Abdominal Aortic Aneurysm - Cardiovascular

Snapshot
- A 67-year-old man presents to his primary care physician due to vague epigastric discomfort. He denies it being associated with meals and reports that this pain occurred insidiously. Medical history is significant for hypertension. He has been smoking 1-pack of cigarettes per day for the past 30 years. On physical exam, he has a pulsatile abdominal mass that is tender to palpation. An abdominal ultrasound is performed, which demonstrates a 6 cm abdominal aortic aneurysm. He is scheduled for an elective abdominal repair surgery for the following day.

SUmmary
- Abdominal aortic aneurysm (AAA) is a condition characterized by a segmental and full-thickness dilation of the abdominal aorta. It is caused by inflammation and stress upon the aortic wall leading to dilatation and aneurysm. It typically presents in older men 60-70 years of age. Patients often present lower back pain and a pulsatile abdominal mass, with bruits heard on auscultation.
- Diagnosis is made via imaging revealing an aortic diameter greater than 3cm. CT angiography is typically used following ultrasound for further characterization and intervention planning.
- Treatment is usually surgical repair via endovascular or open surgical operation and is recommended for aneurysms larger than 5.5 cm, expanding greater than 1 cm per year, or severe symptoms.

Anatomy
- The aorta originates from the left ventricle and travels inferiorly until it bifurcates infrarenally around L4
  
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