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Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
Screening Men with Coronary Heart Disease for Abdominal Aortic Aneurysm: A Prospective Cohort Study
Ville Vänni1, Jussi Hernesniemi, Matti Turtiainen
1Department of Surgery, North Karelia Central Hospital, Tikkamäentie 16, 80210, Joensuu, Finland, ville.vanni@pkssk.fi.
Insights
Coronary heart disease patients have a significant prevalence of undiagnosed abdominal aortic aneurysms (AAA). Screening for AAA during routine cardiac ultrasounds is recommended for early detection and management in this high-risk group.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Diagnostic Imaging
Background:
- Abdominal aortic aneurysm (AAA) prevalence is notably higher in individuals with coronary heart disease (CHD) compared to the general population.
- This suggests a potential shared pathophysiology or risk factors between these two conditions.
Purpose of the Study:
- To determine the prevalence of undiagnosed abdominal aortic aneurysms (AAA) in male patients diagnosed with coronary heart disease (CHD).
- To identify predictors of AAA in this specific patient cohort.
Main Methods:
- A cohort of 438 active male outpatients with CHD underwent abdominal ultrasound (US) screening for AAA.
- AAA was defined as an infrarenal aortic diameter exceeding 30 mm.
- Screening duration averaged 5 minutes per patient.
Main Results:
- A total of 25 abdominal aortic aneurysms (AAAs) were detected, yielding an incidence of 5.7% within the CHD cohort.
- Independent predictors for AAA included advanced age, a family history of AAA, and current or past smoking status.
- The cost per screened patient was €15 ($18.50), and the cost per identified AAA was €257 ($325).
Conclusions:
- A considerable proportion of patients with CHD harbor previously undiagnosed abdominal aortic aneurysms (AAAs).
- Routine AAA screening is advisable for active CHD patients.
- Integrating AAA screening into routine cardiac ultrasound examinations performed by cardiologists is a feasible and recommended practice.
Background:
The prevalence of abdominal aortic aneurysms (AAA) is higher among patients with coronary heart disease (CHD) compared with control population.
Objective:
To assess and determine the prevalence of non-diagnosed AAA in men with CHD.
Materials And Methods:
A total of 438 active male out-patients with CHD were screened for AAA by abdominal ultrasound (US) examination. The largest infrarenal aortic dimension was registered. The patient was regarded to have AAA when the aortic diameter was greater than 30 mm.
Results:
We found altogether 25 AAAs. The incidence of AAA was 5.7%. One AAA patient was operated on, and the other AAA patients are under surveillance. Independent predictors for AAA among CHD patients were increased age, family history of AAA, and current or previous smoking. The screening process took on average 5 min per patient, and the cost of screening was 15
Conclusions:
The prevalence of previously undiagnosed AAAs among patients with CHD is considerable. Screening of AAA should be considered among active patients with CHD. The most feasible and simplest option would be to perform the screening during any routine or elective cardiac US by a cardiologist, and we recommend to adopt it as a standard practice.
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