By Dr. Max Gomez

NEW YORK (CBSNewYork) — The condition that took the life of a legendary high school football coach in New Jersey is something most of us have never or rarely heard of — an aortic aneurysm or dissection.

It took the life of Jonathan Larson, the creator of Broadway’s hit musical “Rent,” as well as TV star John Ritter.

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As CBS2’s Dr. Max Gomez explains, aneurysms are simply a ballooning out of an artery anywhere in the body, although they’re most common in the brain and the aorta, the body’s largest artery.

In the aorta, they can occur in the abdomen or the chest, and either way, if they start to tear or dissect, as happened with Ramapo High School football coach Drew Gibbs, it’s very bad news.

“If an aneurysm ruptures outside the hospital, the vast majority are fatal. If a patient reaches the emergency room with a ruptured aneurysm, 50% won’t survive. So it really behooves, you know, quick diagnosis, intervention,” said Dr. Thomas Maldonado, the co-director of the aortic center at NYU Langone Health.

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Maldonado says intervention today means either major surgery to cut out the aneurysm, ideally before it starts to tear, and replace it with an artificial graft. Newer and less invasive interventions involve re-lining the aneurysm with a stent to keep it from bursting.

The problem is, Maldonado says, “The vast majority of them are asymptomatic until they’re not. And so they’re found incidentally on a screen for back pain, an MRI or an ultrasound for a gallbladder. And lo and behold, we’ll see an aneurysm. They’re called the silent killer for that reason because they’re silent until all of a sudden they rupture.”

But certain high-risk individuals can and should be screened for an aneurysm, either with ultrasound in the abdomen or a CT scan in the chest. Those include men over the age of 60, people with a history of smoking and especially those with a family history of aneurysms.

If an aneurysm is found, doctors will usually monitor it until it starts growing rapidly or gets larger than about 2 inches in men or slightly smaller in women. That’s when they’re at risk for dissection and rupture and intervention is recommended.

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Dr. Max Gomez