Abdominal aortic aneurysm 

Introduction 

Illustration of abdominal aortic aneurysm

1. aorta
2. heart
3. aortic aneurysm
4. aorta leading away from the heart
5. kidney

What is an aneurysm?

An aneurysm is a bulge in a blood vessel caused by a weakness in the blood vessel wall.

As blood passes through the weakened blood vessel, the blood pressure causes it to bulge outwards.

Exactly what causes the blood vessel wall to weaken is unclear, though hardening of the arteries, smoking and high blood pressure are thought to increase the risk of an aneurysm.

Aneurysms can occur anywhere in the body, but the two most common places for them to form are in the abdominal aorta and the brain.

A burst abdominal aortic aneurysm is also a medical emergency and is usually fatal.

Health checks: later years

Once you reach the age of 65, you'll be offered a range of NHS health checks including some specifically for older people

An abdominal aortic aneurysm (AAA) is a swelling (aneurysm) of the aorta – the main blood vessel that leads away from the heart, down through the abdomen to the rest of the body.

The abdominal aorta is the largest blood vessel in the body and is usually around 2cm wide – roughly the width of a garden hose. However, it can swell to over 5.5cm – what doctors class as a large AAA.

Large aneurysms are rare, but can be very serious. If a large aneurysm bursts, it causes huge internal bleeding and is usually fatal.

The bulging occurs when the wall of the aorta weakens. Although what causes this weakness is unclear, smoking and high blood pressure are thought to increase the risk of an aneurysm.

AAAs are most common in men aged over 65. A rupture accounts for more than 1 in 50 of all deaths in this group and a total of 6,000 deaths in England and Wales each year.

This is why all men are invited for a screening test when they turn 65. The test involves a simple ultrasound scan, which takes around 10-15 minutes.

Symptoms of an AAA

In most cases, an AAA causes no noticeable symptoms. However, if it becomes large, some people may develop a pain or a pulsating feeling in their abdomen (tummy) or persistent back pain.

An AAA doesn’t usually pose a serious threat to health, but there’s a risk that a larger aneurysm could burst (rupture).

A ruptured aneurysm can cause massive internal bleeding, which is usually fatal. Around 8 out of 10 people with a rupture either die before they reach hospital or don’t survive surgery.

The most common symptom of a ruptured aortic aneurysm is sudden and severe pain in the abdomen.

If you suspect that you or someone else has had a ruptured aneurysm, call 999 immediately and ask for an ambulance.

Read more about the symptoms of an AAA.

Causes of an AAA

It's not known exactly what causes the aortic wall to weaken, although increasing age and being male are known to be the biggest risk factors.

There are other risk factors you can do something about, including smoking and having high blood pressure and cholesterol level.

Having a family history of aortic aneurysms also means that you have an increased risk of developing one yourself.

Read more about the causes of an AAA.

Diagnosing an AAA

Because AAAs usually cause no symptoms, they tend to be diagnosed either as a result of screening or during a routine examination – for example, if a GP notices a pulsating sensation in your abdomen.

The screening test is an ultrasound scan, which allows the size of your abdominal aorta to be measured on a monitor. This is also how an aneurysm will be diagnosed if your doctor suspects you have one.

Read more about diagnosing an AAA.

Treating an AAA

If a large AAA is detected before it ruptures, most people will be advised to have treatment, to prevent it rupturing.

This is usually done with surgery to replace the weakened section of the blood vessel with a piece of synthetic tubing.

If surgery is not advisable – or if you decide not to have it – there are a number of non-surgical treatments that can reduce the risk of an aneurysm rupturing.

They include medications to lower your cholesterol and blood pressure, and quitting smoking.

You will also have the size of your aneurysm checked regularly with ultrasound scanning.

Read more about treating AAAs.

Prevention

The best way to prevent getting an aneurysm  or reduce the risk of an aneurysm growing bigger and possibly rupturing  is to avoid anything that could damage your blood vessels, such as:

  • smoking
  • eating a high-fat diet
  • not exercising regularly
  • being overweight or obese

Read more about preventing aneurysms.

Screening

Men who are 65 and over are offered a screening test to check if they have an AAA.

All men in England are invited for screening in the year they turn 65.

Men who are over 65 and have not previously been screened can request a screening test by contacting their local AAA screening service directly.

Women and men under 65 are not invited for screening.

However, if you feel you have an increased risk of having an AAA, talk to your GP who can still refer you for a scan.

Read more about screening for an AAA.



Page last reviewed: 30/08/2014

Next review due: 30/08/2016

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Comments

The 15 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Angela42 said on 09 August 2014

A point I forgot to mention. I still have 'pins and needles' in my abdomen and little feeling and which is still swollen. Did anyone else experience this?

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Angela42 said on 09 August 2014

To CRCE - yes, you do have to put your faith in the surgeon. I had a 9cm AAA and without one of the top surgeons in the country at Bedford Hospital, I would not be here now. Although taking longer than I thought (8 months) , I am on the road to recovery. To galty - yes I too have a large ridge on the scar, which is quite sore at times. Am hoping this will eventually heal. A problem I have found is that there is very little information telling you what you may expect. e.g. I expected to be fighting fit after 3 months but this has not happened and I now expect further recovery to take a year or more. However, I am alive and that's what counts. Very, very lucky too.

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CRCE said on 02 August 2014

Four years ago, when I was 66 years old, an extremely competent specialist at the Swindon urology unit discovered that I had a 9.5 cm aortic aneurysm.

Swindon surgeons operated without success and then followed a period of recovery whilst the Swindon surgeon tried to find a hospital that would complete the operation. (a number refused as the odds of success were low)

Eventually they referred me to a consultant at Oxford. He and his team undertook an 11.5 hour operation and I have made a full recovery.

If you are in this predicament you need to place total trust in the specialists and have belief in your own powers of recovery. This takes away the worry, makes the decision making process easier and speeds up recovery.

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pluma2015 said on 31 July 2014

I just had a routine physical and requested an ultra sound to follow up on fatty liver. Well; I still have the fatty liver but they also found an abdominal aortic aneurysm 3.2 CM. The treatment at present is to have an ultra sound every year to monitor it for possible enlargement. I am 79 and plan on having an ultra sound every 6 months. I am wondering if all AAA's tend to grow. It's like a time bomb waiting to go off. very worrysome.

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galty said on 26 March 2014

i would be interested to know if anyone has ended up with diastasis recti,(large ridge running down the scar line ) following open surgery on an aortic aneurysm,

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FionnCal said on 07 August 2013

Why are only men having AAA screening. Do women not count. I am 61 and have an Abdominal Aortic aneurysm picked up by a Dr at a medical. Surely with equality all people over 65 should be screened, not just men.

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lindyloo18 said on 07 July 2013

My Husband aged 69 was diagnosed with AAA size 6.3 in January 2013 after many tests he has now been told he is not suitable for the EVAR method and now he has 30% chance of dying on the table due to his lung function and fitness.
Needless to say we are devastated, we would not risk his life and yet he seems fit and healthy apart from the worry about the bomb that could go off at any minute. he had the tests done again last week on the Monday to be told they would be back with the surgeon in time for our visit on Thursday. However the surgeon has not received the tests. so once again six months down the line we are still in turmoil and sick with worry. We have to go back again next week to see how the fitness tests results are back with the surgeon. Not only was the surgeon disappointed , but so are we. my husband has always been fit and active and still has. he has smoked most of his life, but gave up in January this year when his AAA was discovered.
I only hope and pray that they say he is fit enough as without Im not sure how long that we can keep on going.

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Woodie01 said on 20 April 2013

My father is 73,he was in massive pain in lower back and bottom cheeks,ct scan revealed aaa width of 10cm,operated on within 3hours,3days later his leg was amputated above knee due to complications in theatre.he is in his 10th week in hospital,icu,renal and cardiac.due for rehab hospital next week.He is an amazing man,very well loved,does voluntary work for elderly.He has lost 4stone,he's very weak,heartbreaking to see such a great man now so vulnerable.married to my mum for 51years,their life now turned upside down.Please make use of this scan when you are of age.LIfe is so precious.

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cablemandjh said on 13 October 2012

I had a ruptured AAA on the 6/9/2012. The ambo`s were very good. A & E tried thought I had kidney stones & wanted me on a chair in minors, but when the ambo`s tried to get me off the trolley onto the chair and my BP went through the floor they told A & E staff to keep me in the trolley area. It took them 3 or 4 hours to diagnose the AAA rupture at which time I went for emergency surgery. I of course didn`t know much about this as most of the time I was out of it. I woke in intensive care when a really nice nurse said hello Derek you are lucky. It took a day or so to realize how lucky.

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heve said on 29 September 2012

I would like to know why at the moment it's only men being screened, my mother died when her aortic aneurysm ruptured. Surely, as one of the risk factors is having or had a parent or sibling with an aneurysm, anyone over 65 should be screened

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golfclub said on 17 June 2012

any info on iliac aneurysm like size before intervention

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LesSnit said on 31 May 2012

My Dad suffered a fatal ruptured aortic neurysm at the age of 57, my brother has been diagnosed with one at the age of 51. Should I be screened? As a female does is the risk as great?

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MikeC1 said on 11 March 2012

I had a friend who's just had a fatal aortic aneurysm, aged only 52. Perhaps screening should be made available at a younger age?

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brian1953 said on 09 January 2012

You give info on the incidence in men but none for women. Also nothing on inherited predisposition to this condition. Are there any circumstances in which women of whatever age should be screened? This is a very male-oriented article.

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paulkeit said on 17 July 2011

I have an abdominal aortic aneurysm which was re-diagnosed 2 years ago.
i have never been contacted by the hospital (cov uni) since.
should i have expected to have been?

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