From the Guidelines
Abdominal aortic aneurysms (AAAs) are often asymptomatic until they rupture, and when symptoms do occur, they may include a pulsating sensation in the abdomen, deep persistent abdominal or back pain, and tenderness when the abdomen is pressed, as reported in the most recent study 1.
Symptoms of Abdominal Aortic Aneurysm
The symptoms of AAA can be divided into two categories: symptoms before rupture and symptoms after rupture.
- Before rupture, symptoms may include:
- A pulsating sensation in the abdomen
- Deep persistent abdominal or back pain that may radiate to the buttocks, groin, or legs
- Tenderness when the abdomen is pressed
- Feeling the heartbeat in the abdomen
- After rupture, symptoms become severe and life-threatening, including:
- Sudden, intense abdominal or back pain
- Dizziness
- Rapid heart rate
- Sweating
- Nausea
- Vomiting
- Low blood pressure
- Shock
Risk Factors
Risk factors for AAA include smoking, high blood pressure, age over 65, male gender, family history, and atherosclerosis, as identified in the study 1.
Screening and Diagnosis
Regular screening is recommended for men aged 65-75 who have ever smoked and selectively for men who have never smoked and women with risk factors, as suggested in the study 1.
Treatment and Management
If you experience sudden, severe abdominal or back pain, seek emergency medical attention immediately as a ruptured AAA is life-threatening and requires immediate surgical intervention, as emphasized in the study 1.
Follow-up and Surveillance
For patients with small AAA, surveillance is indicated, and the intervals between US surveillance examinations depend on aneurysm size, as reported in the study 1.
From the Research
Symptoms of Abdominal Aortic Aneurysm
- Acute onset abdominal and back pain, as seen in an 82-year-old man with a known aneurysm of the abdominal aorta (AAA) who presented with a history of acute onset abdominal and back pain of a few hours 2
- Pain on pressure over the aneurysm, as observed in the same patient who was haemodynamically stable and had pain on pressure over the aneurysm 2
- The symptoms can be non-specific and may not always be directly related to the aneurysm, as in the case of a duodenum perforation resulting from the unnoticed swallowing of a sharp object 2
Diagnostic Considerations
- Echographic or CT-scan investigations can confirm or exclude a ruptured AAA, thus avoiding unnecessary surgery 2
- These investigations also gather preoperative data for potential endovascular reconstruction 2
- Imaging techniques such as US, CT, MRI, and angiography can be used to evaluate abdominal aortic aneurysm, each with its own strengths and limitations 3