Aortic aneurysms are often discovered during an X-ray, ultrasound, or echocardiogram done for other reasons. Sometimes an abdominal aneurysm is felt during a routine physical exam. If your doctor thinks you might have an aortic aneurysm, you will likely have a medical history and physical exam. You might have further tests to locate the aneurysm.
When an aneurysm is suspected or diagnosed, it is important to:
- Pinpoint the location of the aneurysm.
- Estimate its size.
- Find out how fast it is growing.
- Find out whether other blood vessels are involved.
- See if there are blood clots or inflammation.
Medical history and physical exam
Your doctor may ask:
- Do you have symptoms and when did they start?
- Do you smoke?
- Do you have other diseases, such as high blood pressure?
- Do you have a family member who has had an aortic aneurysm?
- Have you had a chest injury recently?
As part of a physical exam, your doctor might:
- Listen to your heart to check for blood flow problems.
- Feel your abdomen to check for a mass that might be an enlarged aorta. An aneurysm has to be a certain size, about 4 cm, before it can be felt.
- Check your legs and feet.
If your doctor finds a mass in your abdomen, he or she will suggest further testing. If you are overweight and your doctor feels strongly that you may have an abdominal aortic aneurysm, he or she may also suggest further testing. This is because an abdominal aortic aneurysm is typically more difficult to find in those who are overweight.
Tests to help find out 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 6 to 12 months. If your aneurysm is small, you may need one every 2 to 3 years.
- Computed tomography (CT) and magnetic resonance angiogram (MRA), 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. Your doctor needs this information especially before surgery. CT is used to watch 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 your doctor know what the size of the aneurysm is and if there are aortic 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 aspect of the aneurysm and help measure the risk for rupture.
For abdominal aortic aneurysm
Your doctor may recommend an abdominal ultrasound screening test if you are a man who is:
- Age 65 to 75 and has ever smoked.1
- At least 60 years old and who has a first-degree relative (for example, father or brother) who has had an aneurysm.2
Some doctors think that other groups should be screened too. Talk to your doctor about whether the benefits of screening would outweigh the risks in your case.
For thoracic aortic aneurysm
Your doctor may recommend screening tests for a thoracic aortic aneurysm if you have a close relative (parent, brother, or sister) who has had a thoracic aortic aneurysm.3