Screening for abdominal aortic aneurysm during transthoracic echocardiography. A prospective study in 1202 consecutive patients at high risk: incidence, correlation with risk factors, feasibility, diagnostic accuracy, and increase in echocardiography time

The rupture of abdominal aortic aneurysm is a pathology with a high mortality risk. Conversely, the study of the abdominal aorta is not routinely included in the echocardiography protocol, although it can be performed quickly and easily for screening of the aneurysm. The aim of this study was to evaluate screening of abdominal aortic aneurysm at the end of each echocardiographic exam performed at our laboratory. From March 2002 to October 2003, 1202 patients aged > 40 years were studied at our echo-lab. After the first 4 months of screening, only patients at high risk were screened, namely men > 65 or < 65 years and women > 65 years with at least one risk factor for ischemic heart disease. We evaluated feasibility, diagnostic accuracy, incidence in the study population, interobserver variability, the correlation with risk factors for ischemic heart disease and the increase in total echocardiography time. The mean aortic diameter was 19.08 +/- 5.98 mm and feasibility was very high (95.6%). We found 62 unknown aneurysms and 20 localized aortic dilatations (incidence of 5.6 and 1.7%, respectively); the incidence of both of them was 9.1 in men and 1.6 in women. Multivariate analysis revealed male gender, older age and other arterial district pathologies as independent risk factors. The interobserver concordance was excellent as well as diagnostic accuracy. The mean time increase in routine echocardiography was 33.8 +/- 18.6 s. The abdominal aortic study at the end of a routine echocardiography, in patients at risk of aortic pathology because of age or other risk factors, is a simple and accurate method for screening of abdominal aortic aneurysm. It showed a very low cost, also due to the short-time increase in routine echocardiography.