How are thoracic aortic aneurysms?

Clinical manifestations and natural hx depends on location, medical degeneration most common pathology of ascending aorta, average growth rate 0.1-0.2 cm/year. Risk of rupture related to size and symptoms (2-3% /year <4 cm, to 7% /year >6cm) Most are asymptomatic but compression or erosion of adjacent tissues cause symptoms (chest pain, SoB, cough, dysphagia) CXR (widening of mediastinum shadow/displacement/compression of trachea) TTE/TEE (asses proximal ascending aorta and descending) Contrast CT, MRI, Invasive aortography Tx (b blockers (marfan's, aortic dilatation) control HTN, prosthetic graft is symptomatic/ asymptomatic >5.5cm, if marfan's/ bicuspid aortic valve aneurysm 4-5cm surgery Repair if >6cm descending, endovascular repair >5.5cm, or when diameter increases 1cm/year