Can chest pain, sweating and other symptoms signal that you have a thoracic aortic aneurysm that’s going to rupture soon?

There was a post in a forum by a man who said one day his uncle complained of chest pain and sweating, but didn’t want to go to the emergency room.

He actually felt fine after the rather brief spell of symptoms, and felt fine for about a month.

His nephew then wrote that a month after those initial symptoms, he had another symptom: a fatal dissection of his thoracic aorta.

However, the man never knew that he’d been a ticking time bomb, since TAA’s – that haven’t actually (yet) dissected – often don’t generate symptoms – including signs that are dramatic enough to frighten a person into immediately going to the ER.

On the other hand, nobody will ever know if that man’s chest pain and sweating had actually been caused by a TAA closing in on its dissection event, or, coronary artery disease.

The two conditions are not related.

If a TAA has already been diagnosed, and the patient then experiences chest pain and especially other related symptoms, this is very worrisome for a possible dissection.

“I would have considered this symptomatic already, which would have pushed me to repair this sooner rather than later, provided I knew the patient had an aortic aneurysm that I was following via surveillance,” says Alexandra Kharazi, MD, a cardiothoracic surgeon with the Sharp HealthCare system in CA.

“The problem with vague symptoms — if you don’t already know you have an aneurysm — is they can be attributed to many conditions.

“And a doctor may not even opt to get a CT chest scan unless there is a specific history of a known aneurysm OR clinical exam findings to suggest a CT or an echo.

“Most commonly, symptoms are a sign that the aneurysm is enlarging and putting pressure on nearby structures.”

As mentioned, a TAA and coronary artery disease are not related, but – they can certainly co-exist.

It’s possible that the chest pain and sweating in the OP’s uncle could’ve been from undiagnosed plaque buildup in his heart’s arteries, and that coincidentally, an undiagnosed TAA ruptured a month later.

Dr. Kharazi explains, “In an elective situation (where we plan to fix the aneurysm, as opposed to an emergency), we usually request a left heart catheterization to assess for coronary disease in patients over 40.

“This is to make sure that there is no coronary disease that has to be bypassed at the time of surgery.”

If it turns out there’s a dangerous level of blockage (occlusion) in a coronary artery that’s too extensive to be treated with stents, the surgeon will perform a coronary bypass surgery along with the already-planned repair of a thoracic aortic aneurysm.

Dr. Kharazi has many areas of surgical expertise including the following: aortic aneurysm repair, aortic valve repair and replacement, and CABG. Other areas of focus include arrhythmia, bloodless medicine, lung cancer and resection, septal defect repair and thoracic surgery.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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