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Abdominal Aortic Aneurysms are a relatively common pathology with nearly 200,000 new diagnoses per year in the United States. Ruptured aneurysms have an exceptionally high mortality rate and are the 15th leading cause of death in the United States. Early diagnosis and intervention are paramount to reduce the morbidity and mortality associated with this emergent vascular condition. It is important for clinicians to understand which patients are at greatest risk for developing abdominal aortic aneurysms and which tests best diagnose the condition as traditional history taking and bedside physical exams are unreliable in detecting abdominal aortic aneurysms. This activity reviews the use of point of care ultrasound in diagnosing abdominal aortic aneurysms and highlights the role of the interprofessional team in evaluating and treating patients who have abdominal aortic aneurysms. This activity empowers clinicians with the knowledge and skills needed to independently improve the health outcomes of the patients that they service. Objectives: Identify the routine and emergent indications for the point of care ultrasound evaluation of abdominal aortic aneurysms. Devlelop the skill for sonographic evaluation of abdominal aortic aneurysms. Identify the limitations of bedside ultrasound evaluation of abdominal aortic aneurysms. Determine interprofessional team strategies to diagnose and treat abdominal aortic aneurysms to improve outcomes. Access free multiple choice questions on this topic.

Abdominal Aortic Aneurysms (AAAs) are a relatively common pathology with a prevalence of 1.3% in patients over 50 years and an incidence in elderly men over 12%.[1] Ruptured aneurysms have an exceptionally high mortality rate ranging 50% to 95%. In fact, mortality increases by 1% with each subsequent minute, mandating prompt diagnosis and intervention. Nearly 30% of ruptured AAAs are misdiagnosed on initial presentation. Subjective symptoms, objective signs, and physical examination have demonstrated poor sensitivity in the setting of ruptured AAA.[2] Moreover, less than 25% of patients present with the characteristic triad of hypotension, abdominal pain, and a pulsatile abdominal mass.[3][4][5] Prompt diagnosis by utilizing point of care ultrasound has demonstrated sensitivities of 94% to 99%. Costantino et al. confirmed that bedside ultrasound is accurate within 4 millimeters of CT measurements with respect to AAA. Bedside ultrasound is a safe and effective diagnostic imaging modality that can be performed in under 5 minutes. More significantly, its use has decreased mortality by 20% to 60%.

There are no known complications from the sonographic assessment of the abdominal aorta. Limitations include body habitus, bowel gas, and operator experience. In lieu of a limited evaluation of the abdominal aorta, consider advanced imaging based on the patient's hemodynamic status.

The diagnosis and management of an AAA includes an interprofessional team consisting of a radiologist, vascular surgeon, internist, nurse practitioner, and cardiologist. When an AAA is suspected the initial test of choice is ultrasound. This diagnostic imaging modality permits routine monitoring of patients who are managed non-surgically, while limiting radiation and IV contrast exposure. An MRA or CTA is recommended for surgical planning if the patient is hemodynamically stable. Unstable patients should be managed in close consultation with the vascular surgeon and intensivist.