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Abdominal aortic aneurysm

An abdominal aortic aneurysm (AAA) is a swelling (aneurysm) of the aorta – the main blood vessel that leads away from the heart, down through the abdomen to the rest of the body.

An abdominal aortic aneurysm (AAA) is a swelling (aneurysm) of the aorta – the main blood vessel that leads away from the heart, down through the abdomen to the rest of the body.

The abdominal aorta is the largest blood vessel in the body and is usually around 2cm wide – roughly the width of a garden hose. However, it can swell to over 5.5cm – what doctors class as a large AAA.

Large aneurysms are rare, but can be very serious. If a large aneurysm bursts, it causes huge internal bleeding and is usually fatal.

The bulging occurs when the wall of the aorta weakens. Although what causes this weakness is unclear, smoking and high blood pressure are thought to increase the risk of an aneurysm.

AAAs are most common in men aged over 65. A rupture accounts for more than 1 in 50 of all deaths in this group and a total of 6,000 deaths in England and Wales each year.

This is why all men are invited for a screening test when they turn 65. The test involves a simple ultrasound scan, which takes around 10-15 minutes.

Symptoms of an AAA

In most cases, an AAA causes no noticeable symptoms. However, if it becomes large, some people may develop a pain or a pulsating feeling in their abdomen (tummy) or persistent back pain.

An AAA doesn’t usually pose a serious threat to health, but there’s a risk that a larger aneurysm could burst (rupture).

A ruptured aneurysm can cause massive internal bleeding, which is usually fatal. Around 8 out of 10 people with a rupture either die before they reach hospital or don’t survive surgery.

The most common symptom of a ruptured aortic aneurysm is sudden and severe pain in the abdomen.

If you suspect that you or someone else has had a ruptured aneurysm, call 999 immediately and ask for an ambulance.

Read more about the symptoms of an AAA.

Causes of an AAA

It's not known exactly what causes the aortic wall to weaken, although increasing age and being male are known to be the biggest risk factors.

There are other risk factors you can do something about, including smoking and having high blood pressure and cholesterol level.

Having a family history of aortic aneurysms also means that you have an increased risk of developing one yourself.

Read more about the causes of an AAA.

Diagnosing an AAA

Because AAAs usually cause no symptoms, they tend to be diagnosed either as a result of screening or during a routine examination – for example, if a GP notices a pulsating sensation in your abdomen.

The screening test is an ultrasound scan, which allows the size of your abdominal aorta to be measured on a monitor. This is also how an aneurysm will be diagnosed if your doctor suspects you have one.

Read more about diagnosing an AAA.

Treating an AAA

If a large AAA is detected before it ruptures, most people will be advised to have treatment, to prevent it rupturing.

This is usually done with surgery to replace the weakened section of the blood vessel with a piece of synthetic tubing.

If surgery is not advisable – or if you decide not to have it – there are a number of non-surgical treatments that can reduce the risk of an aneurysm rupturing.

They include medications to lower your cholesterol and blood pressure, and quitting smoking.

You will also have the size of your aneurysm checked regularly with ultrasound scanning.

Read more about treating AAAs.

Prevention

The best way to prevent getting an aneurysm  or reduce the risk of an aneurysm growing bigger and possibly rupturing  is to avoid anything that could damage your blood vessels, such as:

  • smoking
  • eating a high-fat diet
  • not exercising regularly
  • being overweight or obese

Read more about preventing aneurysms.

Screening

Men who are 65 and over are offered a screening test to check if they have an AAA.

All men in England are invited for screening in the year they turn 65.

Men who are over 65 and have not previously been screened can request a screening test by contacting their local AAA screening service directly.

Women and men under 65 are not invited for screening.

However, if you feel you have an increased risk of having an AAA, talk to your GP who can still refer you for a scan.

Read more about screening for an AAA.


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Abdominal aortic aneurysm

In most cases, an unruptured abdominal aortic aneurysm (AAA) will cause no symptoms, unless it becomes particularly large.

In most cases, an unruptured abdominal aortic aneurysm (AAA) will cause no symptoms, unless it becomes particularly large.

Symptoms of an unruptured AAA may include:

  • a pulsating feeling in your stomach (abdomen), usually near your belly button, that's usually only noticeable when you touch it
  • persistent back pain
  • persistent abdominal pain

If you have any of the symptoms above, you should see your GP as soon as possible.

Ruptured AAA

If your aortic aneurysm ruptures, you will feel a sudden and severe pain in the middle or side of your abdomen. In men, the pain can also radiate down into the scrotum.

Other symptoms include:

  • dizziness
  • sweaty and clammy skin
  • rapid heartbeat (tachycardia)
  • shortness of breath
  • feeling faint
  • loss of consciousness

Medical emergency

A ruptured aortic aneurysm is a medical emergency, and it’s important to get to hospital as soon as possible.

Around 80% of people with a rupture die before they reach hospital or don’t survive emergency surgery.

This is why the NHS AAA Screening Programme was introduced, so dangerously large aneurysms can be treated before they burst.

If you suspect that you or someone in your care has had a ruptured aneurysm, call 999 immediately and ask for an ambulance.


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Abdominal aortic aneurysm

The aorta is the largest blood vessel in the body. An abdominal aortic aneurysm occurs when part of the aorta wall becomes weakened, causing it to bulge outwards to form an aneurysm.

The aorta is the largest blood vessel in the body. It transports oxygen-rich blood away from the heart to the rest of the body.

An abdominal aortic aneurysm (AAA) occurs when part of the aorta wall becomes weakened and the large amount of blood that passes through it puts pressure on the weak spot, causing it to bulge outwards to form an aneurysm.

The abdominal aorta is usually around 2cm wide – about the width of a garden hosepipe  – but can swell to over 5.5cm, which is what doctors classify as a large aneurysm.

Risk factors for an AAA

It's not known exactly what causes the aortic wall to weaken, although increasing age and being male are known to be the biggest risk factors.

One study found that people aged over 75 are seven times more likely to be diagnosed with an AAA than people under 55 years old.

Men are around six times more likely to be diagnosed with an AAA than women.

However, there are other risk factors that you can do something about – described below – the most important of which is smoking.

Smoking

Research has found that smokers are seven times more likely to develop an AAA than people who have never smoked.

The more you smoke, the greater your risk of developing an AAA. People who regularly smoke more than 20 cigarettes a day may have more than 10 times the risk of non-smokers.

The risk may increase because tobacco smoke contains harmful substances that can damage and weaken the wall of the aorta.

Atherosclerosis

Atherosclerosis is a potentially serious condition where arteries become clogged up by fatty deposits, such as cholesterol.

An AAA is thought to develop because these deposits (called plaques) cause the aorta to widen in an attempt to keep blood flowing through it. As it widens, it also gets weaker.

Smoking, eating a high-fat diet and high blood pressure all increase your risk of developing atherosclerosis.

High blood pressure

As well as contributing to atherosclerosis, high blood pressure (hypertension) can place increased pressure on the aorta's wall.

Family history

Having a family history of AAAs means that you have an increased risk of developing one.

One study found that people who had a brother or sister with an AAA were eight times more likely to develop one than people whose siblings were unaffected.

This suggests that certain genes you inherit from your parents may make you more vulnerable to developing an AAA.

However, no specific genes have yet been identified.

Read about how to reduce your risk of developing an AAA.


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Abdominal aortic aneurysm

An abdominal aortic aneurysm (AAA) usually causes no symptoms. Therefore, they tend to be diagnosed as a result of screening, or during a routine physical examination when a GP notices a distinctive pulsating sensation in your abdomen.

An abdominal aortic aneurysm (AAA) usually causes no symptoms. Therefore, they tend to be diagnosed as a result of screening, or during a routine physical examination when a GP notices a distinctive pulsating sensation in your abdomen.

A diagnosis can be confirmed using an ultrasound scan. Ultrasound can also determine the size of the aneurysm, which is an important factor in deciding on a course of treatment.

Screening

All men in the UK who are 65 or over are offered an ultrasound scan to check for AAAs.

All men should receive an invitation in the year they turn 65 years old. Men who are older than 65 can refer themselves for screening by contacting their local NHS AAA screening service.

For more information, visit our page on AAA screening.


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Abdominal aortic aneurysm

The best way to prevent getting an aneurysm, or reduce the risk of an aneurysm growing bigger and possibly rupturing, is to avoid anything that could damage your blood vessels.

The best way to prevent getting an aneurysm, or reduce the risk of an aneurysm growing bigger and possibly rupturing, is to avoid anything that could damage your blood vessels.

This includes:

  • smoking
  • eating a high-fat diet
  • not exercising regularly
  • being overweight or obese

If your GP finds out you have high blood pressure or a high cholesterol level, you may be prescribed medication for both. This will reduce the risk of developing an abdominal aortic aneurysm (AAA).

Smoking

Smoking is a major risk factor for aneurysms because it causes atherosclerosis (hardening of the arteries) and raises your blood pressure.

Tobacco smoke contains substances that can damage the walls of the arteries.

It is known that smokers are seven times more likely than non-smokers to develop an AAA. 

The more you smoke, the greater your risk. People who regularly smoke more than 20 cigarettes a day may have more than 10 times the risk of non-smokers.

If you want to stop smoking, your GP will be able to refer you to an NHS Stop Smoking Service, which will give you dedicated help and advice about the best ways to quit.

You can also call the NHS Smokefree helpline on 0800 022 4332. The specially trained helpline staff can offer you free expert advice and encouragement.

Read more about stopping smoking and nicotine replacement therapies (NRTs), which can make it easier to quit.

Diet

Eating a high-fat diet increases your risk of atherosclerosis.

It’s especially important to limit the amount of foods you eat that are high in saturated fat, such as biscuits, cakes, butter, sausages and bacon.

This is because eating too much saturated fat can lead to high cholesterol, which can build up in the artery walls.

Read more about high cholesterol. Find out more about healthy eating and how to reduce the amount of saturated fat you eat.

Exercise

Being active and doing regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition.

Regular exercise can also help you lose weight, which will also help lower your blood pressure.

Adults should do at least 150 minutes (two hours and 30 minutes) of moderate-intensity aerobic activity every week.

Examples of moderate intensity activity include cycling or fast walking.

For it to count, the activity should make you feel warm and slightly out of breath. Someone who is overweight may only have to walk up a slope to get this feeling.

Physical activity can include anything from sport to walking and gardening.

Get more ideas on being active.

Weight

Being overweight forces your heart to work harder to pump blood around your body. This can raise your blood pressure, which in turn puts pressure on your arteries.

Use the BMI healthy weight calculator to find out if you need to lose weight.

If you need to shed some weight, it's worth remembering that losing just a few pounds will make a big difference to your blood pressure and overall health.

Get tips on losing weight safely and read more about preventing high blood pressure.


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Abdominal aortic aneurysm

When trumpeter, Peter Cripps, had a CT scan for a kidney stone, an abdominal aortic aneurysm was also discovered.

When trumpeter, Peter Cripps had a CT scan for a kidney stone it was discovered he also had an abdominal aortic aneurysm.

“Just before Christmas I had the most horrendous pain in my abdomen. I had a CT scan, which revealed I had a kidney stone. Thankfully, that was quite small but, more worryingly, the nurse told me I also had an abdominal aortic aneurysm. The surgeon came to see me straight away and recommended an open AAA operation which was done on January 16 2007.

“I’d had a four-way heart bypass four years earlier and five years before that a heart attack and I was convinced I was not going to make it. But the operation went really well and I was out of hospital a week later.

“I felt weak and tired and I was quite insecure when I first got home. But I tried to do a little more each day and was soon back on my feet. In fact, I was able to go back to my part-time job fitting insulation mats on yacht engines within just three weeks. I play trumpet in a band and was able to start blowing again four weeks after the operation.

"I have to admit there have been a few problems since the operation. The surgeon warned me that because the abdominal aorta runs down in front of the spine it might interfere with my nervous system and that this could interfere with some of the ‘important bits’.

"It’s true, things are not as brilliant in that department as they used to be. But there are always ways and means. Your digestion packs up too and I’m still not eating how I used to. I have lost a bit of weight and I’ve had a few problems with my bowels - mainly constipation - but I was told to expect that and I take laxatives.

"The scar is healing nicely but it does still twinge a bit from time to time. Having said all that, I’m feeling better by the day and I’m just grateful it was found when it was, otherwise I might not be here.”

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