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Abdominal aortic aneurysm

An abdominal aortic aneurysm is a widening or dilation of the aorta (the largest blood vessel) in your abdomen (tummy). It’s a serious condition that needs to be monitored closely because if the aneurysm bursts, it’s often fatal.

Your aorta is the artery that distributes blood from your heart through blood vessels, to the rest of your body. The aorta is usually 2 to 3cm wide. It runs upwards from your heart before curving downwards through your chest (the thoracic aorta) and your abdomen (the abdominal aorta).

A weak spot in your aorta can cause it to bulge outwards. This is called an aneurysm. If the bulge is in the aorta as it goes through your chest, it’s called a thoracic aortic aneurysm. If it’s in the aorta as it goes through your abdomen, it's called an abdominal aortic aneurysm. You can have more than one aneurysm at the same time.

Most people who get an abdominal aortic aneurysm are over 50. As many as four in 100 men aged 65 to 74 in England have an abdominal aortic aneurysm. In this age group, abdominal aortic aneurysms are six times more common in men than in women.

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An image showing an abdominal aortic aneurysm


  • Symptoms Symptoms of abdominal aortic aneurysm

    You’re unlikely to have any symptoms of an abdominal aortic aneurysm unless it ruptures. If the aneurysm is pressing on nearby organs, you may feel pain in your back, tummy, side or groin.

    If the aneurysm does rupture, it may cause severe bleeding inside your body. This will be fatal without emergency surgery to repair it.

    If your abdominal aortic aneurysm ruptures you may get pain in the middle or side of your abdomen or in your groin. Or, you may feel a pulsating sensation in your abdomen. You may also have other symptoms that include:

    • a rapid heartbeat
    • feeling faint
    • loss of consciousness
    • feeling sick or vomiting

    If you have severe pain in your abdomen and any of these other symptoms, you must seek urgent medical attention.

    The chance of an aneurysm rupturing depends on its size. If your aneurysm is greater than 5.5cm wide, the chances of rupture are high. The risk increases with increasing size.

  • Diagnosis Diagnosis of abdominal aortic aneurysm

    Because it’s unlikely that you’ll have any symptoms, an abdominal aortic aneurysm is usually diagnosed during screening. It’s sometimes picked up if you’re having tests for another condition or during a routine examination by your GP.

    Your GP will examine you and ask you about your medical history. If you have an aortic aneurysm, your GP may feel a pulsating mass in your abdomen, or the aneurysm may show up on a scan.

    If your GP thinks you may have an abdominal aortic aneurysm, you may need to have other tests in hospital. An ultrasound scan can provide a clear image of your abdominal aorta to identify an aneurysm and measure it. A CT or MRI scan can provide images of your aorta to show the exact position of the aneurysm.


    If you're a man over 65, you’re likely to be invited to be screened for an abdominal aortic aneurysm at your GP surgery or local hospital.

  • Treatment Treatment of abdominal aortic aneurysm

    Your treatment for an abdominal aortic aneurysm will depend on your symptoms and the size of your aneurysm.

    Watchful waiting

    If you have a small aneurysm, your doctor won’t usually advise you to have surgery. However, you will need regular ultrasound checks to see if the aneurysm is expanding. How often you need these checks will depend on the size of your aneurysm.

    It's also important to manage your condition by changing your lifestyle and treating any condition that may be causing the aneurysm. For example, high blood pressure. If you smoke, you should also consider quitting, and losing weight if you’re overweight.


    Your doctor will advise you to have elective (planned) surgery if your aneurysm grows to 5.5cm. You may also need surgery if your aneurysm is causing symptoms, because this can mean it’s growing fast.

    You will need to have emergency surgery if your aneurysm ruptures as this is a serious medical emergency.

    There are two main types of operation for an abdominal aortic aneurysm.

    Open surgery

    Open surgery for an abdominal aortic aneurysm, involves your surgeon opening your abdomen to reach your aorta. They will insert a graft into the weak area of your aorta. The graft is likely to be a synthetic graft made out of an elastic material. Blood will flow through the graft inside your aorta instead of going through the aneurysm, which will prevent the aneurysm getting bigger.

    Endovascular stent graft replacement

    Endovascular aneurysm repair (EVAR) involves your surgeon feeding a tube through an artery in your groin and through your aorta to the aneurysm. This is called a stent. Your surgeon will use X-ray images to guide the placement of the stent. The stent will be covered with synthetic graft material that will bond with the wall of your aorta. Blood will then flow through the stent instead of the weakened aneurysm. However, stents aren't suitable for everyone. It will depend on the location of the aneurysm and other factors. Ask your surgeon for more information.

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  • Causes Causes of abdominal aortic aneurysm

    Abdominal aortic aneurysms develop when the wall of your aorta weakens, causing it to bulge or dilate. Doctors don’t know exactly why some people’s aorta weakens. However, it’s probably due to a variety of factors.

    Many people with an abdominal aortic aneurysm have atherosclerosis. This is a process in which fatty deposits build up on the inside of your arteries and weaken the artery walls.

    You’re more likely to develop an aneurysm, if you:

  • Prevention Prevention of abdominal aortic aneurysm

    You can take steps to reduce your risk of an aortic aneurysm by:

    • not smoking
    • having your blood pressure and cholesterol checked regularly and treated if necessary
    • exercising regularly
    • maintaining a healthy weight
    • eating a healthy diet

    It’s important to have regular medical check-ups if you have a family history of arterial disease. Also, make sure you attend any screening appointments so that your doctor can pick up any problems early.

  • FAQs FAQs

    I have an abdominal aortic aneurysm and I've heard that they can rupture. What does this mean and what can I do to help prevent it happening?


    An abdominal aortic aneurysm can burst if the weakened artery wall of your aorta can't contain the pressure of the blood inside. A ruptured aneurysm is very serious and requires emergency surgery to treat it. It’s important to have regular check-ups and change your lifestyle to help prevent this.


    If you have an abdominal aortic aneurysm, you will need to attend regular appointments with your doctor to check it’s not at risk of bursting. A ruptured abdominal aortic aneurysm is extremely serious. About nine out of 10 people who have a ruptured abdominal aortic aneurysm will die as a result.

    Your abdominal aortic aneurysm is more likely to rupture if you smoke or have:

    The following will help to prevent your abdominal aortic aneurysm from rupturing.

    • Make sure you have regular check-ups to monitor your abdominal aortic aneurysm. The screening service will let you know how often you need to have a check-up ultrasound scan.
    • If you smoke, you should try to quit.
    • If you have high blood pressure, take steps to lower it. Weight loss and exercise can help with this.

    Ask your GP for information about the support available to help you quit smoking, lose excess weight and increase the amount of exercise you take. There may be local services in your area that can help you to achieve your goals.

    What can I do to make my recovery easier after having surgery to treat an abdominal aortic aneurysm?


    Aim to be as fit and healthy as possible before your operation and prepare your home for when you return.


    Before you go into hospital there are several things that you can do to make your recovery quicker and easier.

    It’s important to stop smoking as smoking can increase your chances of getting a chest infection, which will slow your recovery. If you're overweight, your surgeon may recommend a weight-loss programme because being overweight can also slow your recovery.

    It's a good idea to prepare your home for when you return from hospital. This may involve rearranging your furniture to make it easier to move around and placing items that you use a lot at arm level. This is so you don't have to reach for them. It's also a good idea to stock up on non-perishable foods, such as frozen or tinned items. That way, you won’t need to go shopping immediately after your surgery.

    Open surgery for abdominal aortic aneurysm is a major operation. You will probably stay in hospital for around eight to 10 days and you may be off work for about six to 12 weeks. If you have endovascular aneurysm repair surgery you’re likely to be in hospital for three to five days. And you will most probably be off work for around a month. You may want to have books, CDs or DVDs at home to keep you occupied while you recover.

    What is Marfan syndrome?


    Marfan syndrome is a condition that affects the way your body produces fibres that make up the connective tissue in your body.


    People with Marfan syndrome have a defect in a gene that controls the production of elastic fibres in their body. The elastic fibres (connective tissue) hold your joints and organs in place and help control how your body grows. Because connective tissue is found throughout your body, the effects of Marfan syndrome can be widespread. For example, it can involve your heart, lungs, skeleton, skin and eyes.

    About one in 5,000 people have Marfan syndrome. People can inherit the condition, meaning that they get it from a parent who also has the syndrome.

    If you have Marfan syndrome, you're more at risk of getting an aortic aneurysm earlier because the elastic tissue of your aorta isn't produced correctly. This makes your aorta weaker so it widens more easily.

  • Resources Resources

    Further information


    • Abdominal aortic aneurysm. PatientPlus., published 13 June 2012
    • Abdominal aortic aneurysm. Medscape., published 19 November 2014
    • Hole JR and Koos KA. Human anatomy. Dubuque, IA: Wm C Brown; 1994:25–26
    • Abdominal aortic aneurysm – endovascular stent-grafts, NICE Technology Appraisal Guidance (February 2009)., published February 2009
    • Thoracic aortic aneurysm. PatientPlus., published 16 May 2012
    • Simon C, Everitt H, van Dorp F and Burkes M. Oxford handbook of general practice. 4th ed. Oxford: Oxford University Press; 2014. DOI:10.1093/med/9780199671038.003.0010
    • NHS Abdominal Aortic Aneurysm Screening Programme., accessed 25 January 2015
    • Laparoscopic repair of abdominal aortic aneurysm. National Institute for Health and Care Excellence (NICE), August 2007.
    • Map of Medicine. Hypertension. International View. London: Map of Medicine; 2012 (Issue 4)
    • Map of Medicine. Dyslipidaemia. International View. London: Map of Medicine; 2012 (Issue 4)
    • Having heart surgery. British Heart Foundation., published 2013
    • Endovascular abdominal aortic aneurysm repair versus open surgery: a review of the clinical and cost-effectiveness. Canadian Agency for Drugs and Technologies in Health., published 27 September 2013
    • Ramrakha P and Hill J. Oxford handbook of cardiology. 2nd ed. Oxford: Oxford University Press; 2012. doi:10.1093/med/9780199643219.001.0001
    • Marfan syndrome. PatientPlus., published 10 December 2013
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