Aortic Aneurysms – When do you go to the ER?

I would think that your cardiologist should give you the best guidance. Mine told me to find my new normal. I have small vessel disease in addition to a 4.7 cm thoracic AA, which gives me almost constant angina of varying levels. do what you can to get your BP down when you are having problems. I have been instructed to take an extra blood pressure pill and let the doctors nurse know what is going on. Bottom line work closely with your doc.

To benjones: first off, you have to go to the ER with a blood pressure like that. But in the face of your aneurysm, you need followup with your cardiologist. Set up a plan. Second off: wyomingmiller how do you make your judgement call on whether your angina requires an ER trip or not, with your aneurysm sitting there? I struggle with this, and I am interested in how other people make their judgement calls. Thanks you two, for sharing!

Don’t get me wrong. I have gone to the ER twice with angina. I am just trying to figure out when it is intense enough coupled with other unexplained pains like something is happening with my aneurysm. Such as pain in my neck pain in my back, intense, sharp pain, those types of things. I have small vessel disease where three of the small vessels are 85 to 90% blocked, but they are inoperable due to the location of each of them being at the branch of the small vessel. so rather than pay for ER visits , I have tried to figure out what is real and what I can live with. It’s a hard call, but I check my Apple Watch despite the fact that the doctor doesn’t like it and I follow what I can see on an abnormal ECG. That gives me enough information that I know if something is really happening or not then is when I would make the call to go to the ER again. It is a very real and hard thing to figure out and we are all doing our best so everyone keep up the good work and live each day with purpose

Hi @benjones, welcome to our support community. My ascending aortic aneurysm is the same size as yours. I struggled a lot with this question and brought it up to my cardiologist. He recommended I consult with the surgeon who would actually do the surgery in the event of an impending dissection. The surgeon's guidance was very clear: When you have severe crushing/squeezing pain in your chest and back that doesn't go away.
Fast forward to last September when I got that exact kind of pain. I called 911, they arrived within about 5-10 min and we were enroute to the ER. After ~15 min in the ambulance I began to feel much better, asked to be taken home but they continued to the ER to get checked out. After 7 hrs and many cardiac tests, they released me, finding nothing consequential.
Over the next 3 1/2 months I had several recurrences but not as severe until I was awakened @3am with same kind of pain. So I asked myself, when in the past have I felt anything similar to this? Answer: 3 years earlier when I was hospitalized for what turned out to be a large stone blocking my common bile duct. Long story short: That was removed in mid-December and I've been well ever since. A 4 month road to learning that if I have the kind of pain the cardiac surgeon told me about, I need to go to the ER but keep in mind it might be GI related. Dr.'s say the blockage can def. come back but hopefully I'll be alerted to it and get it resolved sooner.

Thank you for your input. It's greatly appreciated. It's really a tightrope we walk out on this. When something can be so fatal so fast. It can make you little crazy at times. I keep reading all the info I can on these forums. Thanks to everyone!!

Thank you to all of you! Its very helpful!

All comments do help me a little. My aneurysm is very close to the aorta.
6.5 cm. It has been stable for the last few years. In 1996 I had an disecting aneurysm. Lost one kidney and had 50 % of the intestines removed. Due to the brilliant surgeon I am still alive. Cardiologist watches me carefully. Blood pressure needs to be on the low side. Anyone knows if Mayo Clinic is able to operate the aneurysm or just cross your fingers that it does not burst. I am 86 now. Axel.

I would consult your doctor if it was me and my aneurysm was 6.5 cm.

Many cardiologists put you into the watchful waiting mode and only see you once a year. If something happens, they tell you to go to the ER.

Overall, I have seen from medical literature articles and also discussions that Mayo is very good about offering surgery to appropriate patients. An 87 yr old patient that I have been helping is having neurosurgery at Mayo this morning. He had revision (corrective) neurosurgery at Mayo two years ago. Mayo has very skilled surgeons. I have had five very very successful major surgeries at Mayo - one last summer. I am 81!