Living Safely with Abdominal Aortic Aneurysm
The aorta carries blood from the heart to the rest of the body. Age, smoking and other factors can weaken the aortic wall, resulting in a balloon-like bulge called an aneurism. An abdominal aortic aneurysm, or AAA, is a bulge in the wall of the aorta where it passes through the abdomen. Most people with an AAA don’t experience any symptoms — in fact, they probably don’t realize they have it at all. But a small percentage of AAAs rupture. When that happens, this usually benign medical condition suddenly becomes a life-threatening emergency.
Doctors use ultrasound imaging—a pain-free, radiation-free scan—to detect and measure AAAs and monitor their growth. That way any necessary surgical repair can happen proactively before a rupture occurs. Regular screening gives doctors more control over the condition and gives people living with higher-risk AAAs more peace of mind.
What happens when an abdominal aortic aneurysm ruptures
The abdominal aorta typically measures around two centimeters. A bulge in the abdominal aorta qualifies as an aneurism when it measures more than three centimeters. Undetected and untreated, an AAA tends to gradually expand. But when it becomes very large (more than 5.5 centimeters) or expands very rapidly, the risk of rupture significantly increases.
Most people with AAA have no symptoms, although a larger aneurysm might cause backache or pain in the sides or abdomen. However, an AAA rupture creates an immediate, intense chain of medical events:
- Sudden back pain that spreads to the sides or groin
- Dizziness as a large quantity of blood leaks into the abdominal cavity
- Loss of consciousness
- Collapse of the circulatory system
According to a study from Postgraduate Medical Journey, an AAA rupture has an overall mortality rate of 90%. Additionally, more than half of patients who experience rupture die before they reach the emergency room and only 25 to 50% of people with an AAA rupture show all three classic symptoms—pain, low blood pressure and a pulsing abdominal mass. Due to these factors, doctors frequently misdiagnose this extremely critical condition. Even patients who receive and survive emergency surgical repair remain at high risk of death.
But for high-risk patients who undergo elective surgical repair to prevent rupture, “the prognosis is good to excellent.”
Causes and risk factors of AAA
Major risk factors include age, gender and ethnicity, as well as a family history of AAA. Controllable risk factors include smoking, high blood pressure and high cholesterol.
Three to six out of 100 men with an AAA larger than 5.5 centimeters will experience rupture within a year. Ultrasound screening for men over 65 has been shown to lower the risk of fatal rupture. The Society for Vascular Surgery (SVS) Guidelines recommends screening for all men and women 65 or older who have smoked or who have a family history of AAA.
Diagnosing AAA
If you have an abdominal aortic aneurysm, the recommended treatment will depend on its size and rate of growth and your overall health. Your doctor will weigh the risk of surgery against the risk of rupture.
If your AAA puts you at high risk for rupture, your doctor may recommend elective surgery. Open surgery involves replacing the aneurysm with an artificial graft. A less-invasive option involves sliding a stent (a tiny supportive tube) into the weakened portion of the aorta through a small incision in the groin.
If you have a smaller aneurysm (less than 5.5 centimeters), your doctor will likely suggest a nonsurgical approach.
Depending on the size of the aneurysm, SVS Guidelines call for monitoring smaller AAAs at six-month, one-year or three-year intervals.
How Ultrasound Works
One of the safest imaging technologies, ultrasound uses sound waves to produce images of soft tissues. It involves no radiation or contrast agents and is especially useful for observing blood flow in the veins and arteries. An ultrasound generally takes 20 to 40 minutes.
Numerous American Health Imaging centers offer same-day appointments and a lower-cost scan than are offered at the hospital. AHI’s radiologists will provide a full report to your referring doctor within 24 hours.
Learn more about ultrasounds and how they work.