Which finding suggests an abdominal aortic aneurysm in a hypertensive patient?

Which finding suggests an abdominal aortic aneurysm in a hypertensive patient?

• A. Upper back pain
• B. Hoarseness
• C. Pulsations around umbilicus
• D. Abdominal bruit

Answer: (D)

An abdominal bruit signals turbulent blood flow through an enlarged abdominal aorta, which is what happens when an abdominal aortic aneurysm forms. In someone with long-standing hypertension, the risk of an aneurysm increases, so hearing a bruit over the abdomen makes AAA a likely possibility, especially when a pulsatile mass isn’t easily detected. The other signs are less specific: upper back pain can occur with aneurysm or dissection but isn’t unique to the abdominal aorta; hoarseness points to thoracic involvement; pulsations around the umbilicus can occur but aren’t as reliable or audible as a bruit. So, an abdominal bruit directly reflects abnormal flow in the abdominal vessel, making it the most suggestive finding for an AAA in this context.

An abdominal bruit signals turbulent blood flow through an enlarged abdominal aorta, which is what happens when an abdominal aortic aneurysm forms. In someone with long-standing hypertension, the risk of an aneurysm increases, so hearing a bruit over the abdomen makes AAA a likely possibility, especially when a pulsatile mass isn’t easily detected. The other signs are less specific: upper back pain can occur with aneurysm or dissection but isn’t unique to the abdominal aorta; hoarseness points to thoracic involvement; pulsations around the umbilicus can occur but aren’t as reliable or audible as a bruit. So, an abdominal bruit directly reflects abnormal flow in the abdominal vessel, making it the most suggestive finding for an AAA in this context.