Abdominal Aortic Aneurysm: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Abdominal Aortic Aneurysm?
A vascular surgeon (a doctor who operates on blood vessels) usually treats an abdominal aortic aneurysm. A primary care doctor may find it first with a screening ultrasound. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is an abdominal aortic aneurysm?
The aorta is the main artery that carries blood from the heart to the rest of the body. An aneurysm is a bulge in the wall of an artery. An abdominal aortic aneurysm is a bulge in the part of the aorta that runs through the belly area. That part of the aorta is the most common place for an aneurysm.
The aorta has thick walls that stand up to normal blood pressure. Weakness in the wall lets blood push outward and form a bulge. An aneurysm can grow for years before it causes any symptoms. A large aneurysm can burst (rupture) or tear. Both can be life threatening.
Symptoms
Abdominal aortic aneurysms often cause no symptoms while they grow. During an exam, a doctor may feel a lump or a pulsating feeling in the belly. Signs may come on quickly if the aneurysm tears or ruptures. They include:
- Sudden, severe, or constant pain in the belly or back. It may spread to the groin, buttocks, or legs.
- Passing out or feeling dizzy.
- Clammy skin.
- Nausea and vomiting.
- A fast heart rate.
Causes and who gets it
The exact cause is not known. An aneurysm happens when an artery wall weakens. Risk factors include smoking, high blood pressure, male sex, and genetic factors. An injury (trauma) can also weaken the aorta wall. This problem is most often seen in men over age 60 who have risk factors. The larger the aneurysm, the more likely it is to break open or tear.
How doctors diagnose it
A doctor examines the belly and feels the leg pulses. A lump or a pulsating feeling may be a sign. When an aneurysm is suspected, the first test is an ultrasound of the belly. An ultrasound is a scan that uses sound waves to make pictures. A CT scan is an X-ray test that shows detailed pictures and confirms the size. For people with no symptoms, a doctor may order a screening ultrasound of the belly. A one-time screening ultrasound is advised for men age 65 to 75 who have smoked.
Treatment
Treatment depends on the size and location of the aneurysm and how fast it grows. If the aneurysm is small and causes no symptoms, surgery is rarely done. The doctor checks its size with ultrasound over time. Quitting smoking is the most important step to slow growth. Blood pressure medicines and statins (medicines that lower cholesterol) may be prescribed. Surgery is usually done when the aneurysm is bigger than 5 centimeters (about 2 inches) across or growing quickly.
There are two types of surgery. In open repair, the doctor makes a large cut in the belly, removes the aneurysm, and sews in a graft (a tube made of man-made material). Recovery takes about a month. In endovascular repair, the doctor makes a small cut, usually in the groin, and guides a stent graft (a tube covered with fabric) up to the aorta. The stent graft expands and attaches to the aortic wall. This approach usually needs less recovery time. If an aneurysm ruptures, emergency surgery is needed right away.
Both repairs can have serious problems. These include bleeding, infection, stroke, kidney damage, and an endoleak (a blood leak around the graft). Complications can be life threatening.
When to see a doctor
Go to the emergency room or call 911 if you have belly or back pain that is very bad or does not go away. Also call if you pass out, feel dizzy, or have clammy skin or a fast heartbeat. A ruptured aneurysm is a medical emergency. Only about 1 in 5 people survive a ruptured abdominal aortic aneurysm. If you are a man over 65 who has smoked, ask your doctor about a one-time screening ultrasound.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This doctor can check your blood pressure, help you quit smoking, and order a screening ultrasound. They can also watch a small aneurysm over time and coordinate your care with the vascular surgeon.
Common questions
Can an abdominal aortic aneurysm grow without symptoms?
Yes. Aneurysms often grow slowly over many years with no symptoms at all. That is why screening matters for people at risk.
Who should have a screening ultrasound?
Men age 65 to 75 who have ever smoked should have this test one time. Some men in that age group who never smoked should also have it. Ask your doctor if screening is right for you.
What is the difference between open repair and endovascular repair?
Open repair uses a large cut in the belly and a graft sewn in place. Endovascular repair uses a small cut, usually in the groin, and a stent graft guided through the blood vessel. Endovascular repair usually needs less recovery time.
How serious is a ruptured abdominal aortic aneurysm?
It is a medical emergency. Only about 1 in 5 people survive it. Call 911 right away for belly or back pain that is very bad or does not go away, or if you pass out.
Sources
- MedlinePlus - Abdominal aortic aneurysm
- NHLBI, NIH - What Is Aortic Aneurysm?
- NHLBI, NIH - Aortic Aneurysm Treatment
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
