Overview

An abdominal aortic aneurysm is an enlarged area in the lower part of the body's main artery, called the aorta. The aorta runs from the heart through the center of the chest and belly area, called the abdomen.

The aorta is the largest blood vessel in the body. An abdominal aortic aneurysm that ruptures can cause life-threatening bleeding.

Treatment depends on the size of the aneurysm and how fast it's growing. Treatment varies from regular health checkups and imaging tests to emergency surgery.

Symptoms

Abdominal aortic aneurysms often grow slowly without noticeable symptoms. This makes them difficult to detect. Some aneurysms never rupture. Many start small and stay small. Others grow larger over time, sometimes quickly.

If you have a growing abdominal aortic aneurysm, you might notice:

  • Deep, constant pain in the belly area or side of the belly.
  • Back pain.
  • A pulse near the bellybutton.

When to see a doctor

If you have pain, especially if pain is sudden and severe, seek medical help right away.

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Causes

Aneurysms can develop anywhere along the aorta. Most aortic aneurysms occur in the part of the aorta that's in the belly area, called the abdomen. Several things can lead to the development of an abdominal aortic aneurysm, including:

  • Hardening of the arteries, called atherosclerosis. Atherosclerosis occurs when fat and other substances build up on the lining of a blood vessel.
  • High blood pressure. High blood pressure can damage and weaken the aorta's walls.
  • Blood vessel diseases. These are diseases that cause blood vessels to become inflamed.
  • Infection in the aorta. Rarely, infection by certain bacteria or fungi might cause an abdominal aortic aneurysm.
  • Trauma. For example, being injured in a car accident can cause an abdominal aortic aneurysm.

Risk factors

Abdominal aortic aneurysm risk factors include:

  • Tobacco use. Smoking is the strongest risk factor for aortic aneurysms. Smoking can weaken the walls of blood vessels, including the aorta. This raises the risk of aortic aneurysm and aneurysm rupture. The longer and more you use tobacco, the greater the chances are of developing an aortic aneurysm. Men ages 65 to 75 who are current or former smokers should have a one-time ultrasound to screen for an abdominal aortic aneurysm.
  • Age. Abdominal aortic aneurysms occur most often in people age 65 and older.
  • Being male. Men develop abdominal aortic aneurysms much more often than women do.
  • Being white. People who are white are at higher risk of abdominal aortic aneurysms.
  • Family history. Having a family history of abdominal aortic aneurysms increases the risk of having the condition.
  • Other aneurysms. Having an aneurysm in the aorta in the chest (thoracic aortic aneurysm) or in another large blood vessel, such as the artery behind the knee, might increase the risk of an abdominal aortic aneurysm.

If you're at risk of an aortic aneurysm, medicines may be given to lower your blood pressure and relieve stress on weakened arteries.

Complications

Complications of abdominal aortic aneurysms include:

  • Tears in one or more of the layers of the wall of the aorta, called an aortic dissection.
  • Rupture of the aneurysm.

A rupture can cause life-threatening internal bleeding. In general, the larger the aneurysm and the faster it grows, the greater the risk of rupture.

Symptoms that an aortic aneurysm has ruptured can include:

  • Sudden, intense and persistent belly or back pain, which may feel like ripping or tearing.
  • Low blood pressure.
  • Fast pulse.

Aortic aneurysms also increase the risk of developing blood clots in the area. If a blood clot breaks loose from the inside wall of an aneurysm, it can block a blood vessel elsewhere in the body. Symptoms of a blocked blood vessel may include pain or reduced blood flow to the legs, toes, kidneys or belly area.

Prevention

To prevent an abdominal aortic aneurysm or to keep one from worsening, do the following:

  • Don't smoke or use tobacco products. If you smoke or chew tobacco, quit. Also avoid secondhand smoke. If you need help quitting, talk to your health care provider about strategies that may help.
  • Eat a healthy diet. Choose a variety of fruits and vegetables, whole grains, chicken, fish, and low-fat dairy products. Avoid saturated and trans fats and limit salt.
  • Keep your blood pressure and cholesterol under control. If your care provider prescribed medicines, take them as instructed.
  • Get regular exercise. Try to get at least 150 minutes a week of moderate aerobic activity. If you haven't been active, start slowly and build up. Talk to your health care provider about what kinds of activities are right for you.

April 25, 2023

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  3. Abdominal aortic aneurysms (AAA). Merck Manual Professional Version. https://www.merckmanuals.com/professional/cardiovascular-disorders/diseases-of-the-aorta-and-its-branches/abdominal-aortic-aneurysms-aaa. Accessed March 1, 2023.
  4. Abdominal aortic aneurysm: Screening. U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/abdominal-aortic-aneurysm-screening. Accessed March 1, 2023.
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  7. US Preventive Services Task Force. Screening for abdominal aortic aneurysm: US Preventive Services Task Force recommendation statement. JAMA. 2019; doi:10.1001/jama.2019.18928.
  8. Antoniou GA, et al. Endovascular vs. open repair for abdominal aortic aneurysm: Systematic review and meta-analysis of updated peri-operative and long term data of randomised controlled trials. European Journal of Vascular and Endovascular Surgery. 2020; doi:10.1016/j.ejvs.2019.11.030.

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