysm. Men are affected about 4 times more often than women. The Western Pacific region, which includes the Philippines, had the highest estimated rate of any world region (1.31%). [Data: Song 2022 AAA]
Who is at risk
- High blood pressure, especially if it is long-standing and poorly controlled. This is the biggest risk factor for dissection. [Ref: AHA Dissection 2026]
- Smoking, now or in the past. [Ref: AHA Aorta Health] [Ref: Song 2022 AAA]
- Older age and being male. [Ref: AHA Aorta Health]
- A parent, brother or sister with an aortic aneurysm or dissection. [Ref: ESC 2024 PAAD] [Ref: ACC/AHA 2022 Aortic]
- Inherited conditions such as Marfan syndrome or Ehlers-Danlos syndrome, and being born with a bicuspid aortic valve (a valve with two flaps instead of three). [Ref: AHA Aorta Health] [Ref: ESC 2024 PAAD]
- High cholesterol and hardening of the arteries. [Ref: AHA Aorta Health]
Who should be screened
A simple ultrasound of the belly can find an abdominal aneurysm early, before it causes harm. It is painless and uses no radiation. [Ref: ESC 2024 PAAD] [Ref: ESVS 2024 AAA]
| Who | Test |
|---|---|
| Men aged 65 and older who have ever smoked | One-time ultrasound of the abdominal aorta [Ref: ESC 2024 PAAD] [Ref: AHA Aorta Health] |
| Men aged 65 and older, especially if they have ever smoked, and other people at high risk | One-time ultrasound, per the European vascular surgery guideline [Ref: ESVS 2024 AAA] |
| All men aged 75 and older, and women aged 75 and older who smoke or have high blood pressure | One-time ultrasound [Ref: ESC 2024 PAAD] |
| Brothers, sisters and children, aged 50 and older, of someone with an abdominal aortic aneurysm | Ultrasound [Ref: ESC 2024 PAAD] |
| Parents, brothers, sisters and children of someone with a thoracic aneurysm or aortic dissection | Imaging of the aorta [Ref: ACC/AHA 2022 Aortic] |
| People with a bicuspid aortic valve or an inherited aortic condition | Regular heart ultrasound, CT or MRI [Ref: ESC 2024 PAAD] [Ref: AHA Dissection 2026] |
Screening advice differs slightly between guidelines, especially for men aged 65 to 74 who have never smoked. Your doctor can help you decide.
Should your aorta be checked? Ask a doctor.
Only a scan can find an aneurysm, and only your doctor can tell how often it should be checked and when it needs repair. Dr. Aaron Christopher P. Novales sees patients with diseases of the aorta.
Sudden, severe pain in the chest, back or belly? Do not wait for a clinic visit. Go to the emergency room now →
Living with an aneurysm
About the medicines on this page
Medicines are described here only to help you understand your doctor's plan. Do not buy or take any medicine because you read about it here. Take only what your doctor prescribes for you, and never start, stop or change a dose on your own.
Most aneurysms found early are small. They are watched with regular scans rather than repaired right away. Size is the main sign of risk, so each scan measures it. [Ref: ESC 2024 PAAD] [Ref: ESVS 2024 AAA] [Ref: ACC/AHA 2022 Aortic]
Keep your scansUltrasound for the belly; CT, MRI or heart ultrasound for the chest.
Control blood pressureThis lowers the strain on the aortic wall.
Stop smokingSmoking speeds up damage to the arteries.
Treat cholesterolYour doctor may prescribe a cholesterol-lowering medicine.
[Ref: AHA Dissection 2026] [Ref: ESC 2024 PAAD] [Ref: ACC/AHA 2022 Aortic]
When repair is needed
Repair is usually advised when the risk of rupture becomes higher than the risk of the operation. [Ref: ESVS 2024 AAA] [Ref: ACC/AHA 2022 Aortic]
Your doctor and an aortic team decide when repair is needed, based on the size of the aneurysm, how fast it is growing, any symptoms and your overall health. New pain in the belly, back or chest needs urgent assessment, whatever the size.
Repair can be done by open surgery or with a stent graft placed through the blood vessels in the groin. Care is best given by an experienced aortic team. After repair, you will need follow-up scans for life. [Ref: ESC 2024 PAAD] [Ref: ACC/AHA 2022 Aortic] [Ref: ESVS 2024 AAA]
Aortic dissection
A dissection can feel like a heart attack, stroke or blood clot in the lungs, so fast scanning in the emergency room is vital. Quick diagnosis and treatment save lives. [Ref: AHA Dissection 2026]
Type A: involves the ascending aorta
Usually needs emergency surgery. [Ref: ACC/AHA 2022 Aortic] [Ref: ESC 2024 PAAD]
Type B: further down the aorta
Often treated first with medicines that lower blood pressure and heart rate. Some people need a stent graft. [Ref: ACC/AHA 2022 Aortic] [Ref: ESC 2024 PAAD]
Talk to your doctor about
Bring these questions to your visit.
- Should I have a screening ultrasound of my aorta?
- How big is my aneurysm, and how fast is it growing?
- How often do I need a scan?
- Should my family members be checked?
- What is my blood pressure target?
Related conditions
Guideline sources for this page
- ESC 2024 PAAD: Mazzolai L, et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J 2024;45:3538–3700. Key aortic points: ACC summary.
- ACC/AHA 2022 Aortic: Isselbacher EM, et al. 2022 ACC/AHA Guideline for the diagnosis and management of aortic disease. Circulation 2022.
- ESVS 2024 AAA: Wanhainen A, Van Herzeele I, Bastos Goncalves F, et al. ESVS 2024 Clinical Practice Guidelines on the management of abdominal aorto-iliac artery aneurysms. Eur J Vasc Endovasc Surg 2024;67:192–331.
- AHA Aorta Health: American Heart Association. Aorta health: risks and symptoms of aneurysm.
- AHA Dissection 2026: American Heart Association News. What is aortic dissection? Symptoms, causes and how to lower risk. 14 September 2026.
- Prevalence data: Song P, et al. The global and regional prevalence of abdominal aortic aneurysms. Ann Surg 2023;277(6):912–9.