Aortic Aneurysms and Aortopathies

Ruptured aortic dissection is the leading cause of death from aortic disease, and many occur in the setting of pre-existing aortic aneurysms. As such, the recognition and management of aortic aneurysms represent an opportunity to identify patients appropriate for medical therapy and elective surgical intervention prior to surgical emergencies, death, or serious complications. While usually identified incidentally, certain patient cohorts may have indications for screening due to increased risk. Outpatient management should focus on appropriate use of surveillance imaging (as dictated by growth rates), medical therapies, appropriate timing of referral for surgical intervention, or expert consultation. Finally, though common processes such as hypertension, smoking, and aging are implicated in the development of the majority of aortic disease, numerous congenital, system, and infectious conditions are associated with aortopathies whose recognition may precede diagnosis of the parent condition.