Ascending Aorta 3.5 cm

Posted by tommot @tommot, May 5 1:50pm

A recent CT (with and without contrast) for something else revealed a finding of an “Ascending aortic ectasia 3.5 cm, somewhat prominent compared to the descending aorta and body habitus..”
The Dr. who ordered the scan, referred me back to my Primary Care Physician for follow up on this finding as it was unrelated and out of his scope of practice. After following up with my primary care physician, he said he researched and conferred with another Dr. and they recommend waiting 2 years for another scan. No referral to a Cardiologist at this time.
After reading about the ascending aorta and possible related issues, I am still concerned. I want to trust my PCP, he has been my physician for quite a number of years and knows my history, but should I request further tests or a referral to a cardiologist? Just FYI, I am a 62 yr old female. Currently I take meds for high blood pressure and high cholesterol. Both are under control at this time.
Thank you in advance for your comments.

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@moonboy

To answer you as plainly as possible: YES, in most cases, annual imaging—usually a CT angiogram or MRI—is considered necessary after aortic graft surgery, especially in the first few years post-op. The goal is to monitor for complications such as aneurysm formation downstream from the graft, progression of a dissection flap if you had one, or changes in the native aorta that might require further intervention. Over time, and depending on how stable things look, your care team may stretch out the intervals. But surveillance is for life. I get mine annual and every three years with contrast dye. The contrast helps visualize things but its hard on your kidneys. The where it was explained to me is that your kidneys are a little bit like a donor cartridge. They don't last forever and every time you inject contrast, it reduces their functionality. All of that contrast overtime can add up and cause more problems than it solves. My thoracic surgeon was very adamant with me about getting annual CT scans.

It's not about paranoia—it's about prevention. These scans catch changes before they become emergencies. I get mine regularly, and while I don’t love the radiation, I love knowing that I’m still ahead of the curve. It gives me peace of mind and lets me focus on living. I had emergency open-heart surgery almost 10 years ago for a Type A aortic dissection. They put in a Dacron graft to replace the ascending aorta and part of the arch. Since then, I've lived with that graft in my chest, and like you, I’ve asked a lot of the same questions. Peace.

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moonboy: Thank you for taking the time to provide great advice. My 1st aneurysm "'look'' was an echocardiogram which being noninvasive was good. My doc wanted a 2nd one in 6 months and when I presented myself at the hospital I was asked if I was allergic to iodine. No other explanation or if my doc had ordered the change. Then processed through a CT Scan with contrast which left me feeling dragged out for two days. I am still not sure is my doctor ordered the change from the echocardiogram or if the hospital just decided that the CT scan was in order on their own. I was not ware of the kidneys problem but will be more inquisitive next time.

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@dew88

@gjms I am surprised that your doctor has not prescribed a statin for cholesterol and an ace inhibitor for blood pressure which are the two meds usually given to seniors as a precaution. But you are passed the precaution stage. The other thing you might consider is an exercise regimen which along with the two types of meds is what I am on. I was just diagnosed with a dual aneurysm 4.2 & 4.5cm root & ascending. But at 88 I have been going to the gym 3 days a week and still doing what i have done since I was your age. It is scary but we can be pro-active and hope for the best outcomes. Good Luck with yours.

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Thank you!

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Perhaps, this will be helpful: I always ask for MRIs instead of CT scans to avoid the radiation. And statins are considered questionable especially for those over 75 years old because a side effect is muscle breakdown. Our heart is a muscle, so it is an individual decision for all of us. Check with your cardiologist on these thoughts to see what is best for you.

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At 3.5 is is just a slight dilation. I agree with you pcp. There is nothing to worry about 3.5 is in the normal ranges

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My husband just had a CT scan that showed an ascending 4 cm aortic aneurysm. Doctor suggests a follow-up scan in one year. He's 69 and hasn't had heart issues other than taking medication for high blood pressure and a statin. However, he has a strong family heart history where numerous members have passed from heart illness, many at younger ages. Both parents, grandparents on both sides, a younger brother, and numerous aunts and uncles have all died due to heart issues. Our concern is whether monitoring should be sooner than one year considering we don't know how long he has had this, or if it might have happened recently and could rapidly get larger. Suggestions or insights would be appreciated - thank you.

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