Abdominal aortic aneurysm (AAA)

Abdominal aortic aneurysm (AAA)

Abdominal aortic aneurysm (AAA) is a potentially life-threatening condition that occurs when the wall of the aorta, the largest artery in the body, weakens and bulges outwards. This can result in a rupture of the aorta, which can be fatal. In this article, we will discuss the case, pathophysiology, signs, symptoms, investigation, treatment, and advice for individuals with AAA.


Mr. Smith is a 67-year-old male who presents to the emergency department with severe abdominal pain. On examination, he has a pulsatile mass in the abdomen, and his blood pressure is significantly lower in his left leg compared to his right. He is diagnosed with a ruptured abdominal aortic aneurysm and undergoes emergency surgery.


AAA is most commonly caused by atherosclerosis, which is the buildup of plaque in the arteries. The atherosclerotic plaque weakens the wall of the aorta, making it more prone to bulging outwards. Other risk factors for AAA include smoking, high blood pressure, high cholesterol, and a family history of the condition.

Signs and symptoms

Many people with AAA do not experience any symptoms until the aneurysm becomes large or ruptures. Some common signs and symptoms of AAA include:

  • Pulsatile mass in the abdomen
  • Abdominal pain or discomfort
  • Back pain
  • A persistent cough
  • Hoarseness
  • Difficulty swallowing
  • Rapid heart rate


If a healthcare provider suspects AAA, they may order imaging tests such as an ultrasound, CT scan, or MRI to confirm the diagnosis. These tests can also help determine the size of the aneurysm and the risk of rupture.


The treatment for AAA depends on the size and location of the aneurysm. Small aneurysms (less than 5 centimeters in diameter) may be monitored with regular imaging tests and lifestyle modifications, such as quitting smoking and managing high blood pressure and cholesterol levels. Large aneurysms (greater than 5 centimeters in diameter) or those that are causing symptoms may require surgery to repair or remove the aneurysm.

Advice (Dos and Don’ts)

If you have been diagnosed with AAA or are at risk for the condition, there are several dos and don’ts to keep in mind:


  • Quit smoking: Smoking is a significant risk factor for AAA, and quitting smoking can reduce your risk of developing the condition.
  • Manage high blood pressure and cholesterol: High blood pressure and cholesterol levels can contribute to the development of AAA, so it is important to keep these levels under control.
  • Exercise regularly: Regular exercise can help improve cardiovascular health and reduce the risk of AAA.
  • Eat a healthy diet: A diet that is low in saturated and trans fats and high in fruits, vegetables, and whole grains can help reduce the risk of AAA.
  • Attend regular check-ups: Regular check-ups with a healthcare provider can help detect AAA early and monitor its progression.


  • Ignore symptoms: If you experience any of the signs or symptoms of AAA, seek medical attention immediately.
  • Delay treatment: If your healthcare provider recommends surgery to repair or remove an AAA, it is important to follow through with the treatment as soon as possible to reduce the risk of rupture.
  • Engage in strenuous activities: Strenuous activities such as weightlifting or heavy lifting can increase blood pressure and strain on the aorta, which can increase the risk of rupture.
  • Ignore lifestyle modifications: Making lifestyle modifications, such as quitting smoking and managing high blood pressure and cholesterol levels, can significantly reduce the risk of AAA and improve overall cardiovascular health.


  • According to the American Heart Association (AHA), AAA is most commonly caused by atherosclerosis (AHA, 2021).
  • One study found that the risk of AAA was significantly higher among individuals who smoked (Lederle et al., 2002).
  • The European Society for Vascular Surgery (ESVS) recommends that individuals with small AAA undergo regular imaging tests to monitor the progression of the aneurysm (ESVS, 2019).

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