Representation of the various aortic anyrusms

Aortic Aneurysms are classified based on their anatomical locations. Largely, they can be divided into two classes: thoracic aortic aneurysm (TAA), those that are in the thoracic aorta, and abdominal aortic aneurysm (AAA), those that are in the abdominal aorta.

TAA can further be divided into:

Aortic root aneurysm
Ascending aortic aneurysm
Aortic arch aneurysm
Descending aortic aneurysm
Aneurysm that straddles multiple portions of the aorta (i.e. from aortic arch to descending aorta)

AAA can be classified as:

Suprarenal aortic aneurysm: above the kidneys
Infrarenal aortic aneurysm: below the kidneys.
Others: Pararenal, Jaxtarenal aortic aneurys.

Most patients with aortic aneurysms (AA) are asymptomatic at the time of diagnosis, because the aneurysms are typically discovered incidentally on imaging studies. When an AA reaches medium to large size (>5cm), symptoms may manifest.

Symptoms for TAA are: patients may suffer a local mass effect, such as compression of the trachea or mainstem bronchus (if in the area of the lungs, will cause cough, dyspnea, wheezing, or recurrent pneumonitis), compression of the esophagus (causing dysphagia), or compression of the recurrent laryngeal nerve (causing hoarseness). Chest pain, generally described as deep and aching or throbbing.

Symptoms of AAA are: pain in the chest, abdomen, lower back, or flank (over the kidneys). A pulsating feeling in the abdomen. A "cold foot" or a black or blue painful toe.

When a patient has abdominal aortic aneurysm of a substantial size, the patient may also have synchronous and metachronous thoracic aortic aneurysm. If causes and conditions are present to create an aneurysm in a large-medium size vessel in one place, you are more likely than those without those causes and conditions to have (or develop) another aneurysm somewhere.

Case 1 - Subject has both TAA and AAA

The subject had CT scans performed at the chest and abdomen.

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pr.xpt

Row	STUDYID	DOMAIN	USUBJID	PRSEQ	PRTRT	PRLOC	VISIT
1	ABC	PR	ABC-123	1	CT SCAN	CHEST	BASELINE
2	ABC	PR	ABC-123	2	CT SCAN	ABDOMEN	BASELINE

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Modeling both TAA and AAA in the CV domain, note for viewing simplicity, some variables are omitted from the table below.

Row 1:	I examined the image of the thoracic cavity and found an aneurysm in the descending aorta.
Row 2:	I measured the diameter of the descending aortic aneurysm.
Row 3:	I examined the image of the thoracic cavity and found out that the descending aorta had dissected.
Row 4:	The dissected descending aorta is classified based on the Stanford Aortic Dissection System.
Row 5:	I examined the image of the abdominal cavity and found an aneurysm in the infrarenal aorta, proximal to the iliac bifurcation.
Row 6:	I measured the diameter of the infrarenal aortic aneurysm.
Row 7:	I examined the image of the abdominal cavity and found out that the infrarenal aorta had dissected.

cv.xpt

Row	STUDYID	DOMAIN	USUBJID	CVSEQ	CVGRPID	CVTEST	CVORRES	CVORRESU	CVLOC	CVMETHOD	VISITNUM	VISIT	CVDTC	CVRESLOC	CVRESLOC Detail
1	ABC	CV	ABC-123	1	1	Aneurysm Indicator	Y		Thoracic Cavity	CT SCAN	1	BASELINE	2020-04-27	Descending Aorta
2	ABC	CV	ABC-123	2	1	Aneurysm Diameter	6	cm	Descending Aorta	CT SCAN	1	BASELINE	2020-04-27
4	ABC	CV	ABC-123	4	2	Dissection Indicator	Y		Thoracic Cavity	CT SCAN	1	BASELINE	2020-04-27	Descending Aorta
6	ABC	CV	ABC-123	6	2	Stanford AoD Classification	Stanford B		Descending Aorta	CT SCAN	1	BASELINE	2020-04-27
7	ABC	CV	ABC-123	7	3	Aneurysm Indicator	Y		Abdominal Cavity	CT SCAN	1	BASELINE	2020-04-27	Infrarenal aorta	proximal to the iliac bifurcation
8	ABC	CV	ABC-123	8	3	Aneurysm Diameter	7	cm	Infrarenal aorta	CT SCAN	1	BASELINE	2020-04-27
10	ABC	CV	ABC-123	10		Dissection Indicator	Y		Abdominal Cavity	CT SCAN	1	BASELINE	2020-04-27	Infrarenal aorta	proximal to the iliac bifurcation

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Case 2 - Subject has AAA but TAA is not found