Frequently Asked Questions About Abdominal Aortic Aneurysm (AAA)
Rudy Boesch, a participant on "Survivor" and former Navy Seal, was nearly stricken by AAA, but an inadvertent detection allowed him to receive the proper treatment in time. Rudy's doctor, Dr. DeMasi, provides answers to some of the more frequently asked questions about AAA, including warning signs and treatment options for this serious but preventable cause of death.
What is an Abdominal Aortic Aneurysm?
An abdominal aortic aneurysm (AAA) is an abnormal expansion of the abdominal portion of the aorta, the largest artery in the body. AAA develops in affected individuals when the aortic wall weakens and eventually starts to bulge. AAA usually develops slowly and most often does not cause symptoms.
Why is AAA dangerous?
If the aneurysm gets too big, then it can rupture, or tear, resulting in massive internal bleeding and death. Most people do not survive a ruptured AAA. Ruptured AAAs are one of the leading causes of death in the elderly in the United States - killing approximately 15,000 Americans each year. Therefore, as a known cause of death in the US, AAA is about equal to HIV/AIDS or several forms of cancer.
What are the risk factors for AAA?
Risk factors for AAA include being over the age of 55, having risk factors for cardiovascular disease (smoking, high blood pressure), and a family history of AAA.
Are there any symptoms?
Most AAAs are never diagnosed because there are usually no symptoms. The symptoms of AAA rupture include a pulsating sensation in the abdomen, sudden and severe abdominal or back pain, clammy skin, rapid heart rate when rising to a standing position, and nausea or vomiting.
How common is AAA?
Approximately 2 million Americans may have an AAA. Although official prevalence figures do not exist, it is estimated that between 4 to 7 percent of adults over the age of 60 have an AAA. Women with a positive family history for AAA or cardiovascular risk factors have almost the same incidence as men.
Is it possible to treat an AAA?
Yes. Abdominal aortic aneurysm is one of the most preventable causes of death because it is highly treatable and curable in 95 percent of men and women when it's detected before rupture occurs. Therefore, early detection is critical.
Surgical treatment is recommended if AAAs appear to be enlarging rapidly or when there is increased risk of rupture with aneurysms that are more than two inches (5 to 5.5 centimeters) in diameter. In many cases, treatment is accomplished using minimally invasive approaches such as an endovascular stent graft.**
How is AAA detected?
Ultrasound examination of the aorta is a highly accurate, painless and completely safe way to detect AAA. Patients who undergo ultrasound screening are half as likely to die of AAAs over a four-year period as those who do not, according to the British Multicentre Aneurysm Screening Study, which involved nearly 60,000 men aged 65 to 74.
What is the cost of AAA screening?
The ultrasound test typically costs approximately $100. More importantly, effective January 2007, Medicare is offering a free, one-time, ultrasound screening benefit to check for AAA in qualified seniors linked to their Welcome to Medicare Physical Exam. Early screening, detection and intervention can save costs associated with spending days or weeks in the intensive care units because of a ruptured AAA.
Who qualifies for the screening under Medicare?
Men who have smoked at least 100 cigarettes during their life, and men and women with a family history of AAA qualify for the one-time screening once they have undergone the exam. The exam must be completed within the first six months of Medicare eligibility. The free exam is only available to new patients entering the Medicare system.