How is an aneurysm diagnosed?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

Since many people who have aneurysms don't have any symptoms, the diagnosis is often made by chance when their doctor is performing a routine checkup or running tests for other reasons. In some cases, the doctor may feel a throbbing mass in the affected artery. If an aneurysm is suspected, the doctor may order one or more imaging procedures to confirm the presence of an aneurysm and determine its size. These may include x-rays, MRIs, CT scans, and ultrasonography.

Ultrasound screenings are an accurate method of identifying abdominal aortic aneurysms, also known as AAAs. Ultrasound is a non-invasive, painless, safe, quick process to identify the tell-tale bulging of the aorta. While most people believe that AAAs occur only in men, recent research published in the Journal of Vascular Surgery reveals that more women are affected than originally believed. In fact, the researchers found that half of the patients with AAA disease would not be found under current federal guidelines, which means that individuals interested in this screening must go to a community-based screening and pay for it themselves. Fortunately, most community-based events offer the screening affordably. Smoking cessation and a healthy lifestyle are associated with a lower risk of AAA, so primary prevention is very important. Aortic aneurysms are responsible for at least 14,000 deaths a year, but that is probably an underestimate. 

If you have aortic aneurysm, but no symptoms, your doctor may find it by chance during a routine physical exam. More often, doctors find aneurysms during tests done for other reasons, such as chest or abdominal pain.

If you have an abdominal aortic aneurysm (AAA), your doctor may feel a throbbing mass in your abdomen. A rapidly growing aneurysm about to rupture can be tender and very painful when pressed. If you're overweight or obese, it may be hard for your doctor to feel even a large AAA.

If you have an AAA, your doctor may hear rushing blood flow instead of the normal whooshing sound when listening to your abdomen with a stethoscope.

Specialists Involved
Your primary care doctor may refer you to a cardiothoracic or vascular surgeon for diagnosis and treatment of an aortic aneurysm.

A cardiothoracic surgeon performs surgery on the heart, lungs, and other organs and structures in the chest, including the aorta. A vascular surgeon performs surgery on the aorta and other blood vessels, except those of the heart and brain.

Diagnostic Tests and Procedures
To diagnose and evaluate an aneurysm, your doctor may recommend one or more of the following tests:

  • Ultrasound - This simple, painless test uses sound waves to create pictures of the structures inside your body. Ultrasound shows the size of an aneurysm, if one is found.
  • Computed Tomography Scan - A computed tomography (CT) scan is a painless test that uses x rays to take clear, detailed pictures of your internal organs.During the test, your doctor will inject a special dye into a vein in your arm. This dye highlights the aorta on the CT scan images.
  • Magnetic Resonance imaging - Magnetic resonance imaging (MRI) uses magnets and radio waves to create images of the organs and structures in your body. This test is very accurate at detecting aneurysms and pinpointing their size and exact location.
  • Angiography - Angiography uses a special dye injected into the bloodstream to highlight the insides of arteries on x-ray pictures. An angiogram shows the amount of damage and blockage in blood vessels.

This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

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

When you come to a doctor with a vascular problem like an aneurysm, he or she will evaluate your whole vascular system. You'll initially get a cardiac evaluation to makes sure there are no bad blockages and that the heart is nice and strong. A stress test would also be mandatory. Your circulation will be checked from neck to toe, and you may also get a neck ultrasound to look for neck artery blockages that could be a cause of a stroke. Your doctor will order a full evaluation of the aorta to examine the aneurysm and decide whether it's the appropriate size to fix.

In terms of the legs, you may have a noninvasive study called ankle brachial index, where the blood pressure in your arms is compared to the pressure in your legs. If the blood pressure in the legs is less than that in the arms, you've got a circulation problem. Doctors always look for skin changes and hair loss, because if there's not good blood flow down to the legs, people can sometimes lose hair on their legs. Doctors will also look for wound issues, discoloration of the toes or the nails, ulcers on the feet and toes, and claudication, which is when the muscles in your legs below the blockage hurt so badly when you walk, that you have to stop.

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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.