Abstract
Background Abdominal aortic aneurysm (AAA) and acute coronary syndrome (ACS) share common risk factors. Objectives To assess the abdominal aortic diameter (AAD) among patients with ACS using transthoracic echocardiography (TTE). Methods Patients with ACS admitted to our intensive cardiac care unit from December 2013 to June 2014 were screened prospectively for AAA via AAD measurement in the subcostal TTE view. AAA was defined as an aneurysm with a transverse diameter of ≥30 mm. Results Sixty seven patients were included. The male-to-female sex ratio was 7 : 1. The vast majority of patients were admitted due to STEMI (73%), and the rest were equally divided as NSTEMI and unstable angina. The mean patient age was 58.4 ± 10.4 years. AAD measurements were feasible in 57 patients (85%); among them, AAA was diagnosed in six patients (10.5%). The average additional time required to measure the abdominal aorta was 4 ± 1 min. All patients with AAA were men and had a higher prevalence of smoking (83.3% vs. 60.6%, p < 0.003) and a lower incidence of diabetes mellitus than those without aneurysm. The prevalence of AAA tended to be related to age (12.5% in those older than 60 years and 18.7% in those older than 65 years). Conclusions The overall prevalence of AAA is significantly high among patients with ACS and increases with age. AAA screening as a part of routine cardiac TTE can be easily, rapidly, and feasibly performed and yield accurate findings. AAD measurement in the subcostal view should be implemented as a part of routine TTE in patients with ACS.
Highlights
Abdominal aortic aneurysm (AAA) is defined as an abnormal vascular dilatation composite of all three endothelial layers of at least 1.5 times the normal diameter or ≥30 mm.e prevalence of AAA worldwide is estimated to be 1%-2% in the general population and increases sharply up to 9% among the elderly population (>65 years) when multiple risk factors are present [1,2,3,4].AAA rupture is the 14th leading cause of death in the United States
AAA rupture usually presents with severe pain and tenderness on palpation; the pain usually radiates to the back, chest, or scrotum, in addition to hypotension and shock [9]. e risk of rupture is related to the size of the aneurysm and the presence of symptoms; it ranges from approximately 0.5%–5% per year for aneurysms 7 cm in diameter [10,11,12]. e overall mortality related to AAA rupture is 80%–90% compared with a 30-day postoperative mortality
By gathering the medical history and characteristics of the patients with acute coronary syndrome (ACS), we aimed to identify an independent risk factor for AAA development, which will be used as a screening tool
Summary
Abdominal aortic aneurysm (AAA) is defined as an abnormal vascular dilatation composite of all three endothelial layers of at least 1.5 times the normal diameter or ≥30 mm.e prevalence of AAA worldwide is estimated to be 1%-2% in the general population and increases sharply up to 9% among the elderly population (>65 years) when multiple risk factors are present [1,2,3,4].AAA rupture is the 14th leading cause of death in the United States. E main risk factors for AAA are male sex, white race, history of smoking (above 100 cigarettes in a lifetime), and age above 65 years. Abdominal aortic aneurysm (AAA) and acute coronary syndrome (ACS) share common risk factors. To assess the abdominal aortic diameter (AAD) among patients with ACS using transthoracic echocardiography (TTE). Patients with ACS admitted to our intensive cardiac care unit from December 2013 to June 2014 were screened prospectively for AAA via AAD measurement in the subcostal TTE view. All patients with AAA were men and had a higher prevalence of smoking (83.3% vs 60.6%, p < 0.003) and a lower incidence of diabetes mellitus than those without aneurysm. E overall prevalence of AAA is significantly high among patients with ACS and increases with age.
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