Enlarged aortic root with a family history

Yes, demand a CT scan. I hope you get good news but stay on top of this. (I'm a retired English professor and I know what I'm talking about. Ha.)

Thank you! I will request a CT scan.
You sound like you know what you're talking about 😉

When you see the Cardiologist, they will order a CT angiogram. Pretty standard treatment to do yearly to monitor your aorta. You said that you were already on cholesterol and BP meds. They are usually ordered with an aortic aneurysm. I was diagnosed in September with a 4.2 cm dilation of my aortic arch and ascending aorta and started on low dose Crestor. My next cardiology appointment is April 1 and I'm going to ask about BP meds, as many in this group were prescribed them.
The initial diagnosis is pretty frightening and especially so for you, as of what your brother has gone through. They may want you to do genetic testing.
The changes I have to make in my life are no NSAIDs, no fluoroquinolone antibiotics, no lifting more than 25 pounds, try to reduce my stress, monitor my BP. I'm not overweight and I've always eaten healthy, so no changes there. They will probably reduce your caffeine.
I'm glad I have the diagnosis, so I can make the changes I need to. The research I've done says that they usually grow slowly. I'm 70, so I hope they are right and I never have to have surgery. If I do, I hope it's after they have developed an easier way.
My advice to you is to read the comments on this blog, do some research and write down all.your questions to bring to your cardiologist. I am more at peace with my diagnosis as time goes on. This blog is helpful for information and support.
Sending prayers and well wishes.♥️

The 3.8 is less than my first "encounter" with this - it was something in the 4.25 range which my cardiologist thought didn't warrant anything past "observation" and a yearly scan. It wasn't until it went over 4.5 that he referred me to a surgeon/cariologist and he didn't think we should do anything at 4.9 x 5.1. In one year it grew to 5.1 x 5.7 and THEN he said to do something.

Thank you for sharing your post. I survived a complete Type A-1 ascending aortic dissection at age 50. I am now 60. Get the CT with Contrast at the best imaging center you can find. It’s understandable that you have concerns given your recent echocardiogram results and your family history of aortic dissection. A few points you might want to discuss with your cardiologist:

Imaging for Precision: While echocardiograms are useful, a CT scan or MRI with contrast often provides more accurate measurements of the aorta. Given your family history and the size noted, it’s worth asking if additional imaging would be helpful.

Family History Considerations: A history of aortic dissection in a close family member may suggest an increased risk, even if your current measurements are within a relatively safe range. You could also discuss whether genetic testing for conditions like Marfan syndrome, Loeys-Dietz syndrome, or other connective tissue disorders might be appropriate. UT Houston's John Ritter Aortic Research Program does free genetic testing for this. Join it to help yourself an others. All you have to do is spit into test tube and mail it back to them.

Lifestyle and Activity: If the cardiologist advises limiting physical activity or caffeine intake, they can provide specific guidelines tailored to your situation. While adjustments can be challenging, clear advice from your doctor will make it easier to plan appropriately.

Regular Monitoring: Ask about the recommended frequency for follow-up imaging. Staying on top of any changes in the aortic root size can help reduce long-term risks.

Your concerns are valid, and it’s great that you’re already taking steps to manage blood pressure and cholesterol. These are significant factors in protecting your aorta over time. If you have other questions for the group or need additional perspectives after speaking with your cardiologist, feel free to reach out. Peace.

I just want to add this: Knowing that you have an enlarged aorta means you can proactively do somethings to prevent it from either getting larger or dissecting entirely. An aortic dissection is an unpredictable, high-stakes medical event. Recognizing symptoms (sudden severe chest or back pain, difficulty breathing, fainting, or symptoms of stroke) and getting to a hospital immediately is critical. With timely intervention, many people can survive and manage their condition successfully.

Here is a refresher of the Ritter Rules for all of us:

URGENCY: Thoracic aortic dissection is a medical emergency. The death rate increases 1%
every hour the diagnosis and surgical repair are delayed.
PAIN: Severe pain is the #1 symptom. Seek immediate emergency medical care for a
sudden onset of severe pain in the chest, stomach, back or neck. The pain is likely to be
sharp, tearing, ripping, moving or so unlike any pain you have ever had that you feel
something is very wrong.
MISDIAGNOSIS: Aortic dissection can mimic heart attack. Heart attacks are far more
common than aortic dissection. But if a heart attack or other important diagnosis is not
clearly and quickly established, then aortic dissection should be quickly considered and
ruled out, particularly if a patient has a family history or features of a genetic syndrome
that predisposes the patient to an aortic aneurysm or dissection.
IMAGING: Get the right scan to rule out aortic dissection. Only three types of imaging studies
can identify aortic aneurysms and dissections: CT, MRI and transesophageal
echocardiogram. A chest X-ray or EKG cannot rule out aortic dissection.
RISK FACTOR: Aortic dissections are often preceded by an enlargement of the first part of
the aorta where it comes out of the heart, called an aortic aneurysm. If you have an
aneurysm, you are at increased risk for an aortic dissection.
RISK FACTOR: A personal or family history of thoracic disease puts you at risk. If you or a
family member is living with an aneurysm or if you have a family member who has had an
aortic dissection, you are at an increased risk for thoracic aortic dissection. You and your
other family members should be evaluated to determine if a predisposition for aortic
aneurysm and dissection is running in the family.
RISK FACTOR: Certain genetic syndromes put you at risk. These genetic syndromes greatly
increase your risk for thoracic aortic disease and a potentially fatal aortic dissection: Marfan
syndrome, Loeys-Dietz syndrome, Turner syndrome and Vascular Ehlers-Danlos syndrome.
RISK FACTOR: Bicuspid aortic valve disease puts you at risk. If you have a bicuspid aortic
valve (two leaflets instead of the typical three), or have had a bicuspid aortic valve replaced,
you need to be monitored for thoracic aortic disease.
TRIGGERS: Lifestyle and trauma can trigger aortic dissection. It is possible to trigger an aortic
dissection through injury to the chest, extreme straining associated with body building, illicit
drug use, poorly controlled high blood pressure or by discontinuing necessary blood
pressure medications. Rarely, pregnancy can trigger an aortic dissection. However, women
with aortic aneurysms and connective tissue disorders who are pregnant are at higher risk
of aortic dissection during late pregnancy and delivery and should be carefully monitored by
a cardiovascular specialist.
PREVENTION: Medical management is essential to preventing aortic dissection. If you have
thoracic aortic disease, medical management that includes optimal blood pressure control,
aortic imaging and genetic counseling is strongly recommended. Talk with your provider.

Credit: JohnRitterFoundation.org

Thank you, for sharing! I'm glad you mentioned the lifestyle changes you are making. I had not thought about avoiding NSAIDs.
I take them occasionally because I have a lot of joint issues. I have other pain meds which I will try to stick to, as needed.
Best wishes to you, also!❤️

Thank you, for responding, and for the information! I have a lot to think about.
I made an appointment w this new cardiologist because I knew I had a small dilation and I was concerned about the meds I was prescribed.
My primary doctor prescribed stimulants because I was struggling w pretty severe fatigue. Every time I saw him and expressed distress over the fatigue, he would grill me about the stimulant. He chastised me several times, but I just didn't feel comfortable taking them, (although, they did help.)
When I shared this w my new cardiologist, he didn't comment one way or the other.
Maybe he will after he considers all of my results.
I'm currently wearing a 2 week Holter monitor.
I have an appointment scheduled w him for next December. I hope he gives me guidance sooner than that.

Again, thank you, so much!
I'm glad you are doing so well, and are willing to share.
I'm going to double back and see if you mentioned having your valve replaced when you had the dissection...

No valve replacement. They salvaged my tricuspid valve after repair and gave me a 30cm (13 in.) aortic graft 32mm diameter.

Thank you, for responding.
If you don't mind me clarifying, you had surgery at that point?