As part of his preparation for retirement, a 66-year-old executive undergoes a complete physical examination. He is in good health and has no symptoms to report. Along with other age-appropriate screening studies, you discuss testing for vascular disease with him.
The patient has had mild hypertension for about 10 years; it is currently well controlled with a low-dose angiotensin-converting enzyme inhibitor. He consumes 1 or 2 drinks daily. He does not smoke but was a half-pack to pack-a-day smoker when he was younger.
His weight is normal for his age and body habitus. Physical findings, including blood pressure, are all within normal limits.
LABORATORY AND IMAGING RESULTS
A hemogram, blood chemistry results, ECG, and chest radiograph are all normal.
Which of the following statements is correct?
A. A one-time screening for abdominal aortic aneurysm (AAA) by CT scanning is indicated now.
B. AAA screening has been effectively performed by your careful abdominal examination in this non-obese man.
C. A one-time screening for AAA by ultrasonography is indicated now.
D. If an AAA is detected, he will require surgery for repair.
1. Almahameed A, Latif AA, Graham LM. Managing abdominal aortic aneurysms: treat the aneurysm and the risk factors. Cleve Clin J Med. 2005;72:877-888.
2. US Preventive Services Task Force. Screening for abdominal aortic aneurysm: recommendation statement. Ann Intern Med. 2005;142:198-202.
3. Kim LG, P Scott RA, Ashton HA, et al. A sustained mortality benefit from screening for abdominal aortic aneurysm. Ann Intern Med. 2007;146:699-706.
4. Birkmeyer JD, Upchurch GR Jr. Evidence-based screening and management of abdominal aortic aneurysm. Ann Intern Med. 2007;146:749-750.
5. Rubin RN. Pulsatile abdominal mass in an elderly man. Consultant. 2005;45:95-98.
6. Powell JT, Greenhalgh RM. Clinical practice. Small abdominal aortic aneurysms. N Engl J Med. 2003;348:1895-1901.