Related Experiment Videos
Screening for abdominal aortic aneurysms during transthoracic echocardiography
M J Eisenberg1, S J Geraci, N B Schiller
1Department of Medicine, University of California, San Francisco 94143, USA.
Insights
Routine ultrasound screening of the abdominal aorta during transthoracic echocardiography is practical for detecting abdominal aortic aneurysms. This brief, low-cost screening identifies patients at risk, proving clinically useful in this population.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Imaging
- Vascular Surgery
Background:
- Patients undergoing transthoracic echocardiography (TTE) frequently have atherosclerotic vascular disease.
- This patient group may be at increased risk for abdominal aortic aneurysms (AAAs).
Purpose of the Study:
- To assess the feasibility and clinical utility of screening the abdominal aorta via ultrasound during routine TTE.
- To identify the prevalence of abdominal aortic aneurysms in patients undergoing TTE.
Main Methods:
- A prospective study involving 323 consecutive patients undergoing routine 2D TTE.
- Ultrasound examination of the abdominal aorta, measuring length and maximum diameter.
- Screening time was recorded for each patient.
Main Results:
- The abdominal aorta was successfully imaged in 82% of patients.
- Average aortic length was 13.0 cm, and average diameter was 1.7 cm.
- Seven patients (3%) had aortic diameters ≥ 2.5 cm, including one large aneurysm (6.7 cm) and six mild dilatations. One mild dilatation was later confirmed as a 3.5 cm infrarenal aneurysm. Aortic dilatation correlated with male gender and older age.
Conclusions:
- Screening for abdominal aortic aneurysms during TTE is practical and clinically valuable.
- Despite a low detection rate, the low cost and minimal time investment suggest routine screening is worthwhile.
- This approach aids in early detection of potentially life-threatening vascular conditions.
Abstract:
Patients undergoing transthoracic echocardiography often have atherosclerotic vascular disease and may be at risk for the development of abdominal aortic aneurysms. We therefore examined the abdominal aorta by ultrasound in 323 consecutive patients undergoing routine two-dimensional transthoracic echocardiography over a 6-month period. Measurements were made of aortic length (diaphragm to most caudal portion visualized) and maximum diameter. The study group comprised 169 men and 154 women with an average age of 57 +/- 19 years (range 13 to 94). The abdominal aorta was imaged in 265 (82%) patients. The average aortic length visualized was 13.0 +/- 4.6 cm, the average diameter 1.7 +/- 0.4 cm, and the time required for screening < 5 minutes. Seven (3%) patients were identified as having abdominal aortas > or = 2.5 cm in diameter: 1 with an aneurysm measuring 6.7 cm in diameter and 6 with mild dilatations measuring 2.5 to 3.0 cm in diameter. One of the patients with mild aortic dilatation was subsequently found to have an infrarenal aneurysm measuring 3.5 cm in diameter. Aortic dilatation was associated with male gender (p = 0.0006) and older age (p = 0.05) but was not associated with a history of ischemic heart disease (p = 0.16). From these results, we conclude that screening for abdominal aortic aneurysms in patients undergoing transthoracic echocardiography is practical and clinically useful. Only a small number of these patients are identified as having aneurysms, but the low cost and brief time required suggest that routine screening in this population may be worthwhile.