Aortic aneurysms are often discovered during an X-ray, ultrasound, or echocardiogram done for other reasons. Occasionally, an abdominal aneurysm is felt during a routine physical examination. If this is the case, your doctor will perform a medical history and physical examination.

Once an aneurysm is suspected or diagnosed, it is important to:

• Pinpoint the location of the aneurysm.
• Estimate its size.
• Determine how fast it is growing and whether surgical treatment is needed.
• Determine whether other blood vessels are involved.
• Detect the presence of blood clots or inflammation.

Tests to help determine the location, size, and rate of growth of an aneurysm include:

• Abdominal ultrasound. Ultrasounds help your doctor know if your aneurysm is growing. If your aneurysm is large, you may need an ultrasound every 3 to 6 months. If your aneurysm is small, you may need one every 1 to 5 years.
• Computed tomography (CT) and magnetic resonance imaging (MRI), which are used if a view more detailed than an ultrasound is needed. This is important when information is needed about the aneurysm's relation to the blood vessels of the kidney or other organs. CT is used to monitor the growth of a thoracic aortic aneurysm.
• Echocardiogram, an ultrasound exam used to study the heart. A transthoracic echocardiogram (TTE) or a transesophageal echocardiogram (TEE) may be done to diagnose thoracic aortic aneurysm.
• Angiogram. An angiogram can help determine the size of the aneurysm and the presence of dissections, blood clots, or other blood vessel involvement.

One of the most important goals of testing is to estimate the risk that an aneurysm may burst, or rupture, and to compare the risk of rupture to the risks of surgery. If an aortic aneurysm is detected, tests such as abdominal ultrasound can be used to closely follow any change in the size or other characteristics of the aneurysm and help measure the risk for rupture.

Early detection

The U.S. Preventive Services Task Force (USPSTF) recommends an abdominal ultrasound screening test for men between the ages of 65 and 75 who have ever smoked.

The recommendation does not apply to women or nonsmoking men, since they are less likely to have an abdominal aortic aneurysm. Screening is not considered beneficial in these groups.

People who have a strong family history of aortic aneurysms or who have Marfan's syndrome, Ehlers-Danlos syndrome, or another condition that puts them at risk may benefit from screening.