Guilt by Association

Abstract

The vast majority of thoracic aortic aneurysms (TAAs) grow without any symptoms, making detection before rupture or dissection extremely challenging. TAAs that have been diagnosed early are typically detected in patients with an existing connective tissue disorder or noted as an incidental finding on a scan done for another purpose. However, this may not be the case for much longer. Eight clinical markers have been discovered that can indicate the presence of a silent TAA intracranial aneurysms, aortic arch abnormalities, abdominal aortic aneurysms, bicuspid aortic valve, renal cysts, a positive thumb-palm test, family history of aortic disease, and giant cell arteritis. Many of these conditions are thought to share similar genetics or pathophysiology to TAA development. These clinical findings, variants, and diseases have an increased incidence in patients with thoracic aortic disease. If clinicians discover one or more of these markers in a patient, proper investigation could lead to early detection and repair of a TAA, reducing the high morbidity and mortality associated with TAAs.