Abdominal aortic aneurysm

An aneurysm is a failure of the arterial wall that results in a balloonlike dilatation of a segment of the artery. Aortic aneurysms constitute the 14th leading cause of death in the United States and the 10th leading cause of death in older men, who are the principal victims (1). Diagnosis of abdominal aortic aneurysm (AAA) is important because the natural history is that of continued enlargement with potentially catastrophic consequences. Because the condition may be entirely asymptomatic, and when symptoms are present, they may be nonspecific, the internist is often the first to evaluate the patient. Thus, understanding the disease, optimal diagnostic methods, and management are crucial for primary care practitioners. Approximately 80% of aortic aneurysms occur between the renal arteries and the aortic bifurcation. Abdominal aortic aneurysm is present in more than 5% of older men who have smoked. Each year in the United States, AAA rupture causes 4500 deaths; another 1400 deaths result from the 45 000 repair procedures done to prevent rupture (2).