Diagnosis

Thoracic aortic aneurysms are often found during routine medical tests, such as a chest X-ray, CT scan or ultrasound of the heart, sometimes ordered for a different reason.

Your doctor will ask questions about your signs and symptoms, as well as your family's history of aneurysm or sudden death.

If your doctor thinks that you have an aortic aneurysm, imaging tests can confirm it. Tests for thoracic aortic aneurysm include:

• Echocardiogram. An echocardiogram uses sound waves to capture real-time images of your heart and the ascending aorta. This test shows how well your heart chambers and valves are working. It may be used to diagnose thoracic aortic aneurysms and screen family members of those with thoracic aortic aneurysm. In some cases, your doctor may recommend a transesophageal echocardiogram to better view the aorta. For this test, the sound waves are generated from a device that's gently guided down your esophagus.
• Computed tomography (CT). CT uses X-rays to create cross-sectional images of the body, including the aorta. It can detect the size and shape of an aneurysm. During a CT scan, you lie on a table inside a doughnut-shaped X-ray machine. A dye, called contrast, may be injected into a vein to help your arteries be more visible on the images. One downside of the use of a CT in detecting and following aortic aneurysms is the exposure to radiation, particularly for people who require frequent monitoring, such as those with Marfan syndrome. However, newer CT scan techniques may be used to reduce your radiation exposure.
• Magnetic resonance imaging (MRI). An MRI uses a magnetic field and radio waves to make pictures of the body. MRI may be used to diagnose an aneurysm and determine its size and location. In this test, you lie on a table that slides into the tunnel (magnet). Doctors may inject a dye into your vein to help your blood vessels to be more visible on images (magnetic resonance angiography). This test may be an alternative to CT scans for people who need frequent monitoring of aneurysms, to reduce their exposure to radiation.

Screening for thoracic aortic aneurysms

Conditions that cause a thoracic aortic aneurysm may run in families. Your doctor may recommend screening 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.

Tests used to screen for thoracic aortic aneurysms may include:

• Echocardiogram. If an echocardiogram shows an enlarged aorta or an aneurysm, you'll likely need another imaging test within six or 12 months to make sure it hasn't grown larger.
• Genetic testing. If you have a family history of aneurysm or another suspected genetic condition that raises your risk of thoracic aortic aneurysm, you may want to consider genetic testing. You may also want to consider genetic counseling before starting a family.