Aortic Aneurysm

Diagnosis

Echocardiography Sound Wave

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Aortic aneurysms may be diagnosed from routine chest X-rays taken to evaluate another condition, such as lung disease. Some abdominal aortic aneurysms are noticed by a physician who feels a pulsating bulge in the abdomen during a physical exam.

Abdominal aortic aneurysms may be evaluated further by ultrasound or computed tomography (CT) scans. Thoracic aortic aneurysms typically are evaluated by echocardiography, CT scans or magnetic resonance imaging (MRI). Occasionally, a test called an aortogram (an X-ray taken after injection of a radiopaque substance into the artery) is required. Test results are generally available within 24 hours in Mayo's state-of-the-art electronic medical record.

Computed Tomography (CT)

For CT scans, the patient lies on a table that is guided into a machine that uses X-ray scanners to create detailed images of the organs and blood vessels in the chest and abdomen. The test may be administered using injected dyes that show the flow of blood. Specialized software can create detailed 3-D pictures of the aorta.

Magnetic Resonance Imaging (MRI)

In MRI, a cylindrical machine scans the body using magnetic fields to create computer images of the body's soft tissues, including the shape of the aorta. Like CT, it can be administered using injected dyes that show the flow of blood, and specialized software may be used to create detailed 3-D pictures of the aorta.

X-rays

Routine X-rays, such as chest X-rays, show widened aortas in 90 percent of patients with symptoms. An aneurysm that has calcified — a sign of atherosclerosis (hardening of the arteries) — will usually appear on an X-ray.

Echocardiography and Ultrasonography

Echocardiography is the process of creating sound wave pictures that can be taken at the patient's bedside. The echocardiogram may be performed from outside the body (the device transducer is applied on the chest) or from the inside (the patient swallows a transducer). These sound wave pictures provide detailed information about heart function as well as the diameter of the large vessels in the chest.

In ultrasonography, a similar device is used to evaluate the aorta in the abdomen.

Dissecting Aneurysms

Aortic dissections are typically diagnosed by CT scans performed in the emergency room on patients with sudden, severe chest pain. The pain is typically described as tearing.

These symptoms provide clues that lead physicians to suspect an aortic dissection:

• A dissection that extends backward toward the heart may cause a murmur that can be heard through a stethoscope.
• Blood leaking from a dissection around the heart may accumulate in the chest and prevent the heart from beating properly, causing a life-threatening condition called cardiac tamponade.