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Published: Monday, 2/6/2006

Test for aortic aneurysm will be standard

Mention AAA, and people often think of the American Automobile Association, which provides services to motorists, rather than a disease that needlessly kills thousands of older people every year.

Abdominal aortic aneurysms (AAAs), however, are about to emerge from years of playing second fiddle to less deadly diseases, and get the higher profile they deserve.

The spotlight will focus on AAAs because the U. S. Congress is about to expand Medicare coverage to include a simple screening test to diagnose the condition.

Both the Senate and the House of Representatives approved it late last year. After minor differences between the two bills are hashed out, Medicare will cover AAA testing for millions of older people.

Many younger people also will start wondering about this simple, safe, potentially life-saving test for an AAA.

An aneurysm is a dangerous bulge in an artery, almost like a bubble in the side of an old garden hose. An aortic aneurysm happens in the aorta, the body's largest artery, which actually is the size of a garden hose. An abdominal aortic aneurysm happens in part of the aorta that runs through the abdominal (stomach) area.

An estimated 3 million people in the United Sates have AAAs. Most are men over age 60 who have a family history or AAAs or heart disease risk factors.

Men who smoke and have high blood pressure and high blood cholesterol, for instance, have a risk of AAAs 2-5 times higher than other people. Women over 60 with heart disease risk factors have double or triple the normal risk of an AAA.

AAAs are the 10th leading cause of death in men age 65 and over. Deaths happen because the bulge gets big and ruptures or bursts, causing bleeding. Often there are no symptoms until the AAA does burst.

About 25,000 deaths from ruptured AAAs occur every year. The actual number of deaths may be higher because some ruptured AAAs are mistaken for heart attacks, strokes, and other conditions.

Almost all of the deaths could be prevented because AAAs can be diagnosed and treated before they get big enough to burst. Treatment may be major surgery to replace the weak spot, or another patching procedure done through an artery in the leg.

An ordinary ultrasound scan, or sonogram, can spot most AAAs, often at a cost of $300-$500. That's the screening test that Medicare would cover for certain people age 65 and older.

Many heart disease experts, however, think that younger people also should get an ultrasound scan to check for an AAA.

Some suggests testing men and women over age 60 who smoked cigarettes at some time in life, have blood vessel disease, or a family history of AAAs. Others argue that all men should get an AAA ultrasound test at age 60.

With 2006 shaping up as the year AAAs emerge from the shadows, it's a good time to talk with the doctor about an AAA test.

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