Throughout the I time spent in my radiology residency, I noticed a large number of people of all ages complaining about a single peculiar symptom – besides in the chest, they can feel their heart beats in their belly area. Some of them were laying down on their back, others on the front, but the main worries are almost always the same: “Do I have an aneurysm?”
An abdominal aortic aneurysm (AAA) is a very serious condition, which demands serious treatment, especially if those pulsating sensations are because of the aneurysm itself. However, there is no reason to start panicking, because though AAA and some other diseases we’ll mention here can cause this sensation, some totally healthy patients feel it too.
You can feel pulsating sensations in your stomach even if you are healthy
Let’s start with the most benign option – that there aren’t any specific underlying causes, and that this sensation is the result of natural causes, such as exercise, emotional stress, overeating, or simply due to your body type.
For example, some elder patients may have normal aortas that are dilated, or even tortuous. However, because of their slim physique, and the fact that most of them suffer from scoliosis, their aorta is more superficially placed than in other people, which makes the patients able to feel its pulsations.
It is also a frequent finding in slim people with a naturally bigger left lobe of the liver, who may experience similar pulsations.
Pregnancy, on the other hand, can cause similar symptoms because the amount of blood circulating your body is higher than normal, so it makes sense that you’ll notice these pulsations more easily. In rare cases, these types of sensations can be felt due to your baby’s heartbeats.
What if this pulsating feeling is Abdominal Aortic Aneurysm after all?
Whenever you are sent to undergo an ultrasound with the goal of diagnosing the pulsating feeling in your belly, doctors will first look for signs of a potential AAA. Unlike other possible causes, an existing AAA, if ruptured, is a potentially urgent condition which can be fatal within a very short period of time.
If an AAA is not the underlying case, only then will the doctors search for any other possible causes. When talking about aneurysms, it is also possible that some branches of the aorta (such as the superior mesenteric artery) can be dilated, and may give similar symptoms.
Some risk factors can contribute to AAA, such as smoking, high blood pressure, high cholesterol levels, obesity, stress, or an inactive lifestyle, so avoiding them lowers your risk of having AAA in the first place.
However, if the AAA is proven diagnostically, it will be treated either with medications, or, if urgent – in the operating room, where a stent graft will be implanted on the damaged part of the aorta, minimizing the chances of it rupturing.
What are the other possible causes of a pulsating sensation in the abdominal area?
The most common tumors in direct contact with the aorta include, but are not limited to:
- Lymphoma, a type of cancer manifested by the enlargement of your lymph nodes. A lot of lymph nodes are normally found near the aorta, which means that they can transmit the aortic pulsations to the surface easily.
- Gastric (stomach), pancreatic, or hepatocellular (liver) cancer can transmit pulsations directly from the aorta due to the enlargement of the particular organ. Just like in lymphoma, these types of cancer can cause lymph node enlargements within the same region.
- Renal masses, which include both benign and malignant types of kidney cancer.
- Urinary bladder and reproductive organ masses, counting benign lesions, such as polyps, as well as various types of cancer.
- Pancreatic pseudocyst, manifested by cyst cavities seen in the pancreas during ultrasound, and complicated by possible obstructions in the GI tract.
- Liver hemangioma, a benign tumor (lump) in the liver, consisted of blood vessels, can also imitate pulsations similar to the aorta, especially if found in the left lobe of the liver.
- Mesenteric lipoma, a type of fat cell tumor. Rare, but can cause complications, depending on the location and size.
- Mesenteric cyst, an extremely rare type of cystic mass, which usually doesn’t give any symptoms. However, if it grows big enough, can transmit aortic pulsations.
- Hydronephrosis, a dilatation of parts of the kidney due to an obstruction of urine flow on its way to the bladder.
- Hepatomegaly/splenomegaly (enlargement of the liver and/or spleen), either due to inflammation, cancer, or any other different reason. For example, congestive heart failure can eventually lead to elevated blood pressure in the portal vein system (blood flow to the liver), which can lead to a series of events that can eventually mimic a sensation of an aneurysm.