A 70-year-old man with hypertension and hyperlipidemia presents for screening. Vitals: BP 158/92 mmHg, HR 88/min, RR 16/min, temp 37.2°C. Abdominal ultrasound reveals a 3.2 cm infrarenal abdominal aortic aneurysm with normal wall thickness and no mural thrombus. He denies abdominal or back pain. Serum creatinine is 1.1 mg/dL. He takes lisinopril and atorvastatin. Which management strategy is most appropriate?
- A)Serial ultrasound surveillance every 12 months with risk factor modificationGABARITO
- B)Initiate beta-blockers and defer imaging follow-up
- C)Immediate elective open surgical repair
- D)Annual computed tomography angiography for definitive surveillance
- E)Endovascular aneurysm repair without delay
Explicação
AAA 3.0-3.9 cm in asymptomatic patients warrants surveillance with ultrasound every 12 months. Repair is not recommended until size ≥5.5 cm or rapid expansion (>0.5 cm/year) occurs. Medical management includes blood pressure control and smoking cessation. Ver explicação completa e trilha adaptativa →