Department of cardiac muscle pathology and transplantation of organs and tissues

Ascending aortic aneurysm

Ascending aortic aneurysm: Etiology, signs and symptoms, diagnostics, and methods of treatment

Ascending aortic aneurysm develops due to the weakness of the aortic walls, which further become thinned under the influence of blood pressure, resulting in the enlargement of a part of the aorta. Large aneurysms may disrupt that may be fatal.

Etiology and risk factors

Atherosclerosis, congenital connective tissue diseases, aortic valve defect, high blood pressure, thoracic traumas, overweight, smoking, etc.

Signs and symptoms

Ascending aortic aneurysm is accompanied by dull retrosternal pain due to the compression or stenosis of the coronary arteries that is accompanied by reflex attacks of dyspnea, palpitations and dizziness. Compression of the superior vena cava by the aneurysm causes a so-called superior vena cava syndrome: Edema of neck, face and hands, as well as swelling of the neck veins.

Rupture of the ascending aorta aneurysm is accompanied by acute and burning pain in thorax, sudden drop of blood pressure and shock due to the internal hemorrhage.


Ascending aortic aneurysm frequently becomes apparent by chance during the examination of thoracic organs, e.g. the heart (chest X-ray, computer tomography or magnetic resonance angiography).


All the measures should be taken for prevention of the aorta rupture. If the aneurysm diameter is up to 5 cm and it causes no discomfort, the watchful waiting includes thoracic ultrasound, CT or MRI to monitor the dynamics of the aneurysm’s size. In the case of a high blood pressure and atherosclerosis, the adequate medication for BP control and decrease of cholesterol levels are administered. Surgery includes the excision of the affected part of aorta with its following replacement with a synthetic tubular prosthesis. This endovascular procedure needs only a small incision to be performed in the region of the inguinal fold through which the surgeon inserts a special device (stent) into the lumen of aorta to strengthen the artery wall.



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