Pediatric Heart Expert Forum
abdominal pulsation
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abdominal pulsation

My son is 16, he has been being tested for an aneurysm/bruit.  His abdominal area has a strong pulsation which seems to go along with his heartbeat and cause him to feel light headed.  He had a ultrasound and catscat but nothing was found.  He continues to have this, we are both very concerned.  Is there any other tests i should request or should they be looking for something else that may cause this?
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Dear Kim,

It’s difficult to tell based on the information that I have what else needs to be done, especially since you say that he has had a reportedly normal ultrasound (abdominal, I presume) and CT scan.  For our other readers, an aneurysm is an abnormal thinning and dilation of a blood vessel (the abdominal aorta, in this case); a bruit is a sound that is made by turbulent blood flow going through a narrowed blood vessel.  Abdominal aortic aneurysms, while certainly seen in adults with long standing atherosclerosis and/or hypertension, is exceedingly rare in children and adolescents, and would typically be associated with a genetic disorder of the connective tissue, which he likely does not have.  You don’t actually mention if anyone has heard a bruit, so it may be safe to say that he does not.

From what you tell me, there may be two different things going on here.  The first is that he may be relatively slim, which may cause the normal pulsations of his abdominal aorta to be transmitted through his body more distinctly.  The second is that the lightheadedness may be possibly associated with insufficient fluid intake, which is something common that we see with adolescents and children.  And, the abdominal aortic pulsations may also be increased because his autonomic nervous system (the part of the nervous system that controls things like heart rate and blood pressure) is increasing tone to maintain his blood pressure, since his tank is not full.  Try having him take in four 8-12 ounce glasses of fluid (milk, water, juice) a day, and see if that helps to improve things.  It is important to make sure that his blood pressure is normal, too.  If it is elevated, that will need to be evaluated by either a cardiologist, a nephrologist, or both.
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Thank you for responding.  I have not been on to see your message until today, because my son had another episode and i took him to the ER.  The doctors finally saw what is happening and did an echocardiogram and a xray of the heart and bw. Again all tests are normal, they now will be checking his thyroid and possibly a halter monitor.  I will follow your advice with the fluids.  They also had him see a neurologist and he felt it was not neurological and i am unsure of what a nephrologist does but i will be looking that up.  Thank you again for your response, and i am very happy that my sons heart seems to be healthy and no  aneurysm has been found.  
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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