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Updated: May 24, 2026
An Approach to Point-Of-Care Ultrasound Evaluation of the Abdominal Aorta
Published on: September 8, 2023
Abdominal aortic aneurysm screening during transthoracic echocardiography: Cardiologist and vascular medicine
E Viviana Navas1, Andrea McCalla-Lewis, Bernardo B Fernandez
1E Viviana Navas, Andrea McCalla-Lewis, Sergio L Pinski, Gian M Novaro, Craig R Asher, Department of Cardiology, Cleveland Clinic Florida, Weston, FL 33327, United States.
Insights
Cardiologists accurately screen the abdominal aorta using transthoracic echocardiography (TTE), showing excellent agreement with vascular specialists. This quick TTE add-on detects abdominal aortic aneurysms (AAA) effectively.
Area of Science:
- Cardiology
- Vascular Medicine
- Medical Imaging
Background:
- Transthoracic echocardiography (TTE) is a standard cardiac imaging modality.
- Screening the abdominal aorta for aneurysms is crucial for cardiovascular health.
- Assessing interobserver variability in TTE-based abdominal aorta screening is important for clinical practice.
Purpose of the Study:
- To evaluate the interobserver agreement between cardiologists and vascular medicine specialists in screening the abdominal aorta via TTE.
- To determine the accuracy and reliability of cardiologist-performed abdominal aorta assessments.
Main Methods:
- Consecutive patients over 55 underwent TTE with abdominal aortic imaging.
- Two cardiologists and one vascular medicine specialist performed blinded image reviews.
- Interobserver agreement was assessed using correlation coefficients, paired t-tests, and Bland-Altman plots.
Main Results:
- Excellent interobserver agreement was found between cardiologists and the vascular specialist (P > 0.05).
- Abdominal aortic aneurysm (AAA) was detected in 5.5% of patients.
- Additional imaging time was minimal, averaging 4.4 ± 0.9 minutes.
Conclusions:
- Cardiologist-performed abdominal aorta assessment during TTE is accurate compared to vascular specialists.
- TTE is a valuable tool for detecting abdominal aortic aneurysms in selected patients.
- The additional time for abdominal aorta imaging during TTE is clinically feasible (<5 minutes).
Aim:
To study the interobserver variability between a cardiologist and vascular medicine specialist in the screening of the abdominal aorta during transthoracic echocardiography (TTE).
Methods:
Consecutive patients, > 55 years of age, underwent abdominal aortic imaging following standard TTE. Two cardiologists and one vascular medicine specialist performed a blinded review of the images. Interobserver agreement of abdominal aortic size was determined by the correlation coefficient and paired t test. Interobserver reliability for each cardiologist was assessed using Bland-Altman plots.
Results:
Ninety patients were studied. The mean age of patients was 72 ± 10 years and 48% were male. The mean aortic diameter was 2.31 ± 0.50 cm and 5 patients (5.5%) had an abdominal aortic aneurysm (AAA). The additional time required for the abdominal aortic images was 4.4 ± 0.9 min per patient. Interobserver agreement between the 2 cardiologist interpreters and the vascular medicine specialist was excellent (P > 0.05 for all comparisons). On Bland-Altman analysis of interobserver reliability, the 95% lower and upper limits for measurement by the cardiologists were 84% and 124% of that of the vascular specialist.
Conclusion:
The assessment of the abdominal aorta during a routine TTE performed by a cardiologist is accurate in comparison to that of a vascular medicine specialist. In selected patients undergoing TTE, the detection rate of AAA is significant. Additional time and effort required to perform imaging of the abdominal aorta after TTE is less than 5 min.
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