1. Aorta Ultrasound indications and Preparation

Indications for Performing Aorta Ultrasound

You should conduct an ultrasound of the aorta whenever you suspect abdominal aortic aneurysm (AAA) or aortic dissection.

  • The US preventative task force recommends a one-time screening for AAA in male patients between the ages of 65-75 who have ever smoked.
  • Male sex and advanced age (≥ 65) are considered risk factors for both AAA and aortic dissection. However, keep in mind that patients with congenital risk factors will commonly present before age 40 (Lederle, Howard).

Below is a table to keep in mind when considering Abdominal Aortic Aneurysm (AAA) or Aortic Dissection:

Abdominal Aortic Aneurysm (AAA)Aortic Dissection
Pain qualityConstant, intense abdominal, back, pelvic, or flank pain that may radiate to buttocks, groin, or thighsAcute-onset, severe chest or back pain with ripping/tearing/sharp or stabbing quality
Risk factorsSmoking 
Atherosclerosis & coronary artery disease
Third Trimester Pregnancy
Amphetamines, cocaine

Connective tissue disease (Ehler’s-Danlos, Marfan’s)
Bicuspid aortic valve
Physical FindingsPain, hypotension, pulsatile abdominal mass (ruptured AAA classic triad)
Systolic abdominal bruit
Signs of GI bleeding or retroperitoneal hemorrhage
Syncope, hypotension/shock
Pulse deficit, systolic BP differential between limbs
Aortic regurgitation murmur
Neurologic Deficits

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