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Heart and Circulatory System

Abdominal Aortic Aneurysm

Abdominal Aortic Aneurysm

The aorta is the primary artery for transporting oxygenated blood from the heart throughout the body. As it exits the heart, the aorta ascends upward in the chest, makes a turn, (the aortic arch) and then continues downward into the chest, then through the diaphragm into the abdomen, where it divides into the iliac and femoral arteries that supply blood to the lower extremities.

An aortic aneurysm is a defect in the arterial wall that results in weakness and bulging of the vessel wall, similar to what happens to an over inflated bicycle tube.  An aneurysm can develop in any area of the aorta, including the chest, where its called a thoracic aortic aneurysm, or, more commonly, in the abdominal aorta.

Aneurysms can result from a number of different triggers, among them, smoking, untreated high blood pressure, genetic abnormalities, or, more generically, a condition called arteriosclerosis, that can weaken the aortic wall under the pressure of blood being pumped from the heart.

An abdominal aortic aneurysm can be a life threatening event if it occurs suddenly, but many people who have aneurysms may remain asymptomatic or experience only mild to moderate symptoms for years, and, in fact, may never require surgical repair.

A dissecting aneurysm, however, is a more complex and more serious type of aneurysm that can result in significant blood loss and is normally considered an emergency requiring immediate surgery.  The FAA evaluates repair of thoracic aortic aneurysms on a case by case basis. 

CT scans and MRA are accurate studies for determining the size of an aneurysm, and are often helpful in determining how to best manage the condition.  Generally, aneurysms smaller than about 5 cm. and not causing symptoms may be considered for more conservative treatment, including:

  • Stopping cigarette smoking;
  • Controlling high blood pressure;
  • Lowering LDL (“bad”) blood cholesterol;
  • Certain medications, including beta blockers, that may slow the rate of aneurysm expansion;
  • Close monitoring of the aneurysm size with ultrasound or CT scan every 6 to 12 months (sooner in higher risk patients).

The FAA will generally not consider any case in which an untreated aneurysm exceeds 4.5 cm in size.

Following a diagnosis and successful treatment, the FAA will need to see the following:

  • Hospital records, including all diagnostic test results, admission history and physical exam, operative report, and discharge summary;
  • A cardiovascular evaluation (CVE) and exercise treadmill stress test, including complete tracings; 
  • Current detailed narrative status report from the treating physician, including prognosis.

If your medical is still current, you can send this information directly to the FAA with a cover letter asking for consideration.

How/Where to Submit to the FAA

Helps you find the contact information for submitting your medical records.

Updated April 2016