Aortic Aneurysm

The aorta is the largest artery in the body, beginning at the heart. It is a tube—one inch diameter and approximately one foot in length—that delivers blood to most of the major organs in the body. It is divided into four sections:

The ascending aorta, which rises up from the heart to supply the heart with blood,
The aortic arch, which curves over the heart to supply the head, neck and arms with blood,
The thoracic aorta, which descends from the heart through the chest,
The abdominal aorta, which begins at the diaphragm and splits in the lower abdomen to become the paired iliac arteries, which carry blood to your legs.

An aneurysm of the aorta is a ballooning or bulge in the wall of the artery. As the artery stretches, it can weaken or burst, causing serious bleeding and possible death.

Causes, signs and symptoms

The wall of the aorta is very elastic and can expand and contract to accommodate blood flow but, as a person ages, the artery can weaken. Medical conditions such as high blood pressure or atherosclerosis (hardening of the arteries) can also weaken the walls of the artery and, as a result, the artery may bulge, burst, or rupture.

Usually, patients experience no signs of an aneurysm though some individuals do experience belly, chest or back discomfort. These symptoms can be persistent or vary in frequency.

The effects of an aneurysm include changes in blood flow that could cause clots to form. Depending on where the aneurysm is located in the aorta, these clots can break off, travel to the brain, and cause a stroke or they may travel through the abdomen to the legs, causing blockages in the belly or legs.

Aneurysms are often diagnosed through screenings using Doppler ultrasound, a CT (X-ray) scan, through an MRI (magnetic resonance image), and occasionally can be identified during exams or tests for other reasons.

If you smoke, have a family history of aneurysm, have high blood pressure or atherosclerosis, you may be at higher risk for an aneurysm.

Medicare aneurysm screening

Medicare covers this one-time screening ultrasound if you get a referral for it as a result of your "Welcome to Medicare" physical exam. You must receive the physical exam and the screening ultrasound referral (not the ultrasound exam itself) within the first twelve months you have Medicare Part B.

People with Medicare who meet the following criteria are eligible:

Each patient must get a referral for the AAA ultrasound screening from a physician or other qualified non-physician practitioner as a result of their "Welcome to Medicare" physical exam.
The screening must be the first AAA ultrasound screening paid for by Medicare.
You must also:

Have a family history of abdominal aortic aneurysm
Be a male, age 65 to 75, who has smoked at least 100 cigarettes in his lifetime

Certain other risk factors may apply. It’s best to talk with your doctor to learn more or visit medicare.gov.

Treatment

There are several ways to treat an aneurysm, depending on its size and how fast it is growing. For fast-growing or larger aneurysms, surgery is the preferred treatment. A vascular surgeon—a surgeon who specializes in treating arteries and veins—will repair or replace the damaged section of the artery using a stent or graft.

Smaller, slow growing aneurysms rarely rupture and are commonly treated with medications for high blood pressure, such as beta-blockers. Your physician will recommend regular screenings to monitor the size and growth of the aneurysm and may also recommend exercise, diet changes, smoking cessation and additional medications to reduce cholesterol levels.