16th September 2020

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. His past medical history includes hypertension and hypercholesterolaemia, 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.  

On examination, his BP is 150/90, and he confirms that his home BP readings have also been high. You perform a general examination of his cardiac, respiratory and gastrointestinal systems, which is normal other than 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.