What Is an Abdominal Aortic Aneurysm?

An aneurysm occurs when part of an artery wall weakens, allowing it to balloon out or widen. The cause of an aneurysm is sometimes unknown. Some people are born with them. They also can be hereditary. Aortic disease or an injury also may cause an aneurysm.

Abdominal aortic aneurysm (AAA) occurs in the segment near or below the renal arteries. The concern for an aortic aneurysm is that as it enlarges, there is a risk of rupture, which is life-threatening. The biggest factors in this risk are the size and characteristics of the AAA. Some aortic aneurysms can remain small, requiring only observation to check the size.

The Norton Heart & Vascular Institute vascular surgeons are fellowship trained and board certified. They are experienced in the latest minimally invasive techniques and traditional surgery to repair an abdominal aortic aneurysm.  They work collaboratively with providers throughout Norton Healthcare to deliver sophisticated treatment customized to your condition and needs.

AAA Screening

Because aortic aneurysms often show no symptoms prior to a rupture, a physical exam of the abdomen, ultrasound imaging or other screening tool can help diagnose this silent problem.

The U.S. Preventive Services Task Force recommends that men, ages 65 to 75 who smoke currently or smoked at some point in their life, get an ultrasound abdominal aortic aneurysm screening even if they have no symptoms. The recommendations for women are still being evaluated, and ultrasound screenings are not currently recommended. Other considerations for screening include a family history of aneurysms and other medical factors.

The ultrasound test is similar to that used to capture images of a fetus in its mother’s uterus and is noninvasive.

Abdominal Aortic Aneurysm Symptoms

Abdominal aortic aneurysms most often grow slowly without any noticeable symptoms. If you notice any of the following symptoms, contact your health care provider. (The symptoms below are not specific and may be caused by other issues.)

• General belly pain or discomfort, which may come and go or be constant.
• Feeling a heartbeat or pulse in your stomach or near your bellybutton.
• Pain in the chest, abdomen, lower back or flank. The pain may be deep, aching, gnawing or throbbing. It may last for hours or days.

A ruptured abdominal aortic aneurysm requires immediate emergency treatment. Signs include:

• Sudden, severe pain in the stomach or lower back
• Dizziness
• Sweaty, pale skin
• Rapid heartbeat
• Shortness of breath
• Fainting

Abdominal Aortic Aneurysm Causes

Many lifestyle habits and health conditions can increase the risk of developing an aortic aneurysm.

• Hardening of the arteries (atherosclerosis). This occurs when fat and other substances build up on the lining of the aorta and other vessels.
• High blood pressure. High blood pressure can damage and weaken the aortic wall.
• Blood vessel diseases. These processes can cause inflammation and damage to the aortic wall.
• Infection in the aorta. Rarely, a bacterial or fungal infection might weaken the aortic wall.
• Trauma. Certain traumas, like a car accident, can directly injure the aortic wall.

Abdominal Aortic Aneurysm Risk Factors

Risk factors for development of abdominal aortic aneurysm include:

• Tobacco use. Smoking is the strongest risk factor. It can weaken the aortic walls, increasing the risk not only of developing an aortic aneurysm, but of rupture. The longer and more you smoke or chew tobacco, the greater the chances of developing an aortic aneurysm.
• Age. These aneurysms occur most often in people ages 65 and older.
• Being male. Men develop abdominal aortic aneurysms much more often than women do.
• Being white. People who are white are at higher risk of abdominal aortic aneurysms.
• Family history. Having a family history of abdominal aortic aneurysms increases your risk of having the condition.
• Other aneurysms. Having an aneurysm in another large blood vessel, such as the artery behind the knee or the aorta in the chest, might increase your risk of an abdominal aortic aneurysm.

Abdominal Aortic Aneurysm Treatment

An abdominal aortic aneurysm of less than 5 centimeters  (about 2 inches), usually can be monitored and may not require treatment unless it gets larger.

You also will be treated for medical conditions, such as high blood pressure, that could worsen your aneurysm. Your doctor may suggest lifestyle adjustments such as stopping smoking or modifying your diet.

You will need regular imaging tests to check on the size of your aneurysm. This can be performed by abdominal ultrasound or CT scan. Regular clinic visits and follow-up exams are determined by the size of the aneurysm. Treatment options include:

• Endovascular aneurysm repair (EVAR)
• Open aneurysm repair

About Norton Heart & Vascular Institute

Norton Heart & Vascular Institute offers advanced care at all of our adult-service hospitals to save hearts and lives.

Awards and Accreditations

• All of Norton Healthcare’s adult-service hospitals in Louisville have received Chest Pain Center accreditation from the American College of Cardiology (ACC).
• Norton Audubon Hospital has been named a HeartCare Center National Distinction of Excellence year after year by the American College of Cardiology. This is the only hospital in Louisville to be recognized for this distinction.
• Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Hospital all are recognized as having ACC Chest Pain Center with Primary PCI accreditation.
• Norton Audubon Hospital earned ventricular assist device (VAD) accreditation from DNV and the Centers for Medicare & Medicaid Services.

Leading the Region in Advanced Care

• First in Louisville to implant a dual-chamber leadless pacemaker
• First in Louisville to use PASCAL and MitraClip to replace and repair heart valves
• First health care system in Louisville to offer CathWorks FFRangio System in a minimally invasive procedure used to treat clogged arteries and advance heart disease
• Highest survival rate in the nation for  extracorporeal membrane oxygenation (ECMO) interventions treating heart failure
• Among the highest survival rates in the nation for treatment of cardiogenic shock in heart failure
• Over 100 transcarotid artery revascularization (TCAR) procedures performed for heart disease patients
• System with the most facilities across the city of Louisville with the ability treat a life-threatening heart attack
• More than 100 board-certified physicians and advanced practice providers with specialized heart and vascular training and experience at nearly 30 locations in Louisville and Southern Indiana

Comprehensive Heart Care for the Whole Person

Norton Heart & Vascular Institute offers patient resources to support you and your family, including free classes for people of all ages who want to improve cardiovascular health or are living with a heart condition.

• Cardiac rehabilitation: Our cardiac rehabilitation providers are leaders in developing and applying innovative techniques that can help you recover and resume your life.
• Connecting Hearts for Support group: The group provides education and support to individuals who have had a heart attack, are living with a heart condition or are at risk for cardiovascular disease.
• Heart health screenings: Prevention is the best way to manage heart disease, and screenings are available to detect early signs of cardiac and vascular disease and identify risk factors.