Harvard Heart Letter

Refining the rules for abdominal aneurysm testing

A new scoring system could improve the detection of an enlarged aorta.

More than one million American men and women have a fragile bulge in the aorta, blood's main pipeline out of the heart. Most of them don't know it. In some people, this condition, called abdominal aortic aneurysm (AAA), never poses a problem. In others, the bulge bursts, with catastrophic consequences.

A small percentage of these aneurysms (ANN-yuh-riz-ums) cause a pulsating pain in the abdomen or generalized back pain. Most, though, give no hint of their presence. They are discovered by accident, say, during a CT scan of the lungs or kidneys. Some stay hidden until they burst, spewing blood into the abdominal cavity. When this happens, the blood supply to vital organs dwindles; death can follow within minutes.

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