For some people, feeling a pulse in the stomach may be a regular harmless occurrence. For others, it may be a sign of something more serious.
In some cases, a pulse in the stomach, or abdomen, might be due to an abdominal aortic aneurysm. An aneurysm occurs when a weakened area of a blood vessel swells, forming a bulge. In people with an abdominal aortic aneurysm, this occurs in part of the aortic artery in the abdomen.
People with this condition rarely experience any other symptoms unless the swelling tears or ruptures, which is a medical emergency.
In this article, we outline the causes of a pulse in the stomach and explain when to see a doctor. We also provide information on abdominal aortic aneurysms, including the symptoms, risk factors, diagnosis, and treatment.
Feeling a pulse in the abdomen can be normal for some people, particularly older adults with a healthy body mass index (BMI). These individuals may notice this sensation when they are lying down or if they gently press down between the ribs and the navel.
Many of the risk factors for cardiovascular problems overlap with those for aortic aneurysms. These include:
An aortic aneurysm is when the aorta bulges outward. The aorta is the largest artery in the body. It begins at the heart and extends down through the chest and abdomen.
The abdominal aorta is the section of the aorta that sits deep inside the abdomen, just in front of the spine.
Certain factors, such as aging or disease, can lead to the walls of the aorta weakening. Blood pumping through the artery may cause the weakened section to bulge outward.
If the bulging occurs in the abdominal aorta, it is called an abdominal aortic aneurysm.
Without treatment, the aneurysm may weaken to the extent that it tears or ruptures.
What causes it?
Other causes include injury and infection.
The following factors may increase the risk of an abdominal aortic aneurysm:
Sex, age, and lifestyle factors
People with the highest risk appear to be men aged 65 years and over who smoke or have previously smoked.
The authors of a 2014 review concluded that these screenings lead to fewer incidents of abdominal aortic aneurysm rupture and a decrease in mortality rates relating to the condition.
According to the National Institutes of Health (NIH), 1 in 10 people who develop an abdominal aortic aneurysm have a family history of the condition.
People who have a first degree relative, such as a parent or sibling, with the condition have a 20% chance of developing the condition.
Other risk factors
Other risk factors include:
- high cholesterol
- high blood pressure
- inflamed arteries
- emphysema, a lung condition
- Marfan syndrome
- Ehlers-Danlos syndrome
Abdominal aortic aneurysms usually develop gradually over many years. Most people who develop one do not experience any symptoms besides a pulse in the stomach, although even this is rare.
For this reason, experts recommend ultrasound screenings for people with specific risk factors.
When symptoms do occur, they are often sudden. The following symptoms are usually the result of a tear or leak in the aorta:
- intense or persistent pain in the abdomen or back
- pain that radiates down to the buttocks and legs
- a rapid heart rate
- low blood pressure
- difficulty breathing
- nausea and vomiting
- feeling sweaty or clammy
- sudden weakness on one side of the body
A severe tear or rupture in the aorta is an emergency, so anyone who has the above symptoms or witnesses someone else experiencing them should call for immediate medical help.
People should see a doctor if they suspect that they have an abdominal aortic aneurysm or if they have a higher risk of developing one.
A doctor will examine the abdominal area and may listen to the abdomen with a stethoscope.
To confirm the diagnosis, the doctor may order one or more of the following diagnostic tests:
- Abdominal ultrasound: This imaging technique uses sound waves to see tissues inside the body and can help determine the size of the aneurysm.
- Doppler ultrasound: This type of ultrasound uses sound waves to assess blood flow through arteries and veins.
- Abdominal and pelvic CT scan: This scan combines a series of X-ray images to give a detailed picture of tissues inside the body. It helps determine the size and extent of an aneurysm.
- Angiography: This test combines X-ray, CT, or MRI scans with a contrast dye to show major blood vessels inside the body.
Treatment options will vary depending on the size and location of the aneurysm. The doctor will also take other factors into account, such as the person's age and health.
For people with an aneurysm that is smaller than 5 centimeters (cm) in diameter, a doctor may recommend the following treatment plan:
- follow-up ultrasounds or CT scans every 6–12 months
- medications to control high blood pressure
- medications to lower cholesterol
- treatments to help with quitting smoking
A doctor may recommend surgery for an aneurysm that is more than 5 cm in diameter or is growing rapidly or leaking. Surgical options include open surgical repair (OSR) and endovascular aortic repair (EAR).
Some people with a healthy body weight may be able to feel a pulse in their stomach. This symptom is often harmless, especially in those without any cardiovascular problems.
However, feeling a pulse in the stomach could indicate an abdominal aortic aneurysm. People should see a doctor if they are concerned about their risks, especially because this condition often causes no symptoms.
Having regular medical check-ups is vital for people who are at increased risk of developing aneurysms.
In some cases, feeling a pulse in the stomach is not a cause for concern. Many people who are at a healthy weight and do not have risk factors for cardiovascular issues can feel their pulse in their abdomen.
In other cases, it may indicate a serious issue called an abdominal aortic aneurysm.
People who have an abdominal aortic aneurysm rarely experience any symptoms before it ruptures, and they may not know that they have the condition.
Not being aware of an aneurysm is dangerous because they usually weaken over time and become more prone to tearing or rupturing.
People should see a doctor if they experience symptoms of an abdominal aortic aneurysm, are at a higher risk of developing one, or have a family history of the condition.
A doctor may recommend managing the condition with medication, or they may suggest surgery to repair the weakened artery.