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.