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Feeling a strong pulse near your navel or developing unexplained abdominal pain can be unsettling, especially when the sensation seems to match your heartbeat. At Capitol Cardiology Associates, a cardiologist can determine whether further vascular testing is appropriate based on your symptoms and risk factors. Keep reading to find out what an abdominal aortogram shows, which problems it can help detect, and what to expect if your heart doctor recommends one.
The abdominal aorta is the large artery that carries oxygenated blood from the heart through the abdomen. Several major arteries branch from it to supply the kidneys, digestive organs, pelvis, and legs. A problem in this part of the circulatory system can affect blood flow far beyond the area where the abnormality begins.
An abdominal aortogram uses contrast dye and X-ray imaging to give doctors a close look at the abdominal aorta and some of the arteries that branch from it. A doctor will insert a thin catheter into an artery, then move it toward the area being examined. Contrast material is injected through the catheter so the blood vessels stand out on the X-ray images. This lets the doctor follow the shape of the vessels and see how blood is moving through them.
An aortogram isn’t always the first test a doctor orders for abdominal symptoms. Depending on what’s going on, ultrasound, CT angiography, or another type of imaging may make more sense at first. The choice depends on your symptoms, previous imaging, kidney function, and the type of vascular problem the doctor is looking for.
An abdominal aortic aneurysm forms when a weakened area in the aortic wall starts to bulge outward. That part of the artery grows wider than it should instead of keeping its usual diameter. Doctors pay close attention to the size of an aneurysm because its width is one of the factors used to decide how closely it should be watched and whether treatment should be considered.
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Many abdominal aortic aneurysms produce no obvious symptoms. Some are discovered during imaging performed for an unrelated problem. When symptoms do occur, a person might notice deep abdominal discomfort, back pain, or a noticeable pulsation in the abdomen. A heartbeat-like movement near the navel doesn’t automatically mean that an aneurysm is present. Thin body composition, normal arterial pulsation, digestive activity, and other causes make abdominal movement more noticeable.
The concern with an aneurysm is the weakened arterial wall. As the vessel enlarges, doctors assess its size, location, shape, growth history, and the patient's overall risk profile. A rupture allows blood to escape from the artery into the abdomen and creates a life-threatening emergency. Sudden severe abdominal or back pain, collapse, fainting, marked weakness, or symptoms associated with shock require immediate emergency care rather than a routine office appointment.
Aneurysms aren't the only abnormalities doctors examine. Arteries can also become narrowed by plaque. Atherosclerosis develops when deposits that contain cholesterol, calcium, cellular debris, and other material accumulate within artery walls. The open channel through which blood travels becomes smaller as plaque occupies more space.
When contrast moves through a healthy vessel, it creates a clear, continuous outline on an angiographic image. A narrowed area looks tighter than the artery around it. With a severe blockage, only a small channel may remain for blood to pass through. A complete obstruction stops contrast from following its normal route. In some people, the body forms alternate circulation pathways around a blockage that has been there for a long time, and those vessels may also be visible on the images.
The location of the narrowing affects which parts of the body receive less blood. Disease lower in the aorta or in arteries that lead to the legs can contribute to leg pain while walking, poor circulation in the feet, or wounds that are slow to heal. Narrowing closer to arteries that supply abdominal organs can cause a different set of problems.
Finding a narrowed artery gives doctors more than confirmation that plaque is present. They also need to see where blood flow is restricted, how severe the restriction is, and which arteries are affected. This information helps them decide whether medication, risk-factor management, another vascular procedure, or continued observation is appropriate.
The abdominal aorta functions as the central route for several important arteries. Its branches supply blood to organs throughout the abdomen. For that reason, an evaluation sometimes extends beyond the main vessel.
The renal arteries carry blood to the kidneys. Significant narrowing in one or both renal arteries can reduce blood flow to kidney tissue and contribute to certain cases of difficult-to-control high blood pressure. Other branches supply the stomach, liver, spleen, intestines, and surrounding structures. Restrictions in these vessels can interfere with the amount of oxygenated blood reaching digestive organs.
The iliac arteries start where the abdominal aorta splits in the lower abdomen and carry blood toward the pelvis and legs. Plaque in this area can limit circulation to the lower extremities. If a doctor finds an abnormality in the lower abdominal aorta, these branches may also be examined to see how much of the surrounding vascular system is involved.
A visible or noticeable abdominal pulse doesn’t tell you what’s causing it. It becomes more concerning when it occurs with pain, dizziness, fainting, weakness, or known vascular risk factors. The type of abdominal pain matters too. Mild discomfort that has lingered for weeks is very different from severe abdominal or back pain that starts suddenly without warning.
Seek emergency medical care for sudden intense abdominal or back pain, fainting, collapse, severe weakness, confusion, difficulty breathing, or other symptoms that point to a medical emergency. A suspected ruptured abdominal aortic aneurysm needs immediate hospital treatment. Don’t wait for a scheduled cardiology visit in Upper Marlboro if your symptoms are severe or getting worse quickly.
Symptoms that aren’t as severe should still be evaluated if they keep coming back, don’t go away, or have no obvious cause. A doctor can review your blood pressure, cardiovascular history, smoking history, family history, cholesterol levels, previous imaging, and other risk factors before choosing the right test. Your cardiologist may start with an abdominal ultrasound or recommend another imaging study based on what your symptoms and history show.
If you've noticed a new pulsating sensation near your navel or unexplained abdominal discomfort, Capitol Cardiology Associates can help. Schedule an evaluation to discuss your symptoms and find out if vascular testing is warranted.