Incidences of abdominal aortic aneurysm are occurring more frequently, and some Spokane-area physicians think a simple screening for the condition ought to become more commonplace.
The screening involves taking ultrasound images of the abdominal aorta, which generally runs through the diaphragm and behind a persons belly button, carrying blood to the lower half of the body, says Dr. Tracy Magnuson, a general and vascular surgeon at Valley Hospital & Medical Center. Ultrasound images show the size of the artery and whether it is dilated in places and in danger of rupturing.
Magnuson says such a screening costs between $45 and $200, but Medicare and most insurance plans dont cover it currently, and it typically isnt included as part of routine physicals.
Its a failure in our complete physical exams that we dont screen for these, she says.
Dr. Bradley Bale, whose practice focuses exclusively on heart-attack prevention, says he screens for abdominal aortic aneurysm regularly when assessing a patients risk of heart disease. Bales practice, however, doesnt accept insurance and requires patients to pay directly.
He believes all people over 60 years old, and all men 50 and over with certain risk factors, should be screened for the condition. He says nearly as many people nationwide die from abdominal aortic aneurysm as die from prostate cancer annually.
Its part of the normal course to screen (for prostate cancer), Bale says. Why dont we all screen for abdominal aortic aneurysm?
Magnuson says most physicians dont screen for the condition regularly because it doesnt have any symptoms. The lack of symptoms, however, is what makes the condition so insidious, she says.
Aneurysms are often called silent killers because they dont have symptoms, she says. Most medical conditions have symptoms. With aneurysms, there often are no symptoms until they do rupture.
When an aneurysm ruptures, the patient dies 90 percent of the time, she says. About half of such patients die before reaching an emergency room, she says. The majority of those patients who do make it to a hospital die during surgery or in the few weeks thereafter, Magnuson says.
On the other hand, when aneurysms are detected and repaired before rupturing, the mortality rate is less than 5 percent, she says.
During the past year, Magnuson has operated on five patients who had suffered ruptured abdominal aortic aneurysms. Fortunately, she says, her patients have beaten the odds, as all of them survived the trauma.
In one case, she operated on a patient who suffered an aneurysm, then screened his son only to find that he had an aneurysm that hadnt ruptured yet. The son was able to have his condition treated before suffering a rupture.
An unruptured aneurysm can be treated either by placing a stent in the aorta using a catheter or by removing the affected part of the vessel and replacing it with a synthetic material. After a rupture, the more invasive surgery is the only alternative, Magnuson says.
The aorta in an average adult male is two centimeters in diameter, or about the diameter of a nickel. Treatment is deemed necessary if a dilated portion of the vessel grows to 5 1/2 centimeters, she says.
The American Heart Association says most aneurysms occur in the abdomen below the arteries connected to the kidneys. An aneurysm typically is caused by a build-up of plaque on the aortic walls, causing them to weaken. In some cases though, aneurysms might occur due to an inherited disease.
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