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How do doctors detect aortic aneurysms?

Dr. David W. Drucker, MD
Cardiologist (Heart Specialist)

There are really two ways that doctors detect abdominal aortic aneurysms. The majority are found incidentally. When a patient has a different medical complaint, like symptoms that are consistent with kidney stones, the doctor will look to make a definitive diagnosis and the patient will get sent in for an ultrasound or a CAT scan. The CAT scan could show kidney stones, but might also reveal an asymptomatic abdominal aortic aneurysm. 70 percent or more of Abdominal Aortic Aneurysms are detected in this way. Determining with your doctor if you are at risk for aneurysms is so important, because you want to be proactive if you're at risk.

A physical examination can also help physicians detect aortic aneurysms. When a patient comes to the doctor’s office the physician will take their history. Is the patient a current or former smoker? Does the patient have a family history of aneurysms? The doctor will examine the patient’s abdomen and may find a palpable mass. The doctor can then order the appropriate test, like an ultrasound, and that will confirm or exclude the diagnosis of an abdominal aortic aneurysm.

Dr. Mark J. Russo, MD
Cardiothoracic Surgeon

Aortic disease is often insidious. Most people with aortic aneurysms experience no symptoms, unless they are extremely large or an aortic dissection occurs. For most people, their aortic condition is discovered incidentally while being tested for other reasons.

According to the American Heart Association:

  • Aortic imaging is recommended for first-degree (e.g., mother, father, sister, brother, son, or daughter) relatives of patients with thoracic aortic aneurysm and/or dissection to identify those with asymptomatic disease; 15 to 25 percent of people with aneurysms have a 1st degree relative with history of aortic disease.
  • If one or more first-degree relatives of a patient with known thoracic aortic aneurysm and/or dissection are found to have thoracic aortic dilatation, aneurysm, and/or dissection, then imaging of second-degree relatives (e.g. aunt, uncle, or cousin) is reasonable.
  • If one or more first-degree relatives of a patient with known thoracic aortic aneurysm and/or dissection are found to have thoracic aortic dilatation, aneurysm, or dissection, then referral to a geneticist may be considered.
  • If the mutant gene (FBN1, TGFBR1, TGFBR2, COL3A1, ACTA2, MYH11) associated with aortic aneurysm and/or dissection is identified in a patient, first-degree relatives should undergo counseling and testing. Only the relatives with the genetic mutation should undergo aortic imaging.

Aneurysms can be detected from any number of imaging tests, such as ultrasound, computerized tomography (CT) scan, magnetic resonance imaging (MRI), angiogram, and even x-ray if very large.

Aortic aneurysms are detected by regular screening, especially in men 65 to 75 years of age and who have a history of smoking. An ultrasound is often used for diagnosis, followed by CT scan if abnormal results are found on the ultrasound.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.