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Cardiolucent

Condition

Aortic aneurysm

Conditions

An aortic aneurysm is an abnormal dilation of the aorta — the body's largest artery — that weakens the vessel wall and raises the risk of rupture or dissection, both of which can be catastrophic. Aneurysms develop in the chest (thoracic aortic aneurysm), in the abdomen (abdominal aortic aneurysm), or at the junction between the two, and each location follows a different natural history and surveillance schedule. Most aneurysms are silent until they reach concerning size, which is why proactive screening in higher-risk patients and surveillance imaging in known cases are central to safe management. Dr. Kedan provides detection, serial monitoring, medical management to slow progression, and coordinated referral for surgical or endovascular repair when size and growth thresholds are reached.

What Cardiolucent Evaluates

  • Abdominal aortic ultrasound and POCUS for screening and routine surveillance
  • Coordination of CT or MR angiography for thoracic aneurysms and detailed anatomy
  • Echocardiography with attention to the aortic root and ascending aorta
  • Family history screen for connective tissue disorders and hereditary aneurysm syndromes
  • Genetic referral when Marfan, Loeys-Dietz, vascular Ehlers-Danlos, or familial pattern is suspected
  • Aggressive blood pressure control with medication tailored to aneurysm location
  • Tobacco cessation support, the single most important modifiable factor
  • Activity counseling and coordination with vascular and cardiothoracic surgery at Cedars-Sinai

Common Symptoms

  • Most aneurysms cause no symptoms and are found incidentally on imaging
  • Deep, dull chest, back, or abdominal pain in larger or rapidly growing aneurysms
  • A pulsating sensation in the abdomen with large abdominal aneurysms
  • Hoarseness or difficulty swallowing if a thoracic aneurysm compresses adjacent structures
  • Sudden severe tearing chest, back, or abdominal pain is a true emergency — call 911 immediately, as this can indicate dissection or rupture
  • Lightheadedness, weakness, or shock with rupture

Risk Factors

  • Tobacco use — the strongest modifiable risk factor for abdominal aneurysms
  • Long-standing hypertension
  • Atherosclerosis affecting other vascular beds
  • Family history of aneurysm, particularly in first-degree relatives
  • Bicuspid aortic valve (especially for ascending thoracic aneurysms)
  • Connective tissue disorders: Marfan, Loeys-Dietz, vascular Ehlers-Danlos
  • Age over 65 and male sex (for abdominal aneurysms)
  • Chronic inflammatory or infectious aortitis in select cases

How Cardiolucent Approaches Treatment

Most aneurysms are managed medically with surveillance, with the goal of slowing growth and detecting size thresholds early. Dr. Kedan focuses on strict blood pressure control, often with beta-blockers or ARBs depending on aneurysm type and patient profile, along with smoking cessation, statin therapy when otherwise indicated, and activity guidance that avoids heavy isometric strain. Imaging frequency is calibrated to aneurysm size and growth rate, not a generic schedule. When repair becomes appropriate — typically based on size thresholds, growth rate, symptoms, or underlying connective tissue diagnosis — Dr. Kedan coordinates referral with vascular and cardiothoracic surgery at Cedars-Sinai for open or endovascular repair.

Common Questions

Frequently Asked Questions

What is an aortic aneurysm?
An aortic aneurysm is an abnormal dilation of the aorta — the body's main artery — that weakens the vessel wall and raises the risk of rupture or dissection. Aneurysms can form in the chest (thoracic) or the abdomen (abdominal), and each has different surveillance and treatment considerations. Most are silent until they become large or unstable, which is why proactive screening is so important.
What causes an aortic aneurysm?
Common contributors include long-standing hypertension, atherosclerosis, smoking, bicuspid aortic valve, and genetic connective tissue disorders such as Marfan or Loeys-Dietz syndrome. A strong family history of aneurysm is itself a significant risk factor. Identifying the underlying cause shapes both the surveillance schedule and the threshold for surgical referral.
Are there symptoms?
Most aortic aneurysms cause no symptoms and are discovered incidentally on imaging done for another reason. When symptoms occur, they may include deep chest, back, or abdominal pain, and any sudden severe tearing pain in the chest, back, or abdomen should be treated as an immediate emergency — call 911. Surveillance is what catches most aneurysms before they reach that point.
How is an aneurysm diagnosed?
Abdominal aortic aneurysms are easily evaluated with ultrasound, including POCUS that Dr. Kedan can perform in the office. Thoracic aneurysms typically require CT or MR angiography, sometimes complemented by transthoracic or transesophageal echocardiography. The choice of imaging depends on aneurysm location, body habitus, and what surveillance interval makes sense going forward.
Who should be screened?
Screening is most important for older adults with a history of smoking, men over 65 (per established guidelines), patients with first-degree relatives who had aneurysms, and patients with bicuspid aortic valve or known connective tissue disorders. Dr. Kedan personalizes screening recommendations to your specific risk profile rather than using a single threshold for everyone.
How is an aneurysm treated?
Small aneurysms are typically managed medically with strict blood pressure control, smoking cessation, statin therapy when appropriate, and serial imaging at intervals dictated by size and growth rate. Once an aneurysm crosses defined size thresholds or grows rapidly, surgical repair — open or endovascular (stent graft) — is recommended. Dr. Kedan coordinates with vascular and cardiothoracic surgery at Cedars-Sinai when intervention becomes necessary.
What size triggers surgery?
Surgical thresholds depend on the location of the aneurysm, the patient's body size, growth rate, family history, and underlying genetic conditions. As general guidance, abdominal aneurysms are typically repaired at 5.0–5.5 cm and thoracic aneurysms at 5.0–5.5 cm or smaller in patients with connective tissue disease. Dr. Kedan reviews your specific imaging and risk factors so the decision is fully individualized.
Should my family be screened?
Yes. First-degree relatives of patients with aortic aneurysms have a notably higher risk and should have a baseline imaging study, particularly if the diagnosis was made at a younger age or there is suspicion of a genetic syndrome. Schedule a consultation with Dr. Kedan to discuss who in your family should be screened and when.
Can I exercise with an aortic aneurysm?
Most patients with small, stable aneurysms can continue moderate aerobic exercise. Heavy lifting, intense isometric activity, and competitive contact sports are usually discouraged because they cause sudden, sharp spikes in blood pressure. Dr. Kedan provides specific activity guidance based on aneurysm size, location, and your overall cardiovascular profile.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.