What is an abdominal aortic aneurysm?
Your aorta is the large, main artery that supplies blood to your body. Shaped like a candy cane, the aorta begins in the upper chamber (left ventricle) of your heart. It curves in your chest and extends down into your abdomen. When the walls in the lower part of the aorta become damaged or weakened, they can balloon outward. This bulge is an abdominal aortic aneurysm.
If an aneurysm ruptures or bursts, it can cause rapid blood loss that can be life-threatening, though most abdominal aortic aneurysms are discovered before they reach that point. Penn Medicine’s aorta center is a top destination for diagnosing and treating aortic conditions. This includes abdominal aortic aneurysms as well as bulges that occur at the top of the aorta (thoracic aortic aneurysm) or in the branches of the abdominal aorta (thoracoabdominal aneurysm). We treat more people for aortic diseases than any other hospital in the region.
Signs and symptoms of an AAA
Because aneurysms develop slowly over several years, most people don’t experience symptoms and may be unaware that they have an aneurysm. However, an AAA that expands rapidly, tears open, or leaks blood can cause sudden, severe pain in your stomach or back. The pain is often constant, can’t be relieved by switching positions or taking pain medication, and may spread to your legs, groin, or buttocks.
You may also experience:
- Clammy skin
- Dizziness
- Fainting
- Low blood pressure
- Nausea and vomiting
- Rapid heart rate
- Organ damage due to reduced blood flow and oxygen levels (shock)
Causes of an abdominal aortic aneurysm
The most significant risk factor for AAA is having a family history of this type of aneurysm. If someone in your family has had AAA and you have severe pain in your back or abdomen that comes on suddenly, get care immediately.
Other risk factors for abdominal aortic aneurysm include having:
- Atherosclerosis, the buildup of plaque (fatty deposits) in artery walls
- Tears in the wall of the aorta (aortic dissection)
- Infections in or near the aorta
- Connective tissue disorders, such as Marfan syndrome
- History of smoking
- Long-standing high blood pressure
Screening for an abdominal aortic aneurysm
Health care providers can screen you for an existing abdominal aortic aneurysm or to assess your likelihood of developing AAA. The screening is a simple, noninvasive ultrasound exam. Ultrasound uses sound waves to show images of your organs and blood vessels.
One-time screening is recommended for men ages 65 to 75 who smoke or have ever smoked. If you are a man ages 65 to 75 who has never smoked, your health care provider may recommend screening based on your personal history and other risk factors. Experts don’t recommend routine screening for women at this time.
How doctors diagnose an AAA
Doctors usually find abdominal aortic aneurysms during a physical exam or on an x-ray. To understand more about the aneurysm, your doctor will examine your abdomen and feel the pulses in your legs. You may need one or more tests to confirm the diagnosis, measure the aneurysm’s size, and plan your treatment. During testing, your health care team may inject a contrast dye that helps your doctor see details of the aneurysm (angiogram).
Abdominal aortic aneurysm treatment
Small aneurysms that don’t cause symptoms may only need active surveillance. This involves monitoring the aneurysm with imaging tests every six to 12 months and making lifestyle changes or using medications to reduce the risk of it growing. Larger aneurysms require surgery, which may include open surgery or a minimally invasive procedure that allows your surgeon to reach the aneurysm by going through a vein.
Penn Medicine’s advanced AAA care
We’re known for our expertise in caring for the most complex aortic conditions. When you choose Penn Medicine, you’ll work with a highly specialized team of vascular surgeons who helped pioneer treatments for abdominal aortic aneurysms. Whether you need active surveillance or surgery, our team can help you effectively manage your condition.
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Patient stories
Father and son undergo bicuspid aortic valve surgery
“If you have surgery at Penn,” said Tyler Schumacher, “know you are at one of the best hospitals in the country. The care doesn’t get better than what I received.” Tyler and his dad both had heart valve surgery for their shared genetic heart valve condition.
Lifesaving care for ascending aortic aneurysm
“This whole experience has been life-changing, not just for me but for my family members.”