Thoracic aortic aneurysms are often found during routine medical tests, such as a chest X-ray or ultrasound of the heart or abdomen, sometimes ordered for a different reason.
If your doctor suspects that you have an aortic aneurysm, specialized tests can confirm it. These tests might include:
- Chest X-ray. Your doctor may first notice you have a thoracic aortic aneurysm by looking at chest X-ray images. Your doctor may order a chest X-ray as a first test to check for problems with the upper part of your aorta, or your doctor may discover a thoracic aortic aneurysm on X-ray images ordered to check for another condition.
- Echocardiogram. Thoracic aortic aneurysms may be diagnosed by echocardiogram, and this technique is often used to screen family members of those with thoracic aortic aneurysm. An echocardiogram is often used to check for aneurysms in someone with Marfan syndrome. An echocardiogram uses sound waves to capture real-time images of your heart in motion. Echocardiograms show how well your heart chambers and valves are working. Occasionally, to better see your aorta, your doctor may recommend a transesophageal echocardiogram — in which the sound waves are generated from within your body by a device threaded down your esophagus.
- Computerized tomography (CT) scan. This painless test can provide your doctor with clear images of your aorta. During a CT scan, you lie on a table inside a doughnut-shaped machine. Detectors inside the gantry measure the radiation that has passed through your body and converts it into electrical signals. One downside of the use of CT in detecting and following aortic aneurysms is the exposure to radiation, particularly for patients who require frequent monitoring, such as those with Marfan syndrome.
- Magnetic resonance angiography (MRA). MRA is another painless imaging test. Most MRA machines contain a large magnet shaped like a doughnut or tunnel. You lie on a movable table that slides into the tunnel. The magnet produces signals that vary according to the type of tissue the magnet scans. Your doctor can use the images produced by the signals to see if you have an aneurysm.
Screening for thoracic aortic aneurysms
Conditions that cause a thoracic aortic aneurysm may run in families. Because of this, your doctor may recommend you have tests to check for thoracic aortic conditions if a first-degree relative, such as a parent, sibling, son or daughter, has Marfan syndrome or another condition that could cause a thoracic aortic aneurysm. These tests may include:
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- Imaging tests. Your doctor may recommend that your first-degree relatives have an echocardiogram or another type of imaging test to check for Marfan syndrome or another thoracic aortic condition. If your doctor finds you have an enlarged aorta or an aneurysm, you'll likely need another imaging test within six months to make sure your aorta hasn't grown larger.
- Genetic testing. If you have a family history of Marfan syndrome, or another genetic condition that raises your risk of thoracic aortic aneurysm, you may want to consider genetic testing and genetic counseling before starting a family.
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