The body's main pipeline for blood, called the aorta, is a sturdy, muscular blood vessel. But if a section of its outer wall weakens, the aorta can bulge out at that spot, forming an aneurysm. If an aortic aneurysm bursts, the massive internal bleeding that follows is often deadly. Bulges in the thoracic aorta—the upper part near the heart—are often neglected, overlooked, and misdiagnosed, reports the August 2010 issue of the Harvard Heart Letter.

Thoracic aortic disease develops slowly and silently, usually without any symptoms. And it often flies under doctors’ radar, in part because no single medical specialty lays claim to the aorta, leaving it in medical limbo.

Most thoracic aortic aneurysms are found by chance on CT scans or echocardiograms done for another reason. This hit-or-miss approach misses most people who have a thoracic aneurysm. That’s a shame, because finding them early can prevent most deaths.

New guidelines from the American College of Cardiology, American Heart Association, and other organizations aim to make doctors more aware of thoracic aortic disease and to improve the identification and treatment of people with it.

Checking everyone for a thoracic aneurysm doesn’t make sense, notes the Harvard Heart Letter. But a more structured approach to looking for them could save lives. A good place to start is in people likely to have the condition. This includes individuals with any of the following:

• A bicuspid aortic valve. That’s an aortic valve that has two flaps instead of the normal three flaps.
• Certain genetic conditions. Marfan, Loeys-Dietz, vascular Ehlers-Danlos, and other syndromes are linked to thoracic aortic aneurysm.
• Family history. If you have a thoracic aneurysm, urge your siblings, children, and parents to be checked for one. The reverse holds as well.

Read full-length article: “Shining a light on thoracic aortic disease”