Ascending Aortic Aneurysm

The ascending aorta is the main trunk of the aorta. From the aortic root, this section of the aorta travels up toward the head. An ascending aortic aneurysm is a medical condition characterized by an abnormal and potentially dangerous enlargement or bulging of the ascending aorta. It means that this segment of the aorta has weakened and expanded beyond its normal size. If left untreated, an ascending aortic aneurysm can continue to grow, potentially leading to serious and life-threatening complications such as rupture, dissection, and compression of nearby structures. 


There are many potential causes of an ascending aortic aneurysm, including: 

  • Genetics and family history of aneurysms 
  • Connective tissue disorders, such as Marfan syndrome, Vascular Ehlers-Danlos syndrome, and Loeys-Dietz syndrome 
  • High blood pressure 
  • Smoking (leading to injury of the wall of the aorta) 
  • Age 
  • Atherosclerosis (hardening of the arteries) 
  • Bicuspid aortic valve, a congenital heart condition 
  • Infections affecting the aorta 
  • Trauma or injury to the aorta 


Ascending aortic aneurysms often have no symptoms. Some possible aneurysm symptoms are: 

  • Dull chest pain 
  • Chest pain during exercise 
  • Shortness of breath 

Symptoms of a dissected or ruptured ascending aortic aneurysm include: 

  • Sharp chest pain, sometimes also felt in the back. 
  • Extreme shortness of breath 
  • Trouble swallowing 
  • Fainting/loss of consciousness


Ascending aortic aneurysms are typically diagnosed using the following imaging tests: 

  • Echocardiogram (ultrasound of the heart): An echocardiogram uses sound waves to create a picture of the heart and blood vessels 
  • Computed tomography (CT) scans use X-rays and computer technology to produce detailed images of the aorta. 
  • Magnetic resonance angiography (MRA) scans are a type of MRI that looks specifically at the body’s blood vessels. 

Treatment Options

Ascending Aorta Replacement

In cases where the aneurysm does not involve the aortic root or the aortic valve, the surgeon may perform a replacement of the ascending aorta without touching the aortic valve.  This will require open heart surgery.

Monitoring and Medical Management of Ascending Aortic Aneurysms

Medical management of ascending aortic aneurysms involves regular monitoring of the aneurysm’s size and shape and taking steps to prevent it from growing or rupturing. Monitoring typically involves regular imaging tests, such as CT scan, MRA, or ultrasound/echocardiogram, to track the size and shape of the aneurysm. The frequency of these tests will be determined by your doctor based on the size and rate of growth of the aneurysm.  

Medical management of an ascending aortic aneurysm also involves managing underlying health conditions, such as high blood pressure or smoking, that can contribute to aneurysm growth. If appropriate, your healthcare provider may prescribe medications such as beta-blockers or angiotensin receptor blockers. It is essential to modify your risk for rupture by controlling high cholesterol and high blood pressure and avoiding tobacco use. In some cases, surgical intervention may be necessary to repair or remove the aneurysm.  

It is important to follow your provider’s recommendations and attend all scheduled appointments and tests to ensure proper monitoring and management of an ascending aortic aneurysm. 

Genetic Counseling for Ascending Aortic Aneurysms

Certified genetic counselors are healthcare professionals with specialized training in genetics and counseling. They are available to discuss the potential role of genetics in the development of aortic aneurysms. The genetic counselor will review your personal and family medical history and may perform genetic testing to identify any potential genetic mutations that increase the risk of developing aortic aneurysms. If a mutation is found, the genetic counselor will discuss the implications for you and your family members, including the risks of inheriting the condition and the potential for future generations to be affected. They will also provide information about available screening and monitoring options and the importance of regular check-ups. 

Genetic counselors work with you and your family to discuss: 

  • The inheritance pattern, including the role of genetic and environmental factors. 
  • The potential risks for the individual and their family members, including the likelihood of developing the condition and the potential impact on their health and daily life. 
  • The available genetic testing options, including the benefits, limitations, and results of genetic testing for a thoracic aortic aneurysm. 
  • The management options for an aortic aneurysm, including medical, surgical, and lifestyle interventions. 
  • The psychological and emotional impact of an aortic aneurysm and the importance of support and resources for individuals and families affected by the condition.

Make an Appointment

To request an appointment or to get more information, please call 734-936-9010 and a team member will get back to you within two business days.