Echo shows 4.1cm aortic root dilation- is it an aneurysm?

Hey there. I'm a survivor of a complete Type A ascending aortic arch dissection. You're going to be fine. Just stay on top of your cardiologist and get a second opinion from a thoracic surgeon who has done lots of aortic repairs. Look for someone with gray hair. Depending on the current size of the aneurysm, they may just watch and wait. Otherwise, if they recommend surgery do it. You won't get the chance to do it is you have a complete dissection. I dissected suddenly at 50 years old. I barely survived and it was a real personal, medical, and professional disaster. If I knew in advance what was coming I would have done the surgery 100 times out of 100. For you: Just relax. No smoking, drinking, heavy lifting or running for now until you know where you're at. I am 9 years post-surgery and I am thankful for every day I have had since June 28, 2015. You're in good hands, but make sure you push your doctors to get appointments and stay in the city--don't get on any long-haul flights or go to the Boundary Waters right now. Stay within 30 minutes of Mayo or a Mayo-like facility where you live. An aortic dissection is incredibly painful and feels like someone is peeling the skin off of your back. It's sudden and you cannot wait to call 911. In short, relax. You'll be fine, but don't wait to get in ot the doc and don't hesitate to call an ambulance if you feel chest pain/back pain. And, tell you spouse today. He/She needs to know so that they can prepare. It's super stressful, but better that they're looped in before anything happens. Peace.

With family history and that dilatation (though small), it would be prudent to get a second opinion (and maybe even a third) opinion) at an academic center that has an aortic disease program and which does a high volume of aortic aneurysm repairs.
Often these centers also have heart transplant programs. Remember that descending and ascending aortic aneurysms require different surgical skill sets and use different methods of repair. Make certain you see an expert experienced surgeon.
Getting advice from a community cardiologist is not a wise avenue.

Hi, being a person with Marfan Syndrome, I had The Unfortunate experience of having my aorta dissect. My daughter Had a 5 cm dialation of Her aorta, Underwent life saving surgery to prevent dissection.

I Think you need to see a cardiothoracic surgeon.
Just for a second opinion.
I believe a Dialation of that size needs to be looked at.

Good luck

I was 68 when my aneurism was found (by accident). I was told it was a 4cm. Like you, I was for, active, no prior health issues, and the cardiologist said once a year checks. While waiting for an appointment I had an emergency aortic dissection and life flighted to Mayo (I live 2 hours away). I was repaired in 3 places, a 4.5cm at the time of surgery. I had the area at the base of the heart and where the arorta join repaired. They told me my valve was not involved and that was good news. Find a cardiovascular MD and a medical center that specializes in this surgery/care. Don’t panic. Keep your BP low, don’t lift anything that would cause you to hold your breath, grunt, groan, etc. be persistent and do your homework now so you have someone you trust to handle your condition. Best wishes.

Many thanks to everyone whose replied! I wrote to my new cardiologist the other day, and much to his credit he quickly replied with the following response. Of note, I asked him if I have an actual diagnosis of aneurysm, and what if any restrictions I have.
"There is only a slight dilation of the aortic root. It's not an aneurysm.
- There are therefore no major restrictions on physical exercise, but it is advised that you do not engage in sports associated with static/isometric exercises such as weightlifting or intense training with weight machines in the gym. In terms of lifting loads, I advise, as a general rule, to avoid carrying heavy loads (we can use 10-20 Kg [5 to 10 kg on each arm] as a reference)...
- I only recommend repeating the echocardiogram after 6 month to one-year. If there is growth, there will be an indication for CT or MRI, but not yet. It is still a very mild dilation and we expect it will stay that way for a long period (as long as the blood pressures are kept well controlled)."
I should mention, that I no longer live in the US, but in a southern European country where English is not the first language. I sought out this particular cardiologist due to the fact he is a professor of medicine and is regarded as being prominent in the field. I'm only speculating here, but because this is Southern Europe, I'm guessing the culture here in medicine is rather paternalistic, and not what I'm used to in my many years of nursing in the US. That said, he's a lovely, affable and engaging gentleman. I am however somewhat surprised he did not review these precautions with me at the time of my visit, although he was not at all rushed and asked several times if I had any questions. As it was nearly 7:00 p.m. as we were concluding, I was rather hungry, and somewhat dehydrated from the vigorous activity on the stress treadmill machine. My question to this very kind and learned group is: should I seek a second/third opinion from another cardiologist, a cardio -thoracic surgeon, or both? With many thanks and kind regards to all !

I have a high CAC score and an aortic aneurysm. The aneurysm was found in the CAC scan. I’ve spoken with two different doctors about each condition. Here’s my take … unless you have a family history of aortic dissection, your doctor’s assessment is consistent with everything I have been told or read. The doctors I have seen also seemed to me to have a somewhat casual reaction to my aneurysm. One was at Mayo and one was Mayo-trained. Did your doctor check for a bicuspid valve (probably since you say you had an echocardiogram)? Did he ask about your family history? These are usual items for follow-up.

I see a cardio thoracic surgeon for monitoring of the aneurysm. Again for my 2 cents, I believe a general cardiologist may not have the expertise a surgeon does in this area. So I see a cardiologist for the CAC and a cardio thoracic surgeon for the aneurysm.

It sounds like you want another opinion, If it’s going to worry you, just do it. Your peace of mind is important. I got two opinions and I still wonder and worry if it is being handled appropriately (by both me and the doctors). It’s been a year and I am getting more comfortable as time goes on.

Hope this helps. I always feel a little weird giving an opinion on something like this. Keep in mind I am just some schlub on the Internet. But now you can add my experience to the others you are getting.

Hi I'm 51 years old found out 2 years ago I had an aortic root aneurysm measured up to 5.0 and now there saying it's 5.1 two years later...they watch it closely but I'm scared every day and my heart doctor says I'm high risk bc I have congestive heart failure I know it's stable but I'm still scared it will dissect ...I've seen a thoracic surgeon at Jefferson in philly Dr Szeto he's. Suppose to be the best but he says my heart is too weak ...what am I suppose to do

Watch your blood pressure, lose weight, no lifting weights, and get a second opinion at Mayo or Cleveland clinic.

Thank you! Fortunately I've been " thin" my whole life, still at my college weight of 150lbs, and I've normal blood pressure/no hypertension. Unfortunately, obtaining a 2nd opinion at either Mayo or CC not feasible as I'm an expat living abroad.