The aorta is the largest artery in the body, a single high-pressure trunk that receives all the cardiac output and distributes it to every organ system through its branches. Its elastin-rich wall acts as a reservoir, converting the pulsatile cardiac ejection into a steadier flow (Windkessel effect) that protects downstream arterioles. Aortic disease produces some of the most dramatic and lethal cardiovascular emergencies encountered in clinical practice.
| Origin | Left ventricle of the heart |
|---|
Aortic aneurysm (dilatation exceeding 50 percent of normal diameter) most commonly involves the infrarenal abdominal aorta, with a threshold for elective repair of 5.5 cm in men and 5.0 cm in women given the rupture risk. Acute aortic dissection (type A involving the ascending aorta, type B sparing the ascending aorta) produces the worst-ever tearing chest pain radiating to the back and is a surgical emergency for type A. Aortic coarctation at the ductus arteriosus level in children produces upper limb hypertension, rib notching from collateral intercostal artery enlargement, and a 3-sign on chest radiograph.
Intimal tear allowing blood into the aortic wall creating a false lumen, producing severe tearing chest-to-back pain requiring emergency surgery for type A and medical management for uncomplicated type B.
Infrarenal aortic dilatation over 3 cm managed with surveillance by ultrasound until repair threshold (5.5 cm in men) when endovascular or open repair is performed.
