1st April 2022

A 65-year-old male attends a GP appointment to review his blood pressure

A 65-year-old male attends a GP appointment to review his blood pressure. Past medical history includes hypertension and hypercholesteremia for which he is prescribed ramipril, candesartan, amlodipine and atorvastatin. Social history includes a 45 pack-year smoking history and weekly alcohol consumption of 20 units. Additionally, he asks if you could give him a once over exam as he is concerned that his home BP readings have been high. On examination, his BP is 150/90, and on general examination of the cardiac, respiratory and gastrointestinal systems you auscultate a faint bruit over the upper abdomen. 

Select the SINGLE most likely cause of the auscultated abdominal bruit from the list below. Select ONE option only.