Abdominal aortic aneurysm

What is an abdominal aortic aneurysm?

Your aorta is the main artery that carries blood high in oxygen from your heart to the rest of your body.

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 will not 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.

What causes an abdominal aortic aneurysm?

It’s not known exactly what causes abdominal aortic aneurysm although it’s linked to atherosclerosis (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.

Other risk factors include:

• high blood pressure

• alcohol

• smoking

• living with excess weight

• high cholesterol.

Managing these factors can 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, such as: 

• ultrasound

• CT scan

• MRI scan.

How does the screening programme work?

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

You may be advised to get a screening if you’re a woman over 70 with a risk factor. If you're transgender, 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 will not need treatment. But they can grow, so if you have an AAA you will need regular scans to check the size. If your aneurysm grows, the risk of it bursting becomes higher. 

If it grows to more than 5.5cm this is described as a large AAA and you will be referred to a surgical specialist to discuss treatment. This may involve surgical or medical treatment. There are two main types of surgical treatments available for an abdominal aortic aneurysm:

• Endovascular aneurysm repair (EVAR) is a type of keyhole surgery. This involves placing a stent-graft (a small metal tube covered with a mesh) inside the abdominal aorta through a small cut in both groin areas (where your thigh meets your tummy). If you have this procedure, you may be given a general, local, or regional anaesthetic (where you’re awake but an area of your body is temporarily made to feel numb for the procedure). You should be able to get up and walk around the next day. Most people can go home 2 or 3 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 open surgery where the affected part of your aorta is replaced 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 is not appropriate, you’ll have regular scans and information around lifestyle choices and medicines from your doctor.

Heart Helpline and support

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