ICD-10: I71.23

The ICD-10 code I71.23 refers to an aneurysm of the descending thoracic aorta, without rupture. This condition is a significant cardiovascular issue that requires careful clinical attention and management. Below is a detailed overview of this diagnosis, including its clinical description, symptoms, diagnostic methods, and treatment options.

Clinical Description

An aneurysm is defined as an abnormal dilation or bulging of a blood vessel due to a weakness in the vessel wall. In the case of the descending thoracic aorta, this refers specifically to the portion of the aorta that runs down through the chest, extending from the aortic arch to the diaphragm. An aneurysm in this area can lead to serious complications if not monitored or treated appropriately.

Characteristics of I71.23

• Type: Aneurysm of the descending thoracic aorta
• Status: Without rupture, indicating that the aneurysm has not yet compromised the integrity of the aortic wall, which would lead to a life-threatening situation.
• Symptoms: Many patients may be asymptomatic, but some may experience symptoms such as:
• Chest pain or discomfort
• Back pain
• Shortness of breath
• Coughing or hoarseness (if the aneurysm compresses nearby structures)

Diagnostic Methods

Diagnosing an aneurysm of the descending thoracic aorta typically involves several imaging techniques, including:

• Chest X-ray: May show a widened mediastinum or other indirect signs of an aneurysm.
• Computed Tomography (CT) Scan: This is the most common and effective method for visualizing the size and extent of the aneurysm.
• Magnetic Resonance Imaging (MRI): Useful for assessing the aorta and surrounding structures without radiation exposure.
• Echocardiography: Can be used, particularly in emergency settings, to evaluate the aorta's condition.

Treatment Options

The management of an aneurysm of the descending thoracic aorta depends on several factors, including the size of the aneurysm, the presence of symptoms, and the overall health of the patient. Treatment strategies may include:

• Monitoring: Small, asymptomatic aneurysms may be monitored with regular imaging studies to assess growth.
• Medications: Blood pressure control is crucial, often managed with antihypertensive medications to reduce stress on the aortic wall.
• Surgical Intervention: If the aneurysm is large (typically over 5.5 cm) or symptomatic, surgical options may include:
• Open surgical repair: Involves removing the affected section of the aorta and replacing it with a synthetic graft.
• Endovascular repair: A less invasive procedure where a stent graft is placed within the aorta through small incisions, providing support to the weakened area.

Conclusion

The ICD-10 code I71.23 signifies a critical condition that necessitates careful evaluation and management. While many patients may remain asymptomatic, the potential for serious complications underscores the importance of regular monitoring and appropriate treatment strategies. Early detection and intervention can significantly improve outcomes for individuals with an aneurysm of the descending thoracic aorta, ensuring that they receive the necessary care to prevent rupture and other complications.

The ICD-10 code I71.23 specifically refers to an "Aneurysm of the descending thoracic aorta, without rupture." This code is part of a broader classification of aortic aneurysms and related conditions. Below are alternative names and related terms that can be associated with this diagnosis:

Alternative Names

1. Descending Thoracic Aortic Aneurysm: This is the most straightforward alternative name, emphasizing the location of the aneurysm.
2. Non-Ruptured Descending Thoracic Aortic Aneurysm: This term highlights the critical aspect of the aneurysm being non-ruptured.
3. Thoracic Aortic Aneurysm (Descending Segment): This term specifies that the aneurysm is located in the descending segment of the thoracic aorta.
4. Aneurysm of the Thoracic Aorta (Descending Portion): A more descriptive term that indicates the specific part of the thoracic aorta affected.

Related Terms

1. Aortic Aneurysm: A general term for any aneurysm occurring in the aorta, which includes both thoracic and abdominal segments.
2. Thoracic Aortic Aneurysm: This term encompasses all aneurysms located in the thoracic section of the aorta, including both ascending and descending types.
3. Aortic Dissection: While distinct from an aneurysm, this term is often related as it involves a tear in the aorta, which can occur in conjunction with aneurysms.
4. Aneurysmal Disease: A broader term that refers to any disease characterized by the formation of an aneurysm, including those in the thoracic aorta.
5. Vascular Aneurysm: A general term that can refer to aneurysms in any blood vessel, including the aorta.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals when documenting, coding, and discussing patient diagnoses. Accurate terminology ensures proper communication among medical staff and aids in the effective management of patients with aortic conditions.

In summary, the ICD-10 code I71.23 is associated with various alternative names and related terms that reflect its clinical significance and anatomical specificity. These terms are essential for accurate diagnosis, treatment planning, and medical coding.

Aneurysms of the descending thoracic aorta, classified under ICD-10 code I71.23, represent a significant cardiovascular concern. These aneurysms can lead to serious complications if not managed appropriately. The standard treatment approaches for this condition vary based on the size of the aneurysm, the patient's overall health, and the presence of symptoms. Below is a detailed overview of the treatment strategies typically employed.

Monitoring and Surveillance

Observation

For small, asymptomatic descending thoracic aortic aneurysms (generally less than 5.5 cm in diameter), a conservative approach is often recommended. This involves regular monitoring through imaging techniques such as:

• Ultrasound
• Computed Tomography (CT) scans
• Magnetic Resonance Angiography (MRA)

These imaging modalities help assess the aneurysm's size and growth rate, allowing for timely intervention if necessary[1][2].

Surgical Interventions

Indications for Surgery

Surgical intervention is typically indicated for larger aneurysms (generally over 5.5 cm) or for those that are symptomatic. The main surgical options include:

1. Open Surgical Repair

This traditional approach involves:

• Incision: A large incision in the chest to access the aorta.
• Resection: The aneurysmal segment is removed.
• Graft Placement: A synthetic graft is sewn into place to replace the removed section of the aorta.

Open repair is effective but carries higher risks, including longer recovery times and complications such as bleeding or infection[3][4].

2. Endovascular Aneurysm Repair (EVAR)

This minimally invasive technique has gained popularity due to its reduced recovery time and lower complication rates. The procedure involves:

• Access: Insertion of a catheter through the femoral artery.
• Graft Deployment: A stent graft is positioned within the aneurysm to reinforce the aortic wall and prevent rupture.

EVAR is particularly suitable for patients who may not tolerate open surgery due to other health issues[5][6].

Medical Management

Pharmacological Therapy

In addition to surgical options, medical management plays a crucial role in the treatment of descending thoracic aortic aneurysms. This may include:

• Antihypertensive Medications: To control blood pressure, which is critical in reducing stress on the aortic wall. Beta-blockers are commonly prescribed.
• Statins: To manage cholesterol levels and potentially stabilize atherosclerotic plaques.

Lifestyle Modifications

Patients are often advised to adopt lifestyle changes that can help manage risk factors, including:

• Smoking Cessation: Smoking is a significant risk factor for aortic aneurysms.
• Dietary Changes: A heart-healthy diet can help control blood pressure and cholesterol.
• Regular Exercise: As tolerated, to improve cardiovascular health.

Conclusion

The management of a descending thoracic aortic aneurysm without rupture (ICD-10 code I71.23) involves a combination of monitoring, surgical intervention, and medical management tailored to the individual patient's needs. Regular follow-up and imaging are essential for those under observation, while surgical options are reserved for larger or symptomatic aneurysms. By addressing both the physical and lifestyle factors, healthcare providers can significantly improve patient outcomes and reduce the risk of complications associated with this serious condition.

For patients diagnosed with this condition, it is crucial to engage in discussions with healthcare providers to determine the most appropriate treatment plan based on their specific circumstances and health status[7][8].

Aneurysms of the descending thoracic aorta, classified under ICD-10 code I71.23, represent a significant clinical concern due to their potential complications, including rupture. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for timely diagnosis and management.

Clinical Presentation

Definition and Overview

An aneurysm of the descending thoracic aorta is characterized by a localized dilation of the aorta, typically occurring in the segment that runs through the thoracic cavity. This condition can develop gradually and may remain asymptomatic for extended periods, making early detection challenging.

Signs and Symptoms

The clinical presentation of a descending thoracic aortic aneurysm can vary widely among patients. Common signs and symptoms include:

• Chest Pain: Patients may experience a deep, aching pain in the chest, which can sometimes radiate to the back or shoulders. This pain is often described as a "tearing" sensation, particularly if the aneurysm is expanding or if there is impending rupture[1].

• Back Pain: Discomfort in the back, particularly between the shoulder blades, is frequently reported. This symptom can be mistaken for musculoskeletal pain, complicating diagnosis[2].

• Shortness of Breath: As the aneurysm enlarges, it may compress surrounding structures, leading to respiratory difficulties[3].

• Coughing or Hoarseness: Compression of the recurrent laryngeal nerve can result in hoarseness or a persistent cough[4].

• Swelling: In some cases, patients may present with swelling in the arms or legs due to compromised blood flow[5].

Asymptomatic Cases

Many patients with a descending thoracic aortic aneurysm may remain asymptomatic until the aneurysm reaches a significant size or ruptures. Routine imaging studies, such as chest X-rays or CT scans, may incidentally reveal the presence of an aneurysm during evaluations for unrelated conditions[6].

Patient Characteristics

Demographics

• Age: The incidence of descending thoracic aortic aneurysms increases with age, particularly in individuals over 65 years old[7].

• Gender: Males are more frequently affected than females, with a ratio of approximately 3:1[8].

Risk Factors

Several risk factors contribute to the development of a descending thoracic aortic aneurysm, including:

• Hypertension: Chronic high blood pressure is a significant risk factor, as it places increased stress on the aortic wall[9].

• Atherosclerosis: The presence of atherosclerotic disease can weaken the aortic wall, leading to aneurysm formation[10].

• Genetic Conditions: Conditions such as Marfan syndrome, Ehlers-Danlos syndrome, and other connective tissue disorders predispose individuals to aortic aneurysms due to inherent weaknesses in the vascular structure[11].

• Family History: A family history of aortic aneurysms or other cardiovascular diseases can increase risk[12].

• Lifestyle Factors: Smoking, obesity, and sedentary lifestyle are modifiable risk factors that can contribute to the development of aneurysms[13].

Conclusion

Aneurysms of the descending thoracic aorta, coded as I71.23, present a complex clinical picture that can range from asymptomatic to life-threatening. Recognizing the signs and symptoms, along with understanding patient demographics and risk factors, is essential for healthcare providers. Early detection through imaging and management of risk factors can significantly improve patient outcomes and reduce the risk of complications such as rupture. Regular monitoring and timely intervention are critical components of care for individuals diagnosed with this condition.

References

1. Thoracic Aortic Aneurysm Clinical Presentation - Medscape.
2. Survival and patient-centered outcome in a disease-based study.
3. Increasing Incidence of Thoracic Aortic Aneurysm Repair in clinical settings.
4. Thoracic aortic aneurysm and atrial fibrillation: clinical implications.
5. Genetic variants in patients with multiple arterial aneurysms - PMC.
6. Aortic Aneurysms: Clinical Guidelines for Primary Care.
7. ICD-10 Coordination and Maintenance Committee Meeting.
8. ICD-10-CM Code for Aortic aneurysm and dissection I71.
9. 2025 ICD-10-CM Diagnosis Code I71.23.
10. ICD-10-CM Diagnosis Code I71.23 - Aneurysm of the descending thoracic aorta, without rupture.
11. ICD-10 Code for Aneurysm of the descending thoracic aorta, without rupture.
12. 2025 ICD-10-CM Diagnosis Code I71.2.
13. Thoracic Aortic Aneurysm and Dissection | Circulation.

The diagnosis of an aneurysm of the descending thoracic aorta, specifically coded as ICD-10 code I71.23, involves a combination of clinical evaluation, imaging studies, and specific diagnostic criteria. Below is a detailed overview of the criteria and processes typically used for this diagnosis.

Clinical Presentation

Symptoms

Patients with a descending thoracic aortic aneurysm may present with various symptoms, although many cases are asymptomatic. Common symptoms include:
- Chest pain: Often described as a deep, aching pain that may radiate to the back.
- Shortness of breath: This can occur if the aneurysm compresses nearby structures.
- Coughing or hoarseness: Due to pressure on the recurrent laryngeal nerve.
- Dysphagia: Difficulty swallowing if the aneurysm compresses the esophagus.

Risk Factors

Certain risk factors increase the likelihood of developing a descending thoracic aortic aneurysm, including:
- Hypertension: Chronic high blood pressure can weaken the aortic wall.
- Atherosclerosis: Buildup of plaques in the arteries can contribute to aneurysm formation.
- Genetic conditions: Such as Marfan syndrome or Ehlers-Danlos syndrome.
- Age and gender: More common in older adults and males.

Diagnostic Imaging

Imaging Techniques

To confirm the diagnosis of a descending thoracic aortic aneurysm, healthcare providers typically utilize several imaging modalities:
- Chest X-ray: May show a widened mediastinum or other indirect signs of an aneurysm.
- Computed Tomography (CT) Scan: The gold standard for diagnosing aortic aneurysms, providing detailed images of the aorta and its dimensions.
- Magnetic Resonance Imaging (MRI): Useful for assessing the aorta and surrounding structures, particularly in patients who cannot undergo CT due to contrast allergies.
- Echocardiography: Can be used, especially in emergency settings, to visualize the aorta and assess for any complications.

Measurement Criteria

The diagnosis of an aneurysm is typically based on the measurement of the aortic diameter:
- An aortic diameter greater than 3.0 cm is generally considered indicative of an aneurysm.
- For the descending thoracic aorta, a diameter of 4.0 cm or greater is often used as a threshold for diagnosis.

Differential Diagnosis

It is essential to differentiate a descending thoracic aortic aneurysm from other conditions that may present similarly, such as:
- Aortic dissection
- Aortic rupture
- Mediastinal masses
- Pulmonary conditions

Conclusion

The diagnosis of an aneurysm of the descending thoracic aorta (ICD-10 code I71.23) relies on a combination of clinical assessment, imaging studies, and specific measurement criteria. Early detection and monitoring are crucial, as these aneurysms can lead to serious complications if left untreated. Regular follow-up and imaging may be necessary to assess the size and growth of the aneurysm, guiding management decisions.