Do I need a new Dr?

There are cardiologists that specialize in BAVs and aneurysms, (they are related as BAVs make the likelihood of an aneurysm higher). I’m not a Dr but had my aneurysm repaired at 5.2 (also have a BAV), 5.1 seems like repair should be considered. I would get 2nd opinions from surgeon and cardiologist. Being younger and in good physical shape makes the surgery less likely to have complications. Had mine at 54 in very good shape and my surgeon gave me >99% probability of not having any complications, and that’s how it went, fast recovery too. In my case they left the BAV as it was highly functional still, in your case they may replace it at the same time. Let me know if you want any more information, good luck and all the best to you

I think a second opinion is always a good idea. Not all cardiologist have dealt with your situation. So yes I think your talking with a different Doctor would be great idea.

i would check with either Mayo or Cleveland clinic for a second opinion

You definitely need a new cardiologist just based on symptoms alone and his attitude toward them. Echos are not as accurate as CT angiograms. You need a more complete work up.
You have not said what your cardiologist's experience and expertise is with aneurysms and BAVs. Doctors tend to subspecialize. If this person is a general cardiologist, it is not a good "fit" for you right now.
I echo getting a second opinion at either Mayo or the Cleveland Clinic, if possible. Depending on where you live and the center's relationship to that geographical area, you may need to get a telehealth appointment and have them review your tests. However, they will probably suggest more extensive testing.
There are other academic centers that also do significant numbers of aneurysm surgeries and would be able to guide you. For example: Methodist in Houston; the University of Alabama; the University of Florida at Gainesville; and many others.
Good luck and best wishes. I hope you act quickly. This is not something to "fool with."

Yes, I wouldn’t hesitate for a minute to get a second opinion. Do your diligence and find the best cardiovascular or cardiothoracic surgeon you are comfortable with in your area and who oaks with your insurance provider. If you have recent EMR’s they can review in advance of your consultation. A new provider may order more tests on top of what you already had done.

At the end of the day, both doctors may recommend holding off on treatment. But that’s where you need to be persistent and get all your questions and concerns out on the table for discussion so that you leave with a high degree of satisfaction.

I think you do

You definitely need a new Doctor. My Aneurysm was at 5.2cm, local thoracic surgeons both said I can wait. My cardiologist was the same based on the surgeon's interpretation. I went to Mayo for a 3rd opinion and the Surgeon there told me that the position of the aneurysm was the determining factor because it was close to a coronary artery. if it grew anymore, it could cause a heart attack.
I decided to have the surgery, it was done 3/21/24. I am doing great!! He found that the aneurysm was larger than previously determined. I too worked out vigorously prior, and always felt out of breath. I was a walking time bomb.
His words were that you did the right thing to have elective surgery rather than wait and have something catastrophic happen. Get another opinion and a new cardiologist

Yes, find Someone that will listen to you and Go by Medical guidelines.

The threshold is 5.0 cm.
You should be looking at surgery.......not for a new doctor at this time. It's terrible that we have to push our doctors to do what's right.

See if you can find an aortic center there are many around the country.

Good luck keep us updated.

If you are concerned I would definitely get a 2nd opinion. You know your body better than anyone. Maybe you could go to the Mayo Clinic for a second opinion. They are amazing although it might take awhile to get an appointment.

I just got my latest scan and comments from my local cardio and the specialist, who does this type of operation at the medical center in Houston (who also checks my scans). Both told me surgery is done at 5 cm. I also understand it is considered earlier if the rate of increase in the dilation is high. I realized it is important to get opinions from cardiologists that are very familiar with this condition and its treatment.