Abdominal Aortic Aneurysm – Diagnosis and Treatment
Diagnosis
Medical Evaluations and Imaging Methods
A healthcare provider usually starts with a physical exam and a review of your personal and family medical history.
They check for symptoms like belly or back pain and ask about risk factors such as age, smoking, or family members with aneurysms.
When a doctor suspects an abdominal aortic aneurysm (AAA), they use several tools to confirm the diagnosis.
Common tests include:
| Test Name | How it Works | What it Shows |
|---|---|---|
| Abdominal Ultrasound | Uses sound waves to make images of the aorta and blood flow. | Most common tool for detecting an aneurysm and its size. |
| CT Scan (Computed Tomography) | Uses X-rays for detailed pictures, sometimes with a contrast dye. | Shows the exact size, shape, and location of the ballooning. |
| MRI (Magnetic Resonance Imaging) | Uses magnets and radio waves, sometimes with a contrast agent. | Gives detailed images of the aorta and surrounding blood vessels. |
Contrast dye makes the aorta clearer during some CT and MRI scans. These imaging methods let doctors see any enlargement and measure the aneurysm’s size accurately.
Who Should Get Checked for AAA
Not everyone needs regular screening for abdominal aortic aneurysm. People at higher risk include older men and those who have smoked.
- Men ages 65 to 75 who have ever smoked should have a one-time ultrasound to check for AAA.
- Men ages 65 to 75 who have never smoked may need a screening based on other risks, such as a positive family history.
Women who do not smoke usually do not need routine testing for abdominal aortic aneurysm.
If a woman has heart-related risks, a history of smoking, or family members with an aneurysm, she should talk with a healthcare provider about personalized screening advice.
Consider risk factors like age, genetics, and lifestyle before deciding on screening.
How Treatment Works
Ongoing Medical Supervision
Doctors monitor people with a small abdominal aortic bulge that is not causing symptoms rather than treating them right away. Regular checkups and imaging tests help track if the aneurysm is getting larger or changing.
A typical monitoring schedule includes an ultrasound test within six months after diagnosis. After that, doctors recommend ultrasounds at follow-up visits.
During these visits, healthcare professionals also check other factors—such as blood pressure—that can increase the risk of the aneurysm getting worse.
| Factor | What is Checked |
|---|---|
| Aneurysm size | Ultrasound or CT imaging |
| Blood pressure | Regular blood pressure measurement |
| Other risk factors | Blood tests and health reviews |
Doctors remind people to manage related health issues like high cholesterol and to avoid smoking, since these can raise the risk of rupture.
Surgical Repair and Other Interventions
Doctors suggest surgery when the bulge reaches about 2 inches (5 centimeters) wide, grows faster, or symptoms like persistent pain appear. Quick action becomes crucial if a possible rupture is suspected because this can cause severe internal bleeding.
There are two main surgical methods:
Endovascular Aneurysm Repair (EVAR): Surgeons use a thin tube (catheter), inserted through a blood vessel in the groin, to place a stent graft at the weak part of the aorta. The stent graft expands and supports the blood vessel, lowering the risk of rupture. Doctors need to perform follow-up imaging to ensure there is no leak around the repair.
Traditional (Open) Surgery: Surgeons make a large cut in the abdomen, remove the damaged vessel part, and sew in a graft. Recovery takes longer, but this procedure works well for people who cannot have EVAR.
| Surgical Option | How it Works | Recovery Time |
|---|---|---|
| Endovascular Repair | Stent graft inserted via catheter | Shorter |
| Open Surgery | Damaged aorta replaced with graft | Longer (weeks) |
Doctors choose between surgeries based on the aneurysm’s size and position, patient age, and overall health. Both techniques can offer similar long-term results when successful.
Healthy Habits and At-Home Care
People with an aortic aneurysm should avoid heavy lifting or tough exercise because these actions can quickly raise blood pressure. Managing stress helps, since stress can make blood pressure go up.
It also helps to quit smoking, limit foods high in cholesterol, and follow a heart-healthy diet. These steps lower the risk of further problems related to high blood pressure, atherosclerosis, and high cholesterol.
Getting Ready for Your Visit
Steps You Can Take
Call Ahead: When making an appointment, ask if there are any special instructions, like not having food or drinks for several hours before you arrive.
Make a List:
| Item | Details to Include |
| Symptoms | When they started, how often you notice them, and any details that may not seem related. |
| Medical Background | Family history of heart conditions or aneurysms. |
| Current Medications | All prescription and over-the-counter medicine, vitamins, and supplements, including the dosage of each. |
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Prepare Questions: Write down questions for your healthcare team. You might ask:
- What tests do I need?
- What could be causing my symptoms?
- What treatment options are available?
- Should I be screened regularly?
- How can I manage my other health conditions at the same time?
- Stay Open: Bring up any other questions or concerns during your visit. No question is too small.
What Your Healthcare Provider May Ask
Your healthcare provider will likely want detailed information. They may ask:
- Are your symptoms constant, or do they come and go?
- How severe are your symptoms?
They may also ask if you have noticed anything that helps or makes your symptoms worse. Your provider might want to know if you smoke or have ever smoked.
Prepare clear answers to help your provider understand your health. Bring your notes and questions to make the appointment smoother.
