Abdominal Aortic Aneurysm Ultrasound in Ajax

What is the largest blood vessel in your body, and when did anyone last look at it? For most people the honest answer to the second half of that question is “never,” and usually that is perfectly fine. The aorta does its work quietly for a lifetime. For some adults, though, a health-care provider will suggest taking a look at the section that runs through the belly, because a slow widening there, called an abdominal aortic aneurysm, rarely causes symptoms until it becomes a problem.

Ultrasound is one of the simplest ways to check. This article explains what the abdominal aorta is, what an aneurysm means, why a provider might request an ultrasound, and what the appointment is usually like for people in Ajax, Pickering, Whitby and the rest of Durham Region. It is general education, not personal advice, so please bring your own questions to the provider who knows your history.

Sudden, severe pain in the belly, back or side, especially with dizziness, fainting, sweating or a racing heart, is a medical emergency. Call 911. Do not drive to a community imaging clinic or wait for a booked appointment. Outpatient ultrasound is for planned, non-urgent checks.

Meet the aorta

The aorta leaves the heart, arches over the top of it and then travels down through the chest. Once it passes through the diaphragm, it becomes the abdominal aorta. It runs down near the spine, roughly behind the belly button, and then divides into two smaller arteries that carry blood toward the legs.

Along the way, branches leave the abdominal aorta to supply the kidneys, the bowel and other organs. Every heartbeat sends a surge of blood through it, which is why some slim people can feel a gentle pulse when they press on their upper abdomen. That pulse on its own is normal.

The wall of the aorta is strong and slightly elastic, built to absorb the pressure of each beat. Over many years, however, the wall can weaken in places.

What “aneurysm” actually means

An aneurysm is a section of artery that has widened, or ballooned, beyond its usual size. In the abdominal aorta this usually happens slowly, often over years. The widened section tends to sit below the arteries that go to the kidneys, though its exact position varies.

A few points help put the word in perspective:

• Size is the key measurement. Providers describe an abdominal aortic aneurysm mainly by how wide it is. Small ones are often simply watched over time.
• Many cause no symptoms. People commonly learn they have one because a scan was done for another reason or because their provider decided to check.
• Growth is usually gradual. That is why repeat imaging at intervals is a common approach for smaller aneurysms, as decided by a person’s doctor or specialist.
• The main concern is rupture. A large aneurysm can tear or burst, which is a life-threatening emergency. Finding and monitoring an aneurysm early gives the medical team time to plan.

Being told your aorta is “a little wide” or “worth keeping an eye on” is different from being told you need urgent treatment. Your provider is the right person to explain where your own result sits.

Who tends to be checked

There is no single rule for who needs an aortic ultrasound, and the decision belongs to you and your health-care provider. That said, mainstream medical guidance points to certain factors that make an abdominal aortic aneurysm more likely:

1. Older age, particularly from the mid-sixties onward
2. Being male, as men are affected more often than women
3. A history of smoking, including past smoking, which is one of the strongest associated factors
4. A close family member who has had an aortic aneurysm
5. High blood pressure and hardening of the arteries elsewhere in the body
6. Other aneurysms, such as in the arteries behind the knees

Some people are referred because a provider felt a broad, pulsing mass during an abdominal exam. Others are referred because a different test, such as an X-ray or an ultrasound done for the kidneys or gallbladder, hinted that the aorta looked larger than expected. And some are checked simply because their age and history put them in a higher-risk group.

If you are wondering whether a check makes sense for you, it is a good question to raise at your next visit. Screening recommendations and how they are delivered vary, so your provider can tell you what applies where you live.

Why ultrasound is the usual first look

Several imaging tests can show the aorta, including CT and MRI. For a straightforward measurement of the abdominal aorta, ultrasound has a lot going for it:

• It uses sound waves, so there is no ionizing radiation and no injection.
• It is quick and comfortable for most people.
• It can measure the width of the aorta directly on screen.
• It can be repeated safely if your provider wants to follow the size over time.

Ultrasound of the aorta is a vascular exam, because the aorta is an artery. If you want a deeper explanation of how sound waves and Doppler imaging show blood vessels and blood flow, our earlier article on how vascular ultrasound works covers the physics. Here we will stay focused on the aorta itself.

What the technologist is measuring

During the scan, the technologist follows the aorta from the upper abdomen down to where it splits. At several points, they freeze the image and take measurements across the vessel, usually in more than one direction, because an aorta is not always perfectly round. They may also look at the shape of the wall, at any material lining the inside of the vessel and at the arteries just beyond the split.

What can make the scan harder

The aorta sits deep in the abdomen, behind the bowel. Gas in the bowel scatters sound waves and can hide parts of the vessel. Body shape and recent meals can also affect how clearly it shows. The technologist may ask you to change position, take a breath and hold it, or press a little more firmly with the probe to get a better view. If a portion cannot be seen well, that will be noted, and your provider may decide whether another test is needed.

Getting ready for the scan

Because bowel gas is the main obstacle to a clear view, preparation for an abdominal aortic ultrasound often involves not eating for a period beforehand. The exact instructions depend on the exam your provider has requested, so follow the preparation you are given when your appointment is confirmed, and call if anything is unclear. For a closer look at why an empty stomach helps with belly scans in general, see our guide to preparing for an abdominal ultrasound.

A few practical habits also help:

• Bring your health card and your requisition.
• Wear two-piece clothing so you only need to lift your top, or change into a gown if asked.
• Bring a list of your medications. Do not stop taking any medication to prepare for a scan unless your doctor tells you to.
• Arrive a little early so you have time to register and settle.

If your requisition mentions the aorta specifically, it is worth mentioning that when you call to book, so the team can confirm the right exam and the right preparation for you.

On the day in Ajax

Most aortic ultrasounds follow a simple pattern.

You lie on your back on a padded exam bed. The technologist tucks a towel along the waistband of your clothing and applies warm or room-temperature gel to your abdomen. The probe moves from just below the breastbone down toward the belly button and a little below. Some pressure is normal, especially if bowel gas is in the way, but tell the technologist if anything becomes uncomfortable.

The room may be dimmed so the screen is easier to read. You might hear a whooshing sound if the technologist checks blood flow with Doppler. Many people are surprised by how little there is to it. Once the images are complete, you wipe off the gel, dress and head home or back to your day.

Our clinic at 300 Rossland Road East has free parking and ground-floor access, which is helpful for older adults and anyone who prefers not to manage stairs.

After the images are taken

The images and measurements are interpreted and a report is sent to the provider who ordered the scan. The person performing the ultrasound captures the images but does not give a diagnosis during the visit. If you would like to know how reports travel from the clinic to your provider, our article on what happens after your scan walks through it.

When you talk to your provider, it can help to ask:

• Was the aorta seen clearly from top to bottom?
• Is the width within the usual range, or is it wider than expected?
• If it is wider, do I need another scan, and roughly when?
• Is there anything I should be doing now, such as changes to blood pressure care or quitting smoking?
• Should close family members mention this to their own providers?

That last question matters. Because aneurysms can run in families, a result in one person sometimes prompts a useful conversation for siblings or children.

Looking after your arteries in the meantime

Nothing in this section replaces individual advice, but several themes come up again and again in mainstream heart and circulation guidance:

• Not smoking, or getting support to quit, is widely recognized as one of the most helpful steps for artery health.
• Knowing your blood pressure and following the plan you agree on with your provider.
• Taking prescribed medications as directed and asking questions if side effects worry you.
• Staying active in ways your provider says are suitable for you.
• Keeping follow-up appointments, including any repeat scans.

If you have also been asked to have heart tests, such as an echocardiogram or a stress test, those are offered through our cardiology team, Durham Cardiology, with a requisition from your provider.

Arranging an aortic ultrasound in Ajax

If your health-care provider has requested an ultrasound of your abdominal aorta, Rossland Diagnostic Clinic offers vascular ultrasound in Ajax for patients from across Durham Region. Call 905-426-3111 to confirm the exam and your preparation, or request an appointment and our team will get back to you. We are open Monday to Friday from 9:00am to 5:00pm and Saturday from 8:00am to 3:30pm.