Have you been screened for this ‘silent killer?’

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Image showing Abdominal Aortic Aneurysm and the related Thoracic Aneurysm. Screening for this ‘silent killer’ is being done at New Hanover Regional Medical Center (Image courtesy of the National Heart, Lung, and Blood Institute).

WILMINGTON — It is called a “silent killer,” because it does not present many warning signs and can cause fatal, uncontrolled bleeding.

Abdominal aortic aneurysm (AAA), is the swelling of the aorta – the largest artery in the body – beneath the heart. This causes damage to the blood vessel’s walls. The force of blood, often exacerbated by high blood pressure and high-cholesterol, can cause leaks or complete bursts or ruptures into the abdominal cavity; both can be fatal in nearly 90 percent of cases of severe rupture, according to the New England Journal of Medicine.

AAA events were responsible for 9,863 deaths in the United States in 2014, according to the Center for Disease Control (CDC) and contributed to another 17,215 deaths – due to complications, such a renal failure, heart attack or complications in surgery.

The New Hanover Regional Medical Center (NHRMC), which has recently launched an AAA screening program, has tested 1,674 patients to since February of this year. According to Martha Harlan, speaking on behalf of NHRMC, nearly a hundred patients tested positive.

“We found 94 patients who had aorta’s measuring 3cm or more [in diameter],” said Harlan. “That’s not the threshold for surgery, but at that point our physicians are going to watch them. After the test, NHRMC has physicians on hand who can consult patients, and talk about lifestyle changes and possibly medication. They’ll work with them one-on-one to determine the next step.”

The next step often includes diet and exercise, but in some cases can include surgery to repair or strengthen arterial walls.

Anterior view of the surgical steps of an open abdominal aortic aneurysm (AAA) repair, with suturing of aortic graft; SOURCE: cardiacsurg_aaa-open_proc_2.ai; 3D_normal_cns.mb, outline: cardiology_cardio-stent-place_procedure_1_line.ai; cardiology_heart_slide_template; cardiacsurg_aaa-open_proc_2a_layers.psd; cardiacsurg_aaa-open_proc_2b_layers.psd;
Anterior view of the surgical steps of an open abdominal aortic aneurysm (AAA) repair, with suturing of aortic graft. (Courtesy NHRMC)

The screening itself, an ultrasound scan of the abdomen, can performed very quickly.

“It only takes a few minutes,” said Harlan.

NHRMC recommends the test for anyone over the age of 50 with a history of smoking (defined as mover than 100 cigarettes over a person’s life). Specific risk factors include age (men and women over 65), genetic history of AAA, obesity, diabetes and hypertension.

“A lot of the risk factors for heart disease also apply to AAA,” said Harlan. “But anyone who is uncertain should contact their primary care physician, it’s not a difficult call for a doctor to make.”

Compared to some tests which are invasive or require extensive lab-work, the AAA screening is relatively inexpensive. The out-of-pocket costs for the screening is $62.25, though Harlan told Port City Daily, “most insurances will definitely pay for this procedure through your primary care physician. Medicare also offers free, one-time screenings for patients deemed ‘at risk.’ ”

Still, not everyone will have the right insurance coverage – or the out of pocket funds – for the screening. For that reason, NHRMC offers financial assistance through the NHRMC Foundation, a special fund created in 1991. Those in financial need who meet the criteria for AAA should contact the foundation at (910) 667-5002.

Harlan noted that “regardless of insurance or medicare, anyone getting the screening does need a referral. And really the most important part of screening for AAA is having a primary care doctor. Someone who can collect all off your medical information and get the big picture.”

Harlan encouraged those without a primary care physician to visit the NHRMC resource page or to call the hospital’s 24-hour Vitaline for help getting referrals or to find a physician, at (910) 815-5188 or (888) 815-5188. Read more about AAA at NHRMC (including this video) and the CDC.