Obligatory medical device diagnostics.
- Transthoracic echocardiography (ultrasound of the heart through the chest) – if thoracic aortic aneurysm is suspected.
- Abdominal ultrasonography (ultrasound examination of the abdominal organs; with ultrasound contrast agent, if necessary) – if abdominal aortic aneurysm is suspected.
- Computed tomography of the skull (cranial CT, cranial CT or cCT) – if aneurysm of the blood-supplying vessels is suspected.
- Computed tomography (CT) of the abdomen (abdominal CT) – when abdominal aortic aneurysm is suspected.
- Computed tomography of the thorax/chest (thoracic CT) – when thoracic aortic aneurysm is suspected.
- CT angiography (CTA; angio-CT); radiologic imaging of arterial blood vessels by CT (computed tomography), using contrast medium – for suspected thoracic aortic aneurysm or thoracic aortic dissection (acute splitting (dissection) of the wall layers of the aorta (main artery), with a tear of the inner layer of the vessel wall (intima) and a hemorrhage between the intima and the muscle layer of the vessel wall (outer media), in the sense of an aneurysm dissecans (pathological expansion of the artery)) [Gold standard: in suspected aortic dissection]
- Magnetic resonance imaging of the skull (cranial MRI, cranial MRI or cMRI) – in case of suspected aneurysm of the blood-supplying vessels.
- MR arteriography (MRA)
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) – for suspected myocardial infarction (heart attack).
- Echocardiography (echo; cardiac ultrasound) – can detect wall motion abnormalities (WBS) in the affected myocardial area (heart muscle) and resulting ventricular dysfunction, and is used when the ECG could not yield clear findings in acute infarction
- Transesophageal echocardiography (ultrasound of the heart through the esophagus) allows good visualization of the ascending aorta (ascending aorta) – when thoracic aortic aneurysm is suspected.
Aortic aneurysm
| Suprarenal aorta | <25 mm (normal value) |
| Aortic ectasia | 2 35-30 mm |
| Aneurysm | > 30 mm |
Further notes
- For the diagnosis of abdominal aortic aneurysm (AAA) (abdominal aortic aneurysm, BAA), the maximum vessel diameter is critical. The diameter is determined in the plane perpendicular to the blood flow. Sonography must cover the complete vascular axis.
- The examination must be repeated every 3-6 months (watch and wait).
- Surgical therapy: 5.0-5.5 cm (men); > 4.5 cm (women).
- IQWiG (Institute for Quality and Efficiency in Health Care) recommends a one-time “ultrasound screening for abdominal aortic aneurysms” for men aged 65 years and older. The prevalence (disease incidence) of AAA is 1.5% annually. The mortality (death rate) of ruptured abdominal aortic aneurysm is high, up to 80%.
- Ultrasound screening for early detection of abdominal aortic aneurysms is available to men over 65 years of age with statutory health insurance.
