Abdominal aortic aneurysm

What is an abdominal aortic aneurysm?

Your abdominal aorta is usually about 2cm wide or about the width of a garden hose. If you have an aneurysm it can grow from 3cm to over 5.5cm wide. This is classed as an abdominal aortic aneurysm and will need to be checked by a surgical specialist.

What are the symptoms of an abdominal aortic aneurysm?

In most cases there are no noticeable symptoms and most people with AAA won’t be aware that they have one. However, if an aneurysm becomes large it can cause:

• a pulsating feeling in your stomach
• pain in your stomach
• persistent back pain.

A large aneurysm can burst and cause internal bleeding. This is a medical emergency and you should call 999 immediately if you or someone with you has any of these symptoms:

• a sudden severe pain in the abdomen, back or lower back area
• feeling cold, clammy, sweaty, faint and breathless
• fainting or passing out.

Causes of abdominal aortic aneurysm

It’s not known exactly what causes abdominal aortic aneurysm although it’s linked to atherosclerosis and the build-up of fatty material in your arteries. You’re more at risk if you’re a man over the age of 65 or a woman over the age of 70.

You may also have an increased risk of developing AAA if you have a family history of it. If someone in your family has had an AAA, discuss this with your GP and they may recommend an earlier screening.

There are other risk factors that you can do something about, like:

• controlling your blood pressure
• cutting down on alcohol
• giving up smoking
• keeping to a healthy weight
• lowering your cholesterol levels.

Taking these steps can also help reduce the risk of your AAA growing larger if you already have one.

Read more about risk factors.

How is an abdominal aortic aneurysm diagnosed?

An AAA is sometimes picked up during tests for other conditions, commonly by: 

• ultrasound
• CT scan
• MRI scan.

Screening programme 

Abdominal aortic aneurysm is far more common in men over 65. For this reason, all men are invited for a screening test when they turn 65. This test involves a simple ultrasound scan and takes around 10-15 minutes. 

You may be advised to get a screening if you’re a women over 70 with a risk factor. If you're female or under 65 and think that you may have AAA or are at risk of developing it, then speak to your GP about the possibility of being referred for an ultrasound scan.

You can find out more about the screening programme on the NHS website.

How can an abdominal aortic aneurysm be treated? 

Most aneurysms are small (between 3 and 4.4cm) and won’t need treatment. But they can grow, so if you have AAA you will need regular scans to check the size of yours. If your aneurysm grows, the risk of it bursting becomes higher. 

If it grows to more than 5.5 cm you will be referred to a surgical specialist to discuss treatment. There are two main treatments available for an abdominal aortic aneurysm:

• endovascular repair (EVAR) is a type of keyhole surgery. This involves placing a stent-graft (a small metal tube covered with a mesh) inside the artery through a small cut in the groin. If you have this procedure, you’ll usually have a local anaesthetic (where you’re awake but an area on your body is numb). You should be able to get up and walk around the next day. Most people can go home two or three days afterwards. Although this is a simpler and safer procedure than open surgery, it’s not suitable for everyone. Your surgeon will discuss your options with you
• surgical repair involves replacing the affected part of your aorta with a plastic tube (graft). You will need a general anaesthetic, so you will be asleep for the procedure. Most people who have this operation need to stay in hospital for over a week and it can take some weeks to make a full recovery.

If surgery isn’t appropriate, you’ll have regular scans and advice around lifestyle choices and medications from your doctor. 

More information and support

• speak to our cardiac nurses by phone, callback, email or online chat on Heart Helpline (Monday to Friday, 9am to 5pm)
• contact us to talk to our customer care advisors, find your local BHF shop and for any comments, compliments and complaints you may have
• sign up to our Heart Matters magazine for online information packed with health and lifestyle advice
• read about aortic aneurysm
• read about thoracic aortic aneurysm
• meet other people with heart disease by joining a support group or online community.