Two aortic aneurysms

I suffered an aortic dissection in 2015. As far as I know, I only had the single aneurysm, but I had a complete dissection. You don’t want that to happen. It happened emergently for me and I wound up in a coma for about three weeks. You need to meet with your surgeon, take her or his advice, and relax. You’re going to be OK it’s scary, but there is so much they can do for someone like you who knows in advance about this lethal vascular problem. The doctors want to help you and they are not going to recommend surgery unless you need it. I’m not a surgeon so I can’t tell you what you need medically, but I can’t tell you that having survived an aortic dissection, it was by the skin of my teeth and you do not wanna be in that position. So, take a deep breath, get good sleep, and meet with your doctor as soon as possible on July 19. I have survived 9+ years since I had my complete dissection and I can tell you that I would give anything to have known about it in advance. You are much more likely to survive and to thrive if they can get to it before the aneurysm. Once that happens, it is a race against time to try to save your life , you’re gonna be OK. You’re in the hands of good doctors and you are doing what you should be in terms of asking questions. At some point when they recommend surgery you need to simply say yes and let the doctors help you. I know it’s because I’ve been through it, but I’m also thankful for every day I have on this earth and you will be too. Peace.

I'm sorry to hear your news. My brother died last October of a sudden heart event. Unfortunately there was no autopsy performed so we don't know if it was a dissection or some other heart issue. He had no known heart or other health issues at the time. He died immediately. I went in for a heart check up after that, and they have found two aneurysms. Ascending aorta at 4.2, and another at the aortic root is 4.8. I've got some recommendations based on my learnings and the advice I've gotten from the Mayo Clinic. 1) Buy a blood pressure cuff if you don't already have one. (they are less that $100, I like the wireless Omron one which is very portable and helps me keep track on my phone.) Take your blood pressure every morning for a few weeks (three readings back to back each morning) Blood pressure control is the most significant proactive measure you can take) 2) Get a DNA test done if you haven't already. It sounds like you know that it's most likely genetic, but my understanding from my DNA testing results is that some genetic mutations are more dangerous than others. Mayo believes that my aneurysms are genetic in nature, but since I tested negative for the known mutations they are not recommending surgery for me now. Their plan for me right now is here:
"Since hypertension is the #1 population-attributable risk factor for aortic dissection worldwide, it is of utmost importance to maintain normotension. Would recommend maintaining blood pressure at 130/80 mmHg or less. He is presently already at this target.

We discussed exercise recommendations in the presence of aortic disease. It is certainly my recommendation that the patient should remain physically active, but exercise according to the following guidelines:

1. Avoid heavy weightlifting. For patients who have sustained an aortic dissection during heavy weightlifting, average aneurysm size is only 4.3 cm, which indicates the heavy weightlifting can predispose even small aneurysms to dissect. In this case, it is recommended to avoid heavy weightlifting but it would be perfectly acceptable to lift moderate weights with higher repetition counts (12-15), which can be done safely.
2. Avoid any sports with potential for heavy blows to the chest.
3. Avoid extremes of exertion and high-intensity intervals. Aerobic exercise in continuous, moderate effort is safe.
4. Avoid any sports activities with abrupt acceleration or deceleration.

Given evidence from large population based studies indicating increased events of aortic dissection and rupture in the population after fluoroquinolone use, my advice to the patient and care providers is to avoid fluoroquinolone use if possible. In the case of a future bacterial infection, preference should be given to non-fluoroquinolone antibiotics unless it is necessary for a serious or life-threatening indication, or if bacteria is resistant to all other alternatives.
The next follow-up appointment will be in 1 year with transthoracic echocardiogram (TTE) at the time of the appointment."

My understanding of the lifting restrictions is that lifting heavy objects causes a short but significant increase in blood pressure. It is magnified if you hold your breath while lifting which is something all of us tend to do. I've greatly restricted my lifting and I'm very intentional about my breathing when I do it. I do 30 to 45 minutes of aerobic exercise 5x a week and keep my heart rate no higher than 130 ( which is based on my blood pressure reading during my stress test echo, and is still a very good workout for me)
Of course your doctor tomorrow may recommend surgery sooner given your family history. This is certainly not a condition to be complacent about. If you're uncomfortable with your doctor's plan, Cleveland Clinic has an easy virtual path to get a 2nd opinion from them.
Best of luck to you!
Best of luck to you

I know this is scary. I was recently diagnosed and am adjusting to this unexpected diagnosis. I find this group very helpful. I hope you will too. Ask your doctor lots of questions and try to stay calm. If you can. xox

@chrisn61 Thank you for the information. Did your insurance cover the second opinion from CC? I want to do that once I have more scans. I am newly diagnosed, found accidentally via a CT scan. Any help is appreciated. ~S

I haven't gotten a second opinion yet. I just got my my last test results this week, and I'm pondering when to get a second opinion. My Mayo team consists 2 cardiac specialists and their genetic group. I definitely will get a 2nd opinion before surgery, as there are a couple of options given what I have, and I want to make sure my surgeon is very experienced in the specific surgery I may need. Cleveland Clinic has a transparent cost on it and it's about $2,000 depending on what all you include. I don't if insurance will cover it....

I think I have one long aneurysm reaching from my aortic arch to my aortic root, measured 4.5 cm six months ago. My next CT scan is in August. My PCP has not referred me to a surgeon yet but I wish he would. It is a bit nerve wracking. No one in my family has had an aneurysm.

At least yours is being “watched”. I hope you get answers from your surgeon soon.

Asking questions of the medicos is a great idea and I would strongly suggest however that a person writes all of their questions on a piece of paper beforehand and insists upon answers even though the Medico might be in a hurry. I’ve lost count of the times I went away from the consultation bemoaning the fact that I forgot to ask a certain question or three!! And then you have to wait months sweating on what you didn’t find out 😞

Good idea. In fact, that's exactly what I did. What, if I may ask, is your situation?

Sure. I’m an Aussie from down under! 65yo male 210lbs, 6’3”. I was diagnosed in June 24 as having an ascending aneurysm of 4.4cm. Was told it was low to moderate dilation - General Cardio said he would have called me back in 2 years, but as it was my first reading, he wants me back in 12 months to establish a baseline trend of growth rate (if any). My panic mode would have me back in 6 months!! It’s been a depressing episode 🥹 Anyway he upped my bp med - I’m also on a low dose statin and I take a bunch of supplements and my diet is a keto style. Between mid 2021 to current I lost 40 odd lbs to a more normal weight. Also I recently gave up the corporate job and doing Aged Care work which has been less stressful and more rewarding. It’s currently winter here in Melbourne AU so fighting the cold to get my daily walks in ! The best of luck to you and your other half on this odyssey.

I understand your panic. I had a terrible weekend right after I got my diagnosis on a Friday. I inundated my cardiologist with messages over the weekend and was able to get an appointment on the Monday because he'd had a cancellation. I'm ascending at 4.2, which I'm told is moderate. I too try to walk daily but I now hesitate to do heavy work in the garden or lift heavy things. Everyone says that's okay, but I'm too scared to risk it. The weeds are taking over. I'm 78, so I play the age card. It gets you out of a lot of stuff. It's summer here where I am and HOT, which makes walking early in the morning preferable. I wish you good luck as well. Hang in there.