AAAA screening awareness

Overview

An abdominal aortic aneurysm (AAA) is a bulge or swelling in the main blood vessel (the aorta) that runs through your belly. This bulge can grow over time and may burst (rupture), causing life-threatening bleeding. Screening means using a simple ultrasound scan to check for an AAA before it causes symptoms.

AAAs are not very common in the general population, but they become more frequent as people age. Men over 65 are at higher risk.

AAA mainly affects older adults, especially men aged 65 and above. People with a family history of AAA, smokers, and those with high blood pressure or high cholesterol are also more likely to develop one.

Symptoms

Common symptoms

• Most AAAs cause no symptoms at all – that is why screening is important.
• If the aneurysm is large or growing, you might feel a pulsing sensation in your belly, or have deep, constant pain in your back or side.

Symptoms in children

• AAAs are extremely rare in children. This condition is almost always seen in older adults.

Symptoms in older adults

• Usually no symptoms, but an expanding aneurysm may cause a feeling of fullness or tenderness in the abdomen.
• Some people notice a pulsating lump in their belly.

Causes

Main causes

• Atherosclerosis – the buildup of fatty deposits in the arteries, which weakens the aorta wall.
• Inflammation or infection in the aorta (less common).
• Inherited connective tissue disorders (rare).

Risk factors

• Being male and aged 65 or older.
• Smoking or having smoked in the past (the strongest risk factor).
• High blood pressure (hypertension).
• High cholesterol.
• A family history of AAA (parent, sibling, or child).
• Having other blood vessel diseases (e.g., peripheral artery disease).

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe pain in your belly or back, especially with dizziness or fainting – call your local emergency number immediately.
• If you feel a pulsing lump in your abdomen and have any chest or back pain.

Book a routine appointment if:

• If you are a man aged 65 or over – you should be offered AAA screening through your country's health service. Ask your doctor if you are not sure.
• If you have a family history of AAA, talk to your doctor about screening earlier.
• If you have risk factors such as smoking, high blood pressure, or high cholesterol, ask your doctor if screening is right for you.

Diagnosis

AAA is detected with a simple, painless ultrasound scan. The scan uses sound waves to create a picture of your aorta and measure its width.

Tests that may be done

• Abdominal ultrasound – the main test for screening and diagnosis.
• CT scan or MRI may be used if more detail is needed, or to plan treatment.

What to expect at your appointment

The ultrasound is similar to the scan used during pregnancy. You will lie on a bed while a gel is applied to your belly, and the sonographer moves a small device over your skin. It takes about 10–15 minutes and is completely painless. You don't need to do anything special to prepare.

Treatment

Treatment depends on the size and growth of the aneurysm. Small ones (less than 5.5 cm in men) are usually monitored with regular scans. Larger or fast-growing ones may need surgery to prevent rupture.

Self-care at home

• Quit smoking – smoking greatly increases the risk of AAA growth and rupture.
• Keep your blood pressure under control with diet, exercise, and medication as prescribed by your doctor.
• Maintain a healthy weight and eat a balanced diet low in saturated fat and salt.
• Stay active with moderate exercise, but avoid very heavy lifting if you have a known aneurysm.

Medical treatments

Your doctor may prescribe medications to lower blood pressure and cholesterol, which can help slow the growth of an aneurysm. These are part of managing your overall cardiovascular health.

When is surgery considered?

Surgery is usually recommended when the aneurysm reaches a certain size (typically 5.5 cm or larger in men) or is growing quickly. The main options are open surgical repair or endovascular aneurysm repair (EVAR), which uses a stent graft placed through a small incision in the groin. Your surgeon will discuss which option is best for you.

Living with this condition

If you have a small AAA that is being monitored, you can live a normal life. You should attend all follow-up scans and keep your heart healthy. Most people with a small AAA have no restrictions on daily activities.

Lifestyle tips

• Stop smoking – this is the most important change you can make.
• Limit alcohol intake.
• Manage stress with relaxation techniques or hobbies.
• Keep up with regular health check-ups.

Diet and exercise

Eat a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Limit salt, saturated fats, and added sugars. Aim for at least 30 minutes of moderate activity most days, such as walking, swimming, or cycling. Avoid heavy weightlifting or activities that involve straining.

Mental health and emotional wellbeing

Living with an aneurysm can cause anxiety, especially while waiting for scans. It is normal to feel worried. Talk to your doctor or a counsellor if you are struggling. Remember that most small AAAs never rupture and are successfully treated if needed.

Prevention

You can reduce your risk by not smoking, controlling blood pressure and cholesterol, eating well, and exercising. However, some risk factors such as age and family history cannot be changed.

Screening programmes

Screening is the best way to find an AAA early, before it causes symptoms. Many countries offer a one-time ultrasound screening for men aged 65. If you have a family history of AAA, you may be offered screening earlier. Ask your doctor if you are eligible.

Complications

If left untreated

• Rupture of the aneurysm – this is a life-threatening emergency that causes severe internal bleeding.
• Blood clots from the aneurysm that can travel to other parts of the body.
• Pressure on nearby organs, causing pain or digestive problems.

Long-term outlook

The outlook is very good when an AAA is found early through screening. Small aneurysms are closely monitored and rarely cause problems. If surgery is needed, modern techniques are safe and effective. Even if you have an AAA, you can still lead a long, healthy life with proper care.

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