Heart Health
What Does an Echocardiogram Actually Show? A Plain-Language Guide
An abdominal aortic aneurysm — a dangerous bulging of the body's largest artery — ruptures without warning in tens of thousands of people every year. Most of them had no idea it was there. A simple 30-minute ultrasound can find it. Here's what you need to know.
An abdominal aortic aneurysm is a silent killer. The aorta, the largest artery in the body, runs through the abdomen and supplies blood to virtually every organ below the heart. When a section of the aortic wall weakens and expands, forming an aneurysm, there are typically no symptoms until the aneurysm ruptures. At that point, the mortality rate is 50 to 80 percent. The test that detects it takes 30 minutes and involves no radiation.
An aneurysm is a permanent localized dilation of an artery to more than 1.5 times its normal diameter. In the abdominal aorta, a diameter greater than 3.0 centimeters is considered aneurysmal. Aneurysms grow slowly, typically 0.3 to 0.5 centimeters per year in the early stages, and the rate of expansion accelerates as the aneurysm enlarges. Risk of rupture increases dramatically once the diameter exceeds 5.5 centimeters.
The aortic wall weakens due to a combination of atherosclerosis, chronic inflammation, and degradation of the structural proteins elastin and collagen. These changes accumulate over decades and are directly linked to the same risk factors that drive coronary artery disease and stroke. Smoking is the strongest modifiable risk factor for AAA and dramatically accelerates both aneurysm growth and rupture risk.
The United States Preventive Services Task Force has recommended one-time AAA screening for men aged 65 to 75 who have smoked 100 or more cigarettes in their lifetime.[2] This recommendation is based on randomized controlled trial evidence showing that screening in this population reduces AAA-related death by 43 percent.[1]
The recommendation applies to men because AAA is four to six times more common in men than women.[3] However, women who have smoked have a substantially elevated risk compared to non-smoking women, and the consequences of a ruptured AAA in women tend to be worse due to smaller aortic size and more rapid expansion. Evidence increasingly supports screening for women with significant smoking history.
Medicare covers one-time AAA screening for qualifying men. For individuals not covered by this benefit, the test is available at BlackPoint for $397, which is substantially less than most insurance copays for hospital-based imaging.
An AAA screening ultrasound measures the maximum anteroposterior diameter of the infrarenal aorta, the segment below the renal arteries where aneurysms most commonly occur. The measurement is taken at the widest point. A normal aorta measures less than 3.0 centimeters. Measurements are classified as small aneurysm (3.0 to 3.9 cm), medium aneurysm (4.0 to 5.4 cm), or large aneurysm (5.5 cm and above).
The scan also assesses the iliac arteries, which can develop separate aneurysms, and evaluates aortic wall characteristics including thrombus formation within the aneurysm sac. Thrombus does not protect against rupture and is a marker of chronic aneurysm activity.
BlackPoint performs AAA screening at your home in 30 minutes. No preparation required. Written cardiologist report in 24 to 48 hours. $397, no referral required. This is one of the highest-yield screening tests available for the populations listed above.
Book your screening or reach out with any questions about your cardiovascular health.
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