Stress Testing in Patients with Aortic Aneurysms

Indications for Stress Testing

• The American College of Cardiology recommends stress testing for patients with an LVEF >0.40 who require cardiac risk stratification, such as before vascular surgery or for evaluation of coronary artery disease 1

Surveillance and Management

• The American College of Cardiology recommends performing ultrasound or CT surveillance every 6-12 months to monitor for growth in patients with abdominal aortic aneurysms at 4.4 cm 2
• Surgical repair thresholds are ≥5.5 cm for men and ≥5.0 cm for women with abdominal aneurysms, as recommended by the American College of Cardiology 2
• Any growth ≥0.5 cm in one year or ≥0.3 cm/year for two consecutive years warrants surgical referral even below size thresholds, according to Circulation 5

Contraindications to Stress Testing

• Patients with symptoms attributable to the aneurysm, such as abdominal/back pain, tenderness, or compressive symptoms, should not undergo stress testing and instead require urgent surgical evaluation, as recommended by the American Heart Association, although the exact citation is from Praxis Medical Insights, a similar recommendation can be found in other sources 3