Aneurysms

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• Abdominal Aortic Aneurysm: Should I Get a Screening Test?

The wall of the aorta is normally very elastic. It can stretch and then shrink back as needed to adapt to blood flow. But some things weaken the artery walls and can cause an aneurysm. These things include:

Atherosclerosis.

Exactly how atherosclerosis, or hardening of the arteries, leads to aortic aneurysms isn't clear. It may cause changes in the lining of the artery wall that lead to tissue damage.

Genetics.

Certain inherited conditions can affect the arteries. These conditions include Marfan syndrome and Ehlers-Danlos syndrome.

Aging.

The aorta naturally becomes less elastic and stiffer with age.

Infection.

Some infections can cause aneurysms. Examples include syphilis and endocarditis.

Injury.

A sudden, intense blow to the chest or belly can damage the aorta.

Inflammation.

But what causes the aorta to become inflamed isn't clear.

Most people who have an aortic aneurysm don't have symptoms. But symptoms may occur if the aneurysm gets bigger.

Symptoms may include:

• Pain in the chest, belly, or lower back, which may spread to the groin, buttocks, or legs. The pain may be deep, aching, or throbbing.
• A pulsating feeling in the belly.
• A "cold foot" or a black or blue painful toe. This can happen if a blood clot breaks off and blocks blood flow to the legs or feet.
• A cough or shortness of breath if the aneurysm is in the area of the lungs.
• Hoarseness.
• Trouble swallowing, or pain while swallowing.
• Fever or weight loss.

If an aortic aneurysm bursts, or ruptures, it causes sudden, severe pain, an extreme drop in blood pressure, and signs of shock. Without immediate treatment, it can quickly lead to death.

If you have an aortic aneurysm, you will see your doctor regularly to check on the size of the aneurysm. The size of the aneurysm and how fast it is growing both help determine how and when to treat it.

Rupture is a dangerous complication. As an aneurysm expands, the tension on the blood vessel wall increases. This causes the aneurysm to expand further, which puts even more tension on the wall. The larger the aneurysm gets, the greater the chances that it will grow larger and eventually burst. Your doctor will want to repair an aneurysm before it has a risk of rupture.

Call 911 or other emergency services immediately if you have signs of a ruptured aortic aneurysm such as:

• Sudden, severe pain.
• Sudden weakness in the leg or foot on one side of the body.
• An extreme drop in blood pressure.
• Chest, belly, or back pain you have not had before.
• Signs of shock, such as passing out or feeling very dizzy, weak, or less alert.

If you see someone pass out, call 911 or other emergency services and start cardiopulmonary resuscitation (CPR). The emergency operator can coach you on how to do CPR.

Call a doctor now if you have:

• A throbbing lump in your abdomen.
• You have sudden symptoms in your leg or foot such as severe pain, numbness, weakness, tingling, cool skin, or skin color changes. Your skin may be pale, bluish, or purplish.

Call for a doctor appointment if you have:

• Fever or weight loss for no clear reason.

Video Transcript: Hands-Only CPR

Hands-only CPR.

It could be one of the simplest and most important things you ever learn to do.

If you're somewhere when a teen or an adult suddenly collapses, there are just two things you need to do to help give that person the best chance of avoiding brain damage or death. 

Step 1: Call 911.

Or even better, have someone else call 911.

A 911 operator can give you instructions over the phone on how to do CPR until emergency services arrive.

If there's an AED nearby, ask someone to go get it for you.

Step 2: Start chest compressions to help keep blood and oxygen flowing while you wait for help to arrive.

To do chest compressions, place the heel of one hand in the center of the person's chest.

Place your other hand on top, and lace your fingers together.

The top hand can help pull your fingers back so that you're just using the heel of your hand.

Lean forward and firmly press straight down— until the person's chest goes down about 2 inches.

Press hard and fast, at a rate of about 2 compressions a second— or 100 to 120 compressions a minute.

If it helps, think of pushing to the rhythm of the song "Stayin' Alive."

Continue with compressions until help arrives, the person starts breathing, or an AED is ready to use.

That's it.

Two steps.

Call 911.

And start hard and fast chest compressions.

You got this.

Aneurysms are often diagnosed by chance during exams or tests done for other reasons. In some cases, they are found during a screening test for aneurysms. Screening tests help your doctor look for a condition before symptoms appear.

Screening for aortic aneurysms

The U.S. Preventive Services Task Force recommends a screening ultrasound test for abdominal aneurysms for men ages 65 to 75 who have ever smoked.footnote1

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.

Experts recommend screening tests for a thoracic aneurysm for anyone who has a close relative who's had a thoracic aortic aneurysm.footnote2

Diagnosing aortic aneurysms

Sometimes an abdominal aneurysm is felt during a routine physical exam. If your doctor thinks you might have an aortic aneurysm, the doctor may:

Do a physical exam.

As part of a physical exam, your doctor might:

• Listen to your heart to check for blood flow problems.
• Check your legs and feet.

Ask about your medical history.

Your doctor may ask questions such as:

• Do you have symptoms? 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?

Do imaging tests.

You might have imaging tests to:

• Pinpoint the location of the aneurysm.
• Estimate its size and how fast it is growing.
• Find out if other blood vessels are involved.
• Look for blood clots or inflammation.

Imaging tests

These tests include:

Abdominal ultrasound.

Ultrasounds help your doctor check the size of the aneurysm.

CT scan and MRA.

Computed tomography (CT) and magnetic resonance angiogram (MRA) are used if the doctor needs a more detailed view than an ultrasound provides. 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.

Echocardiogram.

This is an ultrasound used to study the heart and the aorta. You might have one of these:

• Transthoracic echocardiogram (TTE)
• Transesophageal echocardiogram (TEE)

Follow-up testing

One of the most important goals of testing is to estimate the risk that an aneurysm may burst, or rupture. The risk of rupture is compared to the risks of surgery. Tests such as abdominal ultrasound can be used to closely follow any change in the aneurysm and help measure the risk for rupture.

• If the aneurysm is large, you may need an ultrasound every 6 to 12 months.
• If the aneurysm is small, you may need an ultrasound every 2 to 3 years.

There may be other things that determine how often you should get an ultrasound.

Learn more

• Abdominal Aortic Aneurysm Screening
• Abdominal Aortic Aneurysm: Should I Get a Screening Test?
• Abdominal Ultrasound
• Computed Tomography (CT) Angiogram
• Echocardiogram
• Magnetic Resonance Angiogram (MRA)

Video Transcript: Learning About Your CT Scan

A computed tomography—or CT—scan uses X-rays to make detailed pictures of organs and other structures in your body.

The test is used to check for lots of different health problems, to help with a surgery or procedure, or to check how well a procedure worked.

The test is done inside a large doughnut-shaped machine called a CT scanner.

It uses a small dose of radiation.

But it's safe, because the amount is very small.

Before the test, let your doctor know if you have any health problems or allergies.

Here's how a CT scan is done.

You'll put on a hospital gown or scrubs and take off any jewelry.

To help the doctor see organs or blood vessels more clearly, you may get a dye, called contrast material, through an I.V. tube in the arm.

Or you may need to drink the dye.

Some people get a headache or feel flushed or sick to their stomach.

You'll need to hold still during the test.

So the doctor may give medicines to help you relax and feel sleepy.

You'll lie down on a table that slides into the opening of the CT scanner, and the scanner will make the images.

The test usually lasts a few minutes.

Depending on the reason for the CT scan, you may go home right after the test.

If you had medicines to help you relax or lie still, you may need to wait an hour or two before going home, so the medicines can wear off.

Or you may need an adult friend or family member who will drive you home.

If a dye was used for the test, make sure you drink plenty of fluids to help flush out the dye, unless your doctor says not to.

Getting a CT scan might seem scary at first, but it's safe and doesn't hurt—it might help to remember that.

And hospital staff will be there the whole time to make sure you're safe and as comfortable as possible.

Repair of an aortic aneurysm may be done if there's a risk of it bursting open (rupturing). Treatment of an aneurysm is based on how big it is, how fast it's growing, and if you have symptoms.

Large or fast-growing aneurysms.

If you have symptoms, a large aneurysm, or a fast-growing aneurysm, you need surgery to fix it. A doctor will repair the damaged part of the blood vessel during open surgery or a minimally invasive procedure.

Small aneurysms.

Small aneurysms rarely rupture. They are not usually treated.

You will have routine ultrasound tests to check the size of the aneurysm and see how fast it's growing.

Even if your aneurysm doesn't grow fast, you may be at risk for heart problems. Your doctor may suggest that you exercise more, eat a heart-healthy diet, and stop smoking. He or she may also prescribe medicine to help lower blood pressure and cholesterol.

Learn more

• Abdominal Aortic Aneurysm Surgery
• Endovascular Repair for Abdominal Aortic Aneurysm

If you have an aortic aneurysm, you need close medical monitoring and possibly treatment.

Your doctor may also suggest lifestyle changes that are good for your heart and blood vessels.

• Go to your regular checkups.

  You will have regular tests to check the size and growth of the aneurysm. Talk with your doctor about how often you should get tested.

• Quit smoking.

  Medicines and counseling can help you quit for good.

• Manage blood pressure and cholesterol.

  A heart-healthy lifestyle and medicines can help you do this.

• Stay at a healthy weight.

  Try to lose weight if you need to.

• Be active.

  Ask your doctor what type and amount of exercise is safe for you. If aerobic activity is safe, try to do activities that raise your heart rate. Exercise for at least 30 minutes on most, preferably all, days of the week.

• Eat a heart-healthy diet.

  Heart-healthy foods include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit foods that are not so good for your heart, like sodium, alcohol, and sugar.

• Manage other health problems.

  Other health problems include conditions such as diabetes or heart disease. If you think you may have a problem with alcohol or drug use, talk to your doctor.

Learn more

• Fitness: Getting and Staying Active
• Heart-Healthy Eating
• Heart-Healthy Lifestyle
• Quitting Smoking
• Weight Management

Video Transcript: 5 Ingredients for Healthy Eating

So here's a recipe for healthy eating.

It only has five ingredients.

And they're already within your reach.

Your doctor may have other recommendations for you.

Ingredient #1: Watch what you eat, but don't deny yourself.

Eat foods you like, but watch your portion size.

If a food is high in fat or calories, you don't have to cut it out completely.

Instead, eat a small amount.

Ingredient #2: Eat more fruits and veggies.

And then eat some more fruits and veggies.

It's really hard to have too many.

Ingredient #3: Eat breakfast.

If you skip breakfast, that doughnut in the break room may be hard to resist.

Ingredient #4: Choose drinks with little or no added sugar.

Sweet drinks, like sodas, juices, sports drinks, and sweetened coffee drinks, are all packed with sugar and calories.

Water is filling, and your body needs it.

If you want more flavor, add a slice of lemon or lime.

Ingredient #5: Plan meals ahead of time.

And stock up on healthy foods you enjoy.

This helps keep your healthy eating goals within reach.

That's it. Five ingredients.

Watch what you eat, but don't deny yourself.

Eat more fruits and veggies.

Eat breakfast.

Choose drinks with little or no added sugar.

Plan meals ahead of time.

Video Transcript: Moving More

We all know exercise is a good thing.

But it can be hard to find the time or motivation to do it.

The truth is, there are many ways to start and many ways to move.

Here are some tips to help get you moving more throughout the day.

And later, we'll look at how you can fit exercise into your life.

First, think of an activity you like to do.

For example, let's go with walking.

Then, make a plan to start slowly.

Think of ways you might sneak a little more walking time into your day.

Maybe you'll walk to a restroom that's a little farther away.

Or you might walk a little farther to the store.

Try parking farther away or getting off a stop or two earlier than you normally would.

Taking small steps at first can help you stay with your plan to move more.

Adding a little activity to something you already do might not seem like much, but each time you do it, you're moving more!

You can also add activity to things you enjoy doing.

If you like talking to a friend on the phone, try going for a stroll while you talk.

Or save a podcast or audio book to listen to while you walk after work.

You might eventually ask friends and family to get moving with you.

Try scheduling a walk at lunch with co-workers, or go for an after-dinner stroll with someone you enjoy.

If you've been walking and are ready for more, or if exercise is more your style, we'll start the same way.

Think of an exercise you like to do.

Let's go with body-weight exercises, like balancing or squats.

Now, make a plan to start slowly.

Try your new activity just before or after doing something you already do.

Try balancing on one foot after you brush your teeth.

Use the countertop if you need to.

And if you want more of a challenge, try closing your eyes.

Or do some squats each time you come back from the bathroom.

Think of ways to make exercise part of your week.

Try stopping at a park gym on the way home from work and using the equipment they have there.

Maybe you'll start going on Mondays and Wednesdays for 15 minutes each.

Once that starts feeling good, you can add more time.

Eventually, you might want to invite friends or family to work out with you.

Try exercising with a co-worker on your work break or hiking or walking on your day off.

If you know someone who is into fitness, maybe they can push and inspire you.

Or maybe you can be that inspiration for someone else.

Moving more in your life shouldn't be a chore or feel like punishment.

It should be fun!

And over time, it'll help you feel better and stronger.

So, how will you choose to move more?

Video Transcript: What Works

Reaching a healthy weight isn't easy...

although lots of popular diets make it seem like it is.

Most diets do work... at first.

But after a while, you get bored or frustrated...

and you gain weight again.

Lots of us want to get to a healthier weight and stay there.

So researchers have spent a lot of time studying strategies that really work.

Being realistic and kind to yourself is one of the things that works.

Start with small goals that you're sure you can do.

Small, ongoing success stories will build your confidence and keep you motivated.

Try to pay attention to what you eat instead of trying to work off extra calories with exercise.

It takes a long time to burn what you ate, and it can make exercise a real chore.

When you slip up and eat something unhealthy, give yourself a break...

and start fresh the next day.

Another strategy is to plan and track.

Planning most of your meals makes it easier to eat healthy foods.

You can even try to plan what you'll eat when you go out...

or before a party.

Tracking what you eat and drink is a great way to see where you might make changes.

You can do it in a notebook... or use a fun online tool or app.

A third strategy is to get support.

You may want to keep your goals quiet...

in case you don't reach them.

But some research says that writing down your goals and sharing them with people that you trust can increase your chances for success.

There are lots of ways to get support...

an organized meeting, an exercise partner, a dietitian...

or a website or app that has message boards and forums.

So... now you know more about three strategies for successful, long-term weight loss: be realistic and kind, plan and track, and get support.

Did you hear anything that you think might help you?

Video Transcript: Healthy Diet

Heart-healthy eating is about choosing foods that give you lots of nutrients and help keep your heart and blood vessels healthy.

When eating a heart-healthy diet, try to eat a variety of fruits and vegetables.

It can be helpful to think about including fruits or vegetables with every meal.

One way to do this is by aiming to fill half of your plate with them.

Choose whole-grain foods.

These include oats, whole-wheat pastas, whole-grain breads, and brown rice.

They give you lots of fiber and other nutrients.

For heart-healthy proteins, try to eat more plant-based proteins like beans, nuts, and soy products such as tofu.

Fish and seafood are other healthy protein sources.

If you eat meat, choose lean cuts and avoid processed meats like bacon and sausage.

When it comes to dairy, choose nonfat or low-fat milk, cheese, and yogurt.

Choose liquid fats such as olive oil, sunflower oil, and canola oil.

And try to avoid solid fats like butter, lard, and coconut oil.

Try to choose foods that are low in sodium, or salt.

Some ways you can do this are to look for lower-sodium versions of canned and packaged foods.

You can also try making more of your meals at home and adding herbs and spices to your food instead of salt.

Also, try to choose foods and beverages without added sugar.

For example, try drinking sparkling water instead of soda.

Or add fruit to unsweetened yogurt instead of eating sugar-sweetened yogurt.

And don't forget to be patient with yourself.

Changing how you eat takes time and practice, but you can do it.

And after a while, these changes will start to feel like just a regular part of how you eat.

• Aortic Valve Regurgitation
• Chest Problems
• Coronary Artery Disease
• Health Screening: Finding Health Problems Early
• Heart Failure
• High Blood Pressure
• High Cholesterol
• Obesity
• Quitting Smoking
• Stroke
• Weight Management

Citations

1. U.S. Preventive Services Task Force (2019). Screening for abdominal aortic aneurysm: U.S. Preventive Services Task Force Recommendation Statement. JAMA, 322(22): 2211–2218. DOI: 10.1001/jama.2019.18928. Accessed April 3, 2020.
2. Hiratzka LF, et al. (2010). 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease. Circulation, 121(13): e266–e369.

Current as of: August 6, 2023

Author: Healthwise Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.