New diagnosis today. Trying to figure what to do..

Posted by mhaney5 @mhaney5, Mar 25 5:44pm

Hello everyone. I could use your help. Today I was diagnosed with a 4.0 aneurism of the aortic root. I read most of the time they don’t do anything till it grows to over 5.0cm. Is that right? What should be my next steps?

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Hey there. So take a deep breath—you’re doing the right thing by asking questions and seeking support.

A 4.0 cm aneurysm of the aortic root is not considered large enough for surgery yet in most cases. You’re right—5.0 to 5.5 cm is the typical surgical threshold for the aortic root or ascending aorta. But the real story is more nuanced.

What happens next depends on a few key things:
• How fast is it growing? If it’s growing more than 0.5 cm per year, that’s a red flag.
• Do you have a connective tissue disorder like Marfan, Loeys-Dietz, or a bicuspid aortic valve? If so, surgeons often act earlier—sometimes at 4.5 cm or even lower.
• What’s your body size? For smaller people, 4.0 cm can already be relatively large when indexed to body surface area.
• Any family history of dissection or sudden death? That can shift the threshold lower.
• Any symptoms? Pain, pressure, or any odd feelings in the chest or back—those matter.

Next steps:
1. Find a cardiologist who understands aortic disease—preferably someone who works closely with a thoracic surgeon.
2. Get a high-resolution CT or MRI scan with contrast, and repeat it every 6–12 months to track changes.
3. Watch your blood pressure like a hawk. Keep it low and steady. Ask your doctor about beta blockers or ARBs—many people with aortic root aneurysms benefit from them.
4. Avoid heavy lifting, straining, and Valsalva maneuvers. Don’t hold your breath during exertion.
5. Stay informed—but not overwhelmed. One step at a time.

You didn’t cause this. But now that you know about it, you have power. Knowledge and surveillance are what keep people safe. Peace.

REPLY
@moonboy

Hey there. So take a deep breath—you’re doing the right thing by asking questions and seeking support.

A 4.0 cm aneurysm of the aortic root is not considered large enough for surgery yet in most cases. You’re right—5.0 to 5.5 cm is the typical surgical threshold for the aortic root or ascending aorta. But the real story is more nuanced.

What happens next depends on a few key things:
• How fast is it growing? If it’s growing more than 0.5 cm per year, that’s a red flag.
• Do you have a connective tissue disorder like Marfan, Loeys-Dietz, or a bicuspid aortic valve? If so, surgeons often act earlier—sometimes at 4.5 cm or even lower.
• What’s your body size? For smaller people, 4.0 cm can already be relatively large when indexed to body surface area.
• Any family history of dissection or sudden death? That can shift the threshold lower.
• Any symptoms? Pain, pressure, or any odd feelings in the chest or back—those matter.

Next steps:
1. Find a cardiologist who understands aortic disease—preferably someone who works closely with a thoracic surgeon.
2. Get a high-resolution CT or MRI scan with contrast, and repeat it every 6–12 months to track changes.
3. Watch your blood pressure like a hawk. Keep it low and steady. Ask your doctor about beta blockers or ARBs—many people with aortic root aneurysms benefit from them.
4. Avoid heavy lifting, straining, and Valsalva maneuvers. Don’t hold your breath during exertion.
5. Stay informed—but not overwhelmed. One step at a time.

You didn’t cause this. But now that you know about it, you have power. Knowledge and surveillance are what keep people safe. Peace.

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Thank you for your reply! I really appreciate it! Does it make things any different if I am also having episodes of Afib and Tachycardia occasionally? Can that be related?

Thanks,
Matthew

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As for your atrial fibrillation and tachycardia: yeah, those could certainly be related. A dilated aortic root can affect the geometry of your heart, especially the left atrium, and that might contribute to rhythm issues. Or it could be the other way around—rhythm disturbances may be stressing your cardiovascular system and unmasking or aggravating the aneurysm. Either way, both issues need coordinated management.

If you haven’t done this already, ask your cardiologist whether a cardiac MRI or CT with contrast is planned. Those are more precise than echocardiogram alone for measuring the aortic root. And make sure someone is tracking the diameter over time. Annual imaging is often appropriate at this stage.

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@mhaney5

Thank you for your reply! I really appreciate it! Does it make things any different if I am also having episodes of Afib and Tachycardia occasionally? Can that be related?

Thanks,
Matthew

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The only thing I would add to moonboy’s post is to take care of your body, if you smoke stop, exercise (keeping in mind the restrictions he listed), it is important to keep your body as healthy as possible, exercise also helps the mind to manage anxiety and stress. At 4.0 you may never get to the point of needing surgery but if you ever do, having taken care of your body will pay dividends. I had my repair at 5.2cm 5 years ago and being in good shape helped me recover quickly.

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@moonboy

Hey there. So take a deep breath—you’re doing the right thing by asking questions and seeking support.

A 4.0 cm aneurysm of the aortic root is not considered large enough for surgery yet in most cases. You’re right—5.0 to 5.5 cm is the typical surgical threshold for the aortic root or ascending aorta. But the real story is more nuanced.

What happens next depends on a few key things:
• How fast is it growing? If it’s growing more than 0.5 cm per year, that’s a red flag.
• Do you have a connective tissue disorder like Marfan, Loeys-Dietz, or a bicuspid aortic valve? If so, surgeons often act earlier—sometimes at 4.5 cm or even lower.
• What’s your body size? For smaller people, 4.0 cm can already be relatively large when indexed to body surface area.
• Any family history of dissection or sudden death? That can shift the threshold lower.
• Any symptoms? Pain, pressure, or any odd feelings in the chest or back—those matter.

Next steps:
1. Find a cardiologist who understands aortic disease—preferably someone who works closely with a thoracic surgeon.
2. Get a high-resolution CT or MRI scan with contrast, and repeat it every 6–12 months to track changes.
3. Watch your blood pressure like a hawk. Keep it low and steady. Ask your doctor about beta blockers or ARBs—many people with aortic root aneurysms benefit from them.
4. Avoid heavy lifting, straining, and Valsalva maneuvers. Don’t hold your breath during exertion.
5. Stay informed—but not overwhelmed. One step at a time.

You didn’t cause this. But now that you know about it, you have power. Knowledge and surveillance are what keep people safe. Peace.

Jump to this post

Ty for your informative comments.
I had another question for you about post surgery medications 💊
What do you need to take afterwards- blood thinners or beta blockers
Temporarily or forever.
A question I failed to ask my last visit .

REPLY

I take 1-atorvastatin, 2-carvedilol, 4-amlodipine, 1-aspirin, 1-multivitamin. Forever. I set my pills up every six months little compartmented containers. It’s easy peasy. Cholesterol, heart rate, blood pressure. I take one round in the morning and one round in the evening. Easiest thing in the world. I do not have an artificial valve or a porcine valve so I don’t need to take any anti-rejection drugs. I should mention I had some pretty serious problems with the Met Forman when they were trying to I guess control my blood sugar. I would be leery of that medication unless you’ve had some experience with it and affect you.

REPLY
@moonboy

Hey there. So take a deep breath—you’re doing the right thing by asking questions and seeking support.

A 4.0 cm aneurysm of the aortic root is not considered large enough for surgery yet in most cases. You’re right—5.0 to 5.5 cm is the typical surgical threshold for the aortic root or ascending aorta. But the real story is more nuanced.

What happens next depends on a few key things:
• How fast is it growing? If it’s growing more than 0.5 cm per year, that’s a red flag.
• Do you have a connective tissue disorder like Marfan, Loeys-Dietz, or a bicuspid aortic valve? If so, surgeons often act earlier—sometimes at 4.5 cm or even lower.
• What’s your body size? For smaller people, 4.0 cm can already be relatively large when indexed to body surface area.
• Any family history of dissection or sudden death? That can shift the threshold lower.
• Any symptoms? Pain, pressure, or any odd feelings in the chest or back—those matter.

Next steps:
1. Find a cardiologist who understands aortic disease—preferably someone who works closely with a thoracic surgeon.
2. Get a high-resolution CT or MRI scan with contrast, and repeat it every 6–12 months to track changes.
3. Watch your blood pressure like a hawk. Keep it low and steady. Ask your doctor about beta blockers or ARBs—many people with aortic root aneurysms benefit from them.
4. Avoid heavy lifting, straining, and Valsalva maneuvers. Don’t hold your breath during exertion.
5. Stay informed—but not overwhelmed. One step at a time.

You didn’t cause this. But now that you know about it, you have power. Knowledge and surveillance are what keep people safe. Peace.

Jump to this post

Keep sharing your experiences and knowledge!
It makes a difference!

REPLY
@dianelynn

Ty for your informative comments.
I had another question for you about post surgery medications 💊
What do you need to take afterwards- blood thinners or beta blockers
Temporarily or forever.
A question I failed to ask my last visit .

Jump to this post

If you had stents with your proceddure make sure you tak a blood thinner A renal stent clogged in year three after my surgery and I lost a kidney

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@larrycouture

If you had stents with your proceddure make sure you tak a blood thinner A renal stent clogged in year three after my surgery and I lost a kidney

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Oh so sorry to hear that, @larrycouture
If you don't mind sharing, where there any warning signs? How did you know there was an issue?
I had a full dissection, and while they cleaned up the aneurysm and ascending aortic dissection, they left the descending dissection. I have an intrusion into the left kidney off the false lumen, and I was told that it may become a problem - but didn't tell me what to look for except "you might feel some pain".
I also have the dissection into the innominate artery. Not sure what to look for there.

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