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Back to Cardiovascular Diseases
Aortic aneurysm
Updated: September 19, 2006
Symptoms and signs
Most aortic aneurysms have no symptoms. In fact, most are diagnosed
on a chest X-ray or computerized tomography (CT) scan performed for
evaluation of another condition, such as lung disease, or during routine
exams. Symptoms may occur, however, due to the aneurysm pressing on
nearby organs or tissue, or if the aneurysm leads to dissection.
Symptoms of dissection include severe tearing pain in the chest or back,
stroke, cold or numb extremities, or abdominal pain.
Screening
When aortic aneurysms are diagnosed early, treatment is safe and
effective and the aneurysm is cured. AAA can be diagnosed by a simple
ultrasound scan that can be performed in a few minutes without risk or
discomfort.
Men between the ages of 65 and 75 who are or have been smokers should
have a one-time ultrasound to screen for abdominal aortic aneurysm,
according to a new recommendation from the U.S. Preventive Services Task
Force. Nearly 70 percent of men in this age group have smoked and would
benefit from routine screening to check for aneurysms.
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Diagnosis
Most patients have no symptoms at the time an AAA is discovered.
Aneurysms are often detected on tests that were performed for entirely
different reasons. Abdominal aortic aneurysms may be diagnosed by a
doctor during a physical exam, or sometimes patients notice a pulsating
mass in their abdomen. The first hint of an aortic aneurysm may be an
abnormal chest X-ray. Although AAA can be detected by physical
examination, most are diagnosed today using an ultrasound scan or CAT
scan, simple exams that are non-invasive and can be done as an
outpatient. Magnetic resonance imaging (MRI) can also help. These exams
also tell us about the size of the aneurysms – the key element to
determine the need for treatment. Since major surgery was required in
the past to repair an aortic aneurysm, that decision depended upon a
comparison of the risk of rupture with risk of the surgery itself. Most
doctors agree that for someone in good health, an AAA larger than 5
centimeters in diameter (about the size of a lemon) needs treatment.
Smaller aneurysms may also need treatment if they cause symptoms (like
back pain or abdominal pain), or tests show that the aneurysm has
rapidly grown larger.
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