What are the signs and symptoms of abdominal aortic aneurysms (AAAs)?

Updated: Jan 08, 2019
  • Author: Saum A Rahimi, MD, FACS; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

AAAs are usually asymptomatic until they expand or rupture. An expanding AAA causes sudden, severe, and constant low back, flank, abdominal, or groin pain. Syncope may be the chief complaint, however, with pain less prominent.

Most clinically significant AAAs are palpable upon routine physical examination. The presence of a pulsatile abdominal mass is virtually diagnostic but is found in fewer than half of all cases.

Patients with a ruptured AAA may present in frank shock, as evidenced by cyanosis, mottling, altered mental status, tachycardia, and hypotension. Whereas abrupt onset of pain due to rupture of an AAA may be quite dramatic, associated physical findings may be very subtle. Patients may have normal vital signs in the presence of a ruptured AAA as a consequence of retroperitoneal containment of hematoma.

At least 65% of patients with a ruptured AAA die of sudden cardiovascular collapse before arriving at a hospital.

See Presentation for more detail.


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