Most people with aortic aneurysms, especially ones in the chest area (thoracic aortic aneurysms), do not have symptoms. But symptoms may begin to occur if the aneurysm gets bigger and puts pressure on surrounding organs.

Abdominal aortic aneurysm

The most common symptoms of abdominal aortic aneurysm include general abdominal (belly) pain or discomfort, which may come and go or be constant. Other symptoms include:

• Pain in the chest, abdomen, lower back, or flank (over the kidneys), possibly spreading to the groin, buttocks, or legs. The pain may be deep, aching, gnawing, and/or throbbing, and may last for hours or days. It is generally not affected by movement, although certain positions may be more comfortable than others.
• A pulsating sensation in the abdomen.
• A "cold foot" or a black or blue painful toe can happen if an abdominal aortic aneurysm produces a blood clot that breaks off and blocks blood flow to the legs or feet.
• Fever or weight loss, if it is an inflammatory aortic aneurysm.

People younger than age 50 are more likely to have symptoms from abdominal aortic aneurysms than those older than 50.³

Thoracic aortic aneurysm

Symptoms of a thoracic aortic aneurysm are most evident when the aneurysm occurs where the aorta curves down (aortic arch). They may include:

• Chest pain, generally described as deep and aching or throbbing. This is the most frequent symptom.
• Back pain.
• A cough or shortness of breath if the aneurysm is in the area of the lungs.
• Hoarseness.
• Difficulty or pain while swallowing.

If an aortic aneurysm bursts, or ruptures, there is sudden, severe pain, an extreme drop in blood pressure, and signs of shock. Without immediate medical treatment, death occurs.

The symptoms of aortic aneurysm are similar to the symptoms of other problems that cause chest or belly pain such as coronary artery disease and peptic ulcer disease.