# Symptoms and phases of aortic aneurysm
An aortic aneurysm usually develops without noticeable symptoms, and therefore it is often discovered by chance. When complaints do occur, this largely depends on the size, location and progression of the aneurysm. This tab describes the course in phases and what symptoms go with each.
Early phase: small aneurysm without complaints
In most cases, a small aortic aneurysm is completely symptom-free. Many people don't even know they have one. The aneurysm is found by chance through imaging done for a completely different reason, for example a CT scan for stomach complaints or a routine examination.
**What you might feel in this phase:**
- Nothing; the aneurysm causes no symptoms
**What this means for daily life: **
- Currently no limitations from the aneurysm itself
- Regular follow-up checks are needed to see if it grows
**How long does this last?**
This very much depends on the individual situation — size, risk factors and the precise location of the aneurysm determine the rate. For many small aneurysms, they remain stable or grow very slowly. Regular check-ups (for example yearly or once every two years with ultrasound or CT) help to keep track of this.
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Phase of growing aneurysm
As the aneurysm gets larger, it can start to press on surrounding structures. This does not happen at the same rate in everyone. Some aneurysms grow very slowly for years, others faster.
**What you might feel:**
- **Pain in the belly, back or side:** usually a deep, pulling pain that can last for hours or days
- **A pulsating or throbbing in the belly:** sometimes felt as a pounding swelling
- **Fatigue** and general malaise
- **Sometimes nothing:** many growing aneurysms cause no problems for a long time
With aneurysms in the chest area (thoracic location), pressure can lead to:
- Pain in the chest or upper back
- Shortness of breath
- Pain in the neck or shoulders
- Difficulty swallowing (especially with very large aneurysms that press on the esophagus)
**What this means for daily life: **
- Regular pain can make exertion more difficult
- Some people feel less stable or fear sudden deterioration
- Heavy exertion (lifting, vigorous exercise) is usually advised to be avoided, because pressure in the belly puts extra strain on the aneurysm
- Regular check-ups become more frequent (for example every 3-6 months)
**Figures on growth:**
The growth rate of aortic aneurysms varies widely. Studies from 2023–2024 show that many abdominal aortic aneurysms (the most common form) grow very slowly — on average a few millimeters per year. However: once an aneurysm becomes larger than about 5-5.5 cm, the risk of rupture increases sharply. This is a general population figure; your own aneurysm may grow faster or slower.
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Phase with planned surgical or catheter intervention
When the aneurysm reaches a certain size (often around 5-5.5 cm, depending on type and location), or when it grows rapidly, intervention is usually considered. This can be via open surgery or via a minimally invasive catheter procedure (endovascular treatment).
**What you feel before and after the procedure:**
- Before the procedure: the same complaints as in the previous phase, sometimes worsened by fear or worry
- Immediately after the procedure: sore pain around the insertion site, general weakness, fatigue from anesthesia
- In the weeks after: gradual recovery, depending on the type of procedure
**What this means for daily life: **
- Hospital stay of a few days to a week
- Recovery period of a few weeks (catheter procedure) to several months (open surgery)
- Restriction on lifting and heavy work initially
- Regular follow-up check-ups (ultrasound, CT) to monitor the procedure properly
**Outcomes at population level:**
Recent studies (2025-2026) show that both endovascular and open surgical treatment of aortic aneurysms has become much safer. The choice depends on the shape and location of the aneurysm. In planned operations, intraoperative mortality (death during the procedure) at specialized centres is below 5%, and most patients recover well. These are population figures; individual risks differ and depend on age, other illnesses and other factors.
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Phase of complications: threatening or ruptured aneurysm
This is the most critical phase. An aneurysm can rupture (break), which is a direct, life-threatening emergency. Sometimes it does not rupture completely, but begins to leak (threatening rupture).
**Symptoms of a threatening or ruptured aneurysm:**
- **Sudden, severe pain in abdomen, back or side** — like a tear
- **Sudden pain in chest or neck** (in thoracic aneurysms)
- **Swelling, bruising or anaemia-like symptoms** (nausea, fainting, palpitations)
- **Cold, clammy skin, confusion**
- **Sometimes acute purple or dark blue discolouration in groin or abdomen**
**This requires immediate emergency care (112).**
**What this means for daily life: **
At this point, there is a medical emergency. Patients are taken to hospital by ambulance and undergo emergency repair as quickly as possible.
**Outcomes:**
The prognosis of a ruptured aortic aneurysm is serious. Without immediate treatment, it is almost always fatal. With emergency surgery, approximately 40–60% of patients survive at population level, depending on age, extent of bleeding and how quickly help arrives (data from studies 2020-2024). These are hospital figures; individual prognosis depends very much on many factors.
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After treatment: follow-up phase
After a planned operation or emergency repair, a long follow-up phase begins.
**What you feel:**
- Gradual decrease in pain and fatigue
- Cautious return to normal activities
- Sometimes persistent fear or hyperalert attitude
- Occasional pain around the operation site
**What this means for daily life: **
- Regular follow-up checks (ultrasound, CT) to monitor whether the repair is working well
- Medication to prevent further growth (for example, for high blood pressure)
- Avoidance of strenuous exertion and lifting (guidelines provided) for several months
- Lifestyle changes (stopping smoking, healthy eating, regular light exercise) are important
**How are things in the long term?**
At population level, recent studies from 2024-2026 show that many patients function well after successful treatment of aortic aneurysm. Five years after treatment, more than 70% of patients are still alive, especially if they were not already very old or had serious comorbidities (data from German and international registers, 2024-2025). These are averages across large groups; individual outcomes vary greatly.
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When to contact your healthcare provider or emergency services?
**Contact your regular doctor or cardiologist if:**
- For the first time you feel doubt or pressure in your abdomen, back, chest or neck
- Existing pain complaints worsen or change character
- You feel unusual fatigue
- You no longer have an appointment at your follow-up check and you need one
**Call 112 immediately if:**
- You suddenly feel severe, tearing pain in your abdomen, back, chest or neck
- This is accompanied by dizziness, nausea or fainting
- You notice blue or purple discolouration in your abdomen or groin
- You feel extreme palpitations with acute pain
_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._