Abdominal aortic aneurysm

Question 1

What is AAA?

Answer 1

Dilation of the abdominal aorta with more than 3cm dilation

Question 2

What are the risk factors of AAA?

Answer 2

Men are affected significantly more often and at a younger age than women
Increased age
Smoking
Hypertension
Family history
Existing cardiovascular disease

Question 3

How does AAA present?

Answer 3

usually screening or when it has ruptured
or
Non-specific abdominal pain
Pulsatile and expansile mass in the abdomen when palpated with both hands
As an incidental finding on an abdominal x-ray, ultrasound or CT scan

Question 4

How do we diagnose AAA?

Answer 4

Ultrasound is the usual initial investigation for establishing the diagnosis.

CT angiogram gives a more detailed picture of the aneurysm and helps guide elective surgery to repair the aneurysm.

Question 5

What does the size of the aneurysm indicate?

Answer 5

Normal: less than 3cm
Small aneurysm: 3 – 4.4cm
Medium aneurysm: 4.5 – 5.4cm
Large aneurysm: above 5.5cm

Question 6

How do we manage AAA?

Answer 6

Treating reversible risk factors: smoking, diet, managing hypertension
Elective surgical repair-> inserting artificial graft via laparotomy or endovascular aneurysm repair

Question 7

How does ruptured AAA present?

Answer 7

Severe abdominal pain that may radiate to the back or groin
Haemodynamic instability (hypotension and tachycardia)
Pulsatile and expansile mass in the abdomen
Collapse
Loss of consciousness