Abdominal aortic aneurysm

What is an abdominal aortic aneurysm?

Your aorta is the main artery in your body. This large artery is like a superhighway that supplies blood to your body. The aorta, which is shaped like a candy cane, begins in the left ventricle (upper chamber) of your heart. It curves in your chest and extends down into your abdomen.

When the walls of your aorta become damaged or weakened, it can balloon outward. This bulge is an aneurysm. The three types of aortic aneurysms include:

  • Abdominal aortic aneurysm (AAA), an aneurysm in the lower part of the aorta
  • Thoracic aortic aneurysm, an aneurysm at the top of the aorta
  • Thoracoabdominal aneurysm, a complex aneurysm that involves branches of the abdominal aorta that supply blood to the liver, intestines, and kidneys

If an aneurysm ruptures or bursts, it can result in rapid blood loss that can be life-threatening. While a ruptured aneurysm is extremely dangerous, most abdominal aortic aneurysms are discovered before they reach that point. AAAs occur most often in people aged 60 and older.

Symptoms of an abdominal aortic aneurysm

Aneurysms develop slowly over several years. Most people don’t experience symptoms. You may be unaware that you have an abdominal aortic aneurysm.

An aneurysm that expands rapidly, tears open or leaks blood can cause symptoms. One notable symptom is a pain in your abdomen or back that you can’t relieve by switching positions or taking pain medication. The pain may be sudden, severe, and constant and may spread to the legs, groin, or buttocks.

You may also experience:

  • Clammy skin
  • Dizziness
  • Fainting
  • Low blood pressure
  • Nausea and vomiting
  • Rapid heart rate
  • 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

Healthcare 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 healthcare provider may recommend screening based on your personal history and other risk factors. Experts don’t recommend routine screening for women at this time.

Diagnosing an abdominal aortic aneurysm

Doctors usually find abdominal aortic aneurysms during a physical examination 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 have one or more of the following tests to confirm the diagnosis:

  • Ultrasound of the abdomen: uses sound waves to produce images of the aorta
  • CT scan of the abdomen: a series of X-rays that produces 3D images that can show an aneurysm’s size and extent
  • CTA (computed tomographic angiogram): imaging that uses contrast (dye) to show details about an aneurysm that can help surgeons plan your treatment

Treatment at Penn Medicine

When you choose Penn Medicine, you will work with a highly specialized team of vascular surgeons who helped pioneer treatments for abdominal aortic aneurysms. Your treatment may include:

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