One minute, you’re going about your daily life, walking the dog, checking your phone, getting coffee. The next, you’re experiencing ripping or tearing chest pain or abdominal pain. That’s how quickly a ruptured or torn aortic aneurysm could sneak up on you.

“We call an aortic aneurysm the silent killer,” says Mark D. Peterson, MD, PhD, system director of aortic surgery at NYU Langone Heart and its Center for Complex Aortic Disease. The condition occurs when the aorta bulges to twice the size of the normal aorta, the major artery that carries oxygen-rich blood away from the heart to the rest of your body. Over time, the bulge can rupture or tear, causing blood to track within the layers of the aortic wall—referred to as an aortic dissection.

Fortunately, though, aortic aneurysm can often be detected and managed before it causes symptoms. At NYU Langone, Dr. Peterson and his aortic disease team are nationally recognized leaders for advancing the technology and other methods used to treat aortic aneurysm, with an emphasis on aortic valve repair and preservation. Awareness and prevention are key, he says.

Below, Dr. Peterson uncovers five things you need to know about this stealth form of heart disease.

Aortic Aneurysms Rarely Cause Symptoms

Aortic aneurysm is found in 5 to 10 people out of every 100,000. Aneurysms are named for the place they occur in the aorta. An aortic root or ascending aortic aneurysm occurs in the part of the aorta that runs from the heart to the chest. An abdominal aortic aneurysm, which occurs below the chest, is the more common form of the disease.

“Most people walk around with aortic aneurysm and don’t even know it because most aortic aneurysms don’t cause symptoms,” Dr. Peterson says. When concerning symptoms do occur, including ripping or tearing chest or abdominal pain, it’s a medical emergency. These symptoms can signal that an aortic aneurysm has weakened and ruptured, potentially causing life-threatening bleeding. Don’t hesitate: call 911.

You Can Reduce Your Risk of Aortic Aneurysm

If you have a family history of aortic aneurysm, talk to your doctor. “You are at increased risk if you have a first-degree relative, such as a mother, father, brother, or sister, who has been diagnosed with an aortic aneurysm or bicuspid aortic valve (BAV) disease,” Dr. Peterson says.

You’re also at higher risk if you smoke, have uncontrolled high blood pressure, you are over age 65, or you have a connective tissue disorder such as Marfan syndrome. Each of these risk factors can damage or weaken the naturally thick walls of the aortic artery, causing an aneurysm.

Get Screened for Aortic Aneurysm

“Most aneurysms are discovered incidentally—when someone has a CT scan, MRI, or ultrasound for another reason and the image shows an enlarged aorta,” Dr. Peterson says.

Still, you can take a more direct approach to aneurysm rupture prevention. If you’re at increased risk for aortic aneurysm, talk to your doctor about screening. “The best way to detect an aortic aneurysm is to have an imaging study, such as a CT scan, echocardiogram, or MRI,” Dr. Peterson says.

Aortic Aneurysm Treatment Doesn’t Always Mean Surgery

If your aortic aneurysm requires surgery, NYU Langone provides the most advanced surgical care for aortic disease, even for people who have been told elsewhere that they are not candidates for surgery.

At the Center for Complex Aortic Disease, Dr. Peterson and his team create customized treatment plans based on each person’s individual diagnosis.

“For patients who don’t require surgery, at least not right away, we create a personalized monitoring plan, which includes specialized imaging, genetic testing, and lifestyle counseling, to help these patients live normally with aneurysms while staying safe,” he says. Lifestyle changes, including stopping smoking, avoiding heavy lifting, and controlling your blood pressure, can reduce the risk of aortic catastrophe, but will generally not reduce the size of the aorta.

“Many patients can continue living normally with an aortic aneurysm. But we will also continue to monitor you with imaging. You become our patient for life,” Dr. Peterson says.

Aortic Aneurysm with Aortic Valve Disease Is Common

People who have an aortic aneurysm often also have aortic valve disease, because over time the aneurysm may affect the function and performance of the valve. If aortic valve surgery is required, the cardiac surgery team at NYU Langone Heart aims to repair the valve, not replace it with an artificial heart valve. Repairing is better for the patient over the long term.

“If patients can avoid an artificial heart valve, they can avoid taking blood-thinning medication, and this can help improve their quality of life. Preserving the patient’s natural aortic valve is also associated with improved long-term survival,” Dr. Peterson adds.

Patients with an aortic aneurysm with a valve that can’t be repaired may be candidates for the Ross procedure, which is also associated with an improved quality of life and long-term survival. The specialized operation involves transplanting a patient’s own pulmonary valve into the aortic position, followed by replacing the pulmonary valve with a healthy donor pulmonary valve.

Within a few hours after surgery, patients are usually up and walking, and are back to their normal activities within a few weeks to months.

Talk to Your Doctor About Aortic Aneurysm Risk

Overall, if you are at increased risk for aortic aneurysm or are concerned about your risk, see your doctor to discuss screening and other possible next steps.

“We understand that being diagnosed with an aortic aneurysm can be anxiety provoking,” Dr. Peterson says. “Whether your aortic aneurysm requires surgery or long-term monitoring, our multidisciplinary care team at NYU Langone is here for you every step of the way.”