Can a 4.2 CM descending aortic aneurysm cause chest tightness/pressure? All of my heart tests have come back clear.

not likely. This is a moderate sized thoracic aneurysm which is not likely to cause symptoms unless expanding. It is possible, though, to cause symptoms if expanding or pressing on surrounding structures. Consult a vascular surgeon if there are questions.
aneurysm. Usually an aneurysm that size is without symptoms. Discuss your symptoms with your dr.

Related Questions

I am taking Lexapro (escitalopram) for anxiety. I just increased to 5 mg and have bad chest tightness. All heart tests are fine. Should I be worried? Suggestions.

Maybe. Anytime you don't feel well, it is a concern. It is good that your heart tests are fine, but how extensive was your work-up. Ibuprofen could be causing stomach or esophageal irritation which can present as chest tightness too. Talk to your doc and see if you should lower the dose of Lexapro (escitalopram) till this is sorted out. If your chest pain persists see a cardiologist to be certain. Read more...