What is the most common symptom in a client with abdominal aortic aneurysm?
A. Abdominal pain
B. Diaphoresis
C. Headache
D. Upper back pain
Correct Answer: A. Abdominal pain
Abdominal pain in a client with an abdominal aortic aneurysm results from the disruption of normal circulation in the abdominal region. Patients may experience unimpressive back, flank, abdominal, or groin pain for some time before rupture. Isolated groin pain is a particularly insidious presentation. This occurs with retroperitoneal expansion and pressure on either the right or left femoral nerve. This symptom may be present without any other associated findings, and a high index of suspicion is necessary to make the diagnosis.
Option B: Diaphoresis isn’t associated with an abdominal aortic aneurysm. At times, AAAs may cause symptoms from local compression, including early satiety, nausea, vomiting, urinary symptoms, or venous thrombosis from venous compression.
Option C: Headache is not a sign of an abdominal aortic aneurysm. Other symptoms include abdominal pain, groin pain, embolic phenomena affecting the toes (eg, livedo reticularis, or blue toe syndrome; see the image below), and fever. Occasionally, small AAAs thrombose, producing acute claudication.
Option D: Lower back pain, not upper, is a common symptom, usually signifying expansion and impending rupture of the aneurysm. Back pain can be caused by erosion of the AAA into adjacent vertebrae.