Abdominal Aortic Aneurysm (AAA)

AAAs do not usually cause any obvious symptoms and are often only picked up during screening or tests carried out for another reason.

Symptoms may include:

• a pulsing sensation in the tummy (like a heartbeat)
• tummy pain that does not go away
• lower back pain that does not go away

If an AAA bursts, it can cause:

• sudden, severe pain in the tummy or lower back
• dizziness
• sweaty, pale and clammy skin
• a fast heartbeat
• shortness of breath
• fainting or passing out

Call 999 for an ambulance immediately if you or someone else develops symptoms suggestive of a ruptured AAA.

An AAA can form if the sides of the aorta weaken and balloon outwards. It’s not always clear why this happens, but there are things that increase the risk.

The main risk factors are:

• family history of aneurysms
• smoking
• high blood pressure
• high cholesterol
• men with inguinal hernias are 3 times more likely to have an AAA

Speak to a GP if you’re worried you may be at risk of an AAA. They may suggest having a scan and making healthy lifestyle changes to reduce your risk of an AAA.

The NHS offers an AAA Screening Programme:

• All men will receive an automatic invitation in their 65th year to come for initial screening (abdominal USS) which is coordinated by the Screening Programme
• The Screening Programme cannot screen men less than 65 years in age or women
• Male patients can contact the screening programme directly to discuss screening if they wish
• Screening started in 2009 so men born before 1/4/1944 may not have been screened. Patients who have not had AAA screening can self-refer by contacting the programme

If a patient has a strong family history of AAA they need to be screened 5 years before the age of the affected relative. This is not part of the NHS AAA Screening Programme, so requires referral by the patient’s GP.

Read more about screening for an AAA.

If you’re a man over 65 and you have not been screened, you can ask for a test by contacting your local AAA screening service directly.

Reducing your risk of an abdominal aortic aneurysm (AAA):

There are several things you can do to reduce your chances of getting an AAA or help stop one getting bigger.

These include:

• stopping smoking – read stop smoking advice and find out about Smokefree
• eating healthily – eat a balanced diet and cut down on fatty food
• exercising regularly – aim to do at least 150 minutes of exercise a week; read about how to get started with some common activities
• maintaining a healthy weight – use the healthy weight calculator to see if you need to lose weight, and find out how to lose weight safely
• cutting down on alcohol – read tips on cutting down and general advice about alcohol

If you have a condition that increases your risk of an AAA, such as high blood pressure, your GP may also recommend taking tablets to treat this.

The recommended treatment for an AAA depends on how big it is.

Treatment is not always needed straight away if the risk of an AAA bursting is low.

Treatment for a:

• Small AAA (3cm to 4.4cm across) – ultrasound scans are recommended every year to check if it’s getting bigger; you’ll be advised about healthy lifestyle changes to help stop it growing
• Medium AAA (4.5cm to 5.4cm) – ultrasound scans are recommended every 3 months to check if it’s getting bigger; you’ll also be advised about healthy lifestyle changes
• Large AAA (5.5cm or more) – surgery to stop it getting bigger or bursting is usually recommended

Ask your doctor if you’re not sure what size your AAA is.

You can find more information about the treatments for AAA here.

What is an abdominal aortic aneurysm? | https://www.bhf.org.uk/

British Heart Foundation | published 24 Oct 2016