Abdominal aortic aneurysm screening for high-risk cardiac patients in the emergency department

Abstract

Background: The prevalence of abdominal aortic aneurysm (AAA) is 1-2 percent in the general population, and is as high as 6 percent in groups with risk factors. Objectives: The aim of this study was to determine the prevalence of AAA amongst high-risk cardiac patients in the emergency department (ED). Methods: A prospective study was conducted to evaluate the prevalence of AAA in a high-risk population presenting to the ED. Inclusion criteria included male gender, Caucasian race, age over 50 years, history of smoking, and presentation to the ED with chest pain requiring admission. Patients enrolled in the study were screened for AAA by ultrasound (US) scan. Study subjects were excluded if there was inadequate imaging. Results: One hundred and nine patients were recruited into the study. Nineteen patients were excluded by the ED US Director secondary to inadequate imaging. Of the remaining 90 patients, eight patients were found to have AAA (n = 8; 8.9%; CI 3.9 - 16.8%). Of the eight patients with an AAA, four had diagnosed cardiovascular disease during their hospital admission. There was no statistically significant difference in secondary risk factors such as hypertension, diabetes, dyslipidemia or previous history of coronary artery disease between those with AAA and those without AAA. Conclusions: This study found that in a single ED, the prevalence of AAA in high-risk cardiac patients admitted to rule out acute coronary syndrome who could be adequately visualized with ultrasound was over 8 percent. With such a high prevalence, this population could be a potential screening group.