What Clinical Factors Should Arouse Suspicion for Abdominal Aortic Aneurysm?

Abstract

Abdominal aortic aneurysm (AAA) is a serious degenerative vascular disease that affects 8% of the population. The majority of cases are asymptomatic until rupture, which harbors a high mortality rate. Early identification of symptomatic AAA and rupture can substantially improve mortality. Abdominal, back, and flank pain are common presenting symptoms, along with hypotension, syncope, and signs of distal hypoperfusion. Risk factors for rupture include aneurysm size, rate of growth, female sex, smoking, and family history of AAA. Physical exam has low sensitivity and can be misleading. Symptomatic AAA and rupture require emergent imaging and evaluation by a vascular specialist.