What is aortic aneurysm?

Most aortic aneurysms don't cause symptoms. But symptoms may occur if the aneurysm gets bigger. The most common symptoms include belly, chest, or back pain that may spread to the groin, buttocks, or legs. The pain may be deep, aching, or throbbing. If the aneurysm bursts, or ruptures, it causes sudden, severe pain.

An aortic aneurysm may be repaired with surgery or a procedure if the aneurysm is at risk of bursting open (rupturing). If you have symptoms, a large aneurysm, or a fast-growing aneurysm, you need surgery to fix it.

Aneurysms are often diagnosed by chance during exams or tests done for other reasons. In some cases, they are found during a screening test for aneurysms. Screening tests help your doctor look for a condition before symptoms appear.

Screening for aortic aneurysms

The U.S. Preventive Services Task Force recommends a screening ultrasound test for abdominal aneurysms for men ages 65 to 75 who have ever smoked.

Some doctors think that other groups should be screened too. Talk to your doctor about whether the benefits of screening would outweigh the risks in your case.

Experts recommend screening tests for a thoracic aneurysm for anyone who has a close relative who's had a thoracic aortic aneurysm.

Diagnosing aortic aneurysms

Sometimes an abdominal aneurysm is felt during a routine physical exam. If your doctor thinks you might have an aortic aneurysm, the doctor may:

Do a physical exam.

As part of a physical exam, your doctor might:

• Listen to your heart to check for blood flow problems.
• Check your legs and feet.

Ask about your medical history.

Your doctor may ask questions such as:

• Do you have symptoms? When did they start?
• Do you smoke?
• Do you have other diseases, such as high blood pressure?
• Do you have a family member who has had an aortic aneurysm?

Do imaging tests.

You might have imaging tests to:

• Pinpoint the location of the aneurysm.
• Estimate its size and how fast it is growing.
• Find out if other blood vessels are involved.
• Look for blood clots or inflammation.

Imaging tests

These tests include:

Abdominal ultrasound.

Ultrasounds help your doctor check the size of the aneurysm.

CT scan and MRA.

Computed tomography (CT) and magnetic resonance angiogram (MRA) are used if the doctor needs a more detailed view than an ultrasound provides. This is important when information is needed about the aneurysm's relation to the blood vessels of the kidney or other organs. Your doctor needs this information especially before surgery.

Echocardiogram.

This is an ultrasound used to study the heart and the aorta. You might have one of these:

• Transthoracic echocardiogram (TTE)
• Transesophageal echocardiogram (TEE)

Follow-up testing

One of the most important goals of testing is to estimate the risk that an aneurysm may burst, or rupture. The risk of rupture is compared to the risks of surgery. Tests such as abdominal ultrasound can be used to closely follow any change in the aneurysm and help measure the risk for rupture.

• If the aneurysm is large, you may need an ultrasound every 6 to 12 months.
• If the aneurysm is small, you may need an ultrasound every 2 to 3 years.

There may be other things that determine how often you should get an ultrasound.

If you have an aortic aneurysm, you may be at risk for heart problems. You may take medicine to help lower blood pressure and cholesterol. Having high cholesterol increases your risk of atherosclerosis, which can cause aortic aneurysms and other conditions, such as coronary artery disease and stroke.

Health professionals who can evaluate symptoms that may be related to an aortic aneurysm and order the tests needed for further evaluation of symptoms include:

• Family medicine physicians.
• Internists.
• Nurse practitioners.
• Physician assistants.
• Cardiologists or vascular surgeons.

If you have a fast-growing aortic aneurysm, you may be referred to a vascular surgeon, who can evaluate your need for surgery.

If you have an aortic aneurysm, you will see your doctor regularly to check on the size of the aneurysm. The size of the aneurysm and how fast it is growing both help determine how and when to treat it.

Rupture is a dangerous complication. As an aneurysm expands, the tension on the blood vessel wall increases. This causes the aneurysm to expand further, which puts even more tension on the wall. The larger the aneurysm gets, the greater the chances that it will grow larger and eventually burst. Your doctor will want to repair an aneurysm before it has a risk of rupture.

Atherosclerosis is one of the causes of abdominal aortic aneurysm. Atherosclerosis seems to cause the walls of the aorta to weaken. Over time, the wall starts to grow larger in the area of the plaque. The end result is an aneurysm.

An aortic aneurysm is a bulge in a section of the aorta, the body's main artery. The section with the aneurysm is overstretched and weak, so it can burst. If the aorta bursts, it can cause serious bleeding that can quickly lead to death.

Repairing an aortic aneurysm is often recommended if the aneurysm is at risk of bursting open (rupturing). Aortic aneurysms that are large, that cause symptoms, or that quickly get bigger are considered at risk of rupturing.

Your doctor will work with you to decide which type of repair surgery—open or endovascular—is right for you. Your doctor will check:

• The shape and location of your aneurysm.
• Your age and overall health, to make sure that you are healthy enough for a surgery.
• If you are able and willing to have the yearly tests that are needed after endovascular repair. Testing is done less often after an open repair.