Abdominal aortic aneurysm history and symptoms: Difference between revisions

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{{Template:Abdominal aortic aneurysm}}
{{Template:Abdominal aortic aneurysm}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}; {{HP}}


{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
==Overview==
Abdominal aortic aneurysms (AAA) are usually asymptomatic until they expand or rupture. Spontaneous [[abdominal pain]] in a patient with a [[Pulsatile flow|pulsatile]] [[epigastric]] mass or a known AAA may signal a rupture into the [[retroperitoneum]] or leakage within the [[aneurysm]] wall. If a patient does develop symptoms, the risk of rupture is quite high, which is why symptoms are considered an indication for [[surgery]]. Pain is the most common symptomatic manifestation.


==Overview==
==History and Symptoms==
The vast majority of aneurysms are asymptomatic.  Spontaneous abdominal pain in a patient with a pulsatile epigastric mass or a known AAA may signal rupture into the retroperitoneum or leakage within the aneurysm wall.  If a patient does develop symptoms, the risk of rupture is quite high, which is why symptoms are considered an indication for surgery.


==History==
=== History ===
Given that smoking increases the risk of abdominal aortic aneurysm development, a smoking history should be obtained in elderly men.  If a male over the age of 65 has a history of smoking, they should undergo ultrasonography to screen for an abdominal aortic aneurysm.


==Symptoms==
* Given that [[smoking]] increases the risk of developing an abdominal aortic aneurysm (AAA), a [[smoking]] history should be obtained in elderly men. If a male over the age of 65 has a history of [[smoking]], he should undergo [[ultrasonography]] to screen for an AAA.<ref name="Isselbacher2005">{{cite journal|last1=Isselbacher|first1=Eric M.|title=Thoracic and Abdominal Aortic Aneurysms|journal=Circulation|volume=111|issue=6|year=2005|pages=816–828|issn=0009-7322|doi=10.1161/01.CIR.0000154569.08857.7A}}</ref>
Possible symptoms include
*Low [[back pain]]
*[[Flank pain]]
*[[Abdominal pain]]
*[[Groin pain]]
*[[Pulsating abdominal mass]]
*[[Peripheral embolization]] is rare with abdominal aortic aneurysms in contrast to popliteal artery aneurysms in which distal embolization is common.


==2005 ACC/AHA Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)-Recommendations for Symptomatic Aortic or Iliac Aneurysms (DO NOT EDIT)<ref name="pmid16549646">{{cite journal |author=Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B |title=ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation |journal=[[Circulation]] |volume=113 |issue=11 |pages=e463–654 |year=2006 |month=March |pmid=16549646 |doi=10.1161/CIRCULATIONAHA.106.174526 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=16549646 |accessdate=2012-10-09}}</ref>==
=== Symptoms ===


{|class="wikitable"
* Abdominal aortic aneurysms are usually asymptomatic until they expand or rupture. The following symptoms may be present:<ref>{{cite book | last = Ferri | first = Fred | title = Ferri's clinical advisor 2015 : 5 books in 1 | publisher = Elsevier/Mosby | location = Philadelphia, PA | year = 2015 | isbn = 978-0323083751 }}</ref>
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]]


|-
**[[Abdominal pain]], radiating to the back, flank, and groin
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''
**[[Clammy skin]]
**[[Early satiety]]
**[[Flank pain]]
** Groin [[pain]]
** Lower [[back pain]]
**[[Nausea and vomiting]]
**[[Syncope]]


|}
===Associated Symptoms===
* [[Hematemesis]] (when associated with aortoenteric [[fistula]]s)
* Lower extremity pain and discoloration (when associated with [[thromboembolization]])
* [[Melena]] (when associated with aortoenteric [[fistula]]s)<ref>{{cite book | last = Ferri | first = Fred | title = Ferri's clinical advisor 2015 : 5 books in 1 | publisher = Elsevier/Mosby | location = Philadelphia, PA | year = 2015 | isbn = 978-0323083751 }}</ref>
* Urinary symptoms (when associated with [[ureteral obstruction]])<ref name="Chaikof-2009">{{Cite journal  | last1 = Chaikof | first1 = EL. | last2 = Brewster | first2 = DC. | last3 = Dalman | first3 = RL. | last4 = Makaroun | first4 = MS. | last5 = Illig | first5 = KA. | last6 = Sicard | first6 = GA. | last7 = Timaran | first7 = CH. | last8 = Upchurch | first8 = GR. | last9 = Veith | first9 = FJ. | title = The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. | journal = J Vasc Surg | volume = 50 | issue = 4 Suppl | pages = S2-49 | month = Oct | year = 2009 | doi = 10.1016/j.jvs.2009.07.002 | PMID = 19786250 }}</ref>


==References==
==References==
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[[CME Category::Cardiology]]


[[Category:Disease]]
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[[Category:Surgery]]
[[Category:Surgery]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date]]
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Latest revision as of 13:37, 7 January 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Hardik Patel, M.D.

Overview

Abdominal aortic aneurysms (AAA) are usually asymptomatic until they expand or rupture. Spontaneous abdominal pain in a patient with a pulsatile epigastric mass or a known AAA may signal a rupture into the retroperitoneum or leakage within the aneurysm wall. If a patient does develop symptoms, the risk of rupture is quite high, which is why symptoms are considered an indication for surgery. Pain is the most common symptomatic manifestation.

History and Symptoms

History

  • Given that smoking increases the risk of developing an abdominal aortic aneurysm (AAA), a smoking history should be obtained in elderly men. If a male over the age of 65 has a history of smoking, he should undergo ultrasonography to screen for an AAA.[1]

Symptoms

  • Abdominal aortic aneurysms are usually asymptomatic until they expand or rupture. The following symptoms may be present:[2]

Associated Symptoms

References

  1. ↑ Isselbacher, Eric M. (2005). "Thoracic and Abdominal Aortic Aneurysms". Circulation. 111 (6): 816–828. doi:10.1161/01.CIR.0000154569.08857.7A. ISSN 0009-7322.
  2. ↑ Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
  3. ↑ Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
  4. ↑ Chaikof, EL.; Brewster, DC.; Dalman, RL.; Makaroun, MS.; Illig, KA.; Sicard, GA.; Timaran, CH.; Upchurch, GR.; Veith, FJ. (2009). "The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines". J Vasc Surg. 50 (4 Suppl): S2–49. doi:10.1016/j.jvs.2009.07.002. PMID 19786250. Unknown parameter |month= ignored (help)

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