emDOCs / EM@3AM - May, 2023 By Dave Ediger, Rachel Bridwell
Reviewed by: Sophia Görgens; Cassandra Mackey; Brit Long
Pearls
- Consider ruptured AAA in all patients over 50 with truncal pain, syncope / presyncope, or hypotension
- AAA is a local manifestation of systemic vascular disease
- A ruptured AAA is a surgical emergency regardless of hemodynamic stability
- Ultrasound is sensitive for rapid bedside AAA screening, but it cannot exclude rupture, which is typically retroperitoneal
- Don’t let hematuria anchor you to renal pathology or lumbago (muscular back pain)
- Magic ultrasound numbers: 3×5 (>3cm defines an aneurysm; >5.5cm at high risk for rupture)