There is a silent killer among us. 15,000 Americans die from it each year and it is the 10th leading cause of death. Innocuously known as Triple A, or AAA, abdominal aortic aneurysm is the third leading cause of death in men over age 60. Although twice as common in men as women, the risk of rupture in women is four times greater than in men and when AAA ruptures, it carries a 75-90 percent mortality rate.

AAA is an aneurysm (blood-filled bulge) occurring in the abdominal aorta, an artery located behind the belly near your back that carries blood to the lower part of the body. You don’t feel it and, until it ruptures, you rarely have symptoms of it.

It is estimated that more than a million people are living with an undiagnosed AAA. About three of every four AAAs are without symptoms.

At Valley Medical Center, vascular surgeon Dr. Wes Arlein sees 30 or more cases of AAA each year.

“To have the aneurysm found, you either have a patient that takes an active role in screening or the patient has had an x-ray for some reason – back pain or lumbosacral spine disease and, low and behold, there’s an aneurysm,” said Dr. Arlein.

Multiple factors appear to play a role in the development of an AAA, but the exact cause is not fully known. Primary risk factors for AAA are:

• age greater than 60

• male*

• family history (first degree relatives such as father or brother)

• genetic factors

• hyperlipidemia (elevated fats in the blood)

• hypertension (high blood pressure)

• smoking

• diabetes

The most common symptom is severe or dull pain in the abdomen, sometimes including a pulsing sensation similar to a heartbeat, or pain in the chest, lower back or groin. The occurrence of pain is often associated with the imminent rupture of the aneurysm.

People who are at risk for AAA need to be screened with a simple non-invasive test known as an ultrasound or sonogram.  This should be done at age 60 in men and perhaps age 65 in women.

“Abdominal aortic aneurysm can be detected easily by screening using ultrasound,” says Dr. Arlein.  “If detected before rupture the vast majority can be treated successfully. With endovascular repair, hospital stay is short (one day on average) and recovery is rapid.”

* While only 2-3 percent of women appear to be affected by AAA, age, smoking, and heart disease are each associated with increased risk of AAA in women. When all three risk factors are present together, the incidence of AAA is as high as 7 percent. Smoking has been shown to be the single most important risk factor for women who develop AAA. Other risk factors include hypertension, high cholesterol, obstructive pulmonary disease, and family history of AAA.