What makes ascending thoracic aortic aneurysms increase in size?

Posted by wonderwoman1121 @wonderwoman1121, Jan 19 7:16pm

I am a 68 year old woman, who considers myself in relatively good shape and health until I was diagnosed with breast cancer 14 months ago. I had a lumpectomy and radiation and now I am on medication which increases cholesterol, causes joint pain, and osteoporosis. In June 2024, I had a CT Scan with contrast due to the cancer and that was fine but I found out I had a 4.1 ascending thoracic aortic aneurysm, which caused me to freak out. My cardiologist had no concern, so I saw a Thoracic Surgeon who said since I’m short, surgery would be needed if it reached 4.5. Typically, they recheck in a year but since I was nervous I just had a CT Scan on 1/17/2025 w/o contrast. I just received the results today, is it really beneficial so see results populating in your portal before you speak to the doctor, not…. anyway… it is now 4.3 so it grew in 7 months. I retired to relieve stress, do Pilates, use my elliptical, increased my BP to 100 mg, I occasionally have a glass of wine or Cosmo at dinner once a week. I don’t have a good feeling about this and I’m trying to be positive but I’m really struggling today.

Are there any statics on how often aneurysms increase in size compared to no change? Are there any statistics on how many people who have surgery survive the surgery but die from complications, or life span after surgery.

I always look for a solution and not one to give up but not being able to fix this is making me crazy.

Also, it seems doctors have a cavalier approach because there really isn’t anything they can do, basically the odds are 50/50…maybe.

Any inspirational hope from anyone?

Interested in more discussions like this? Go to the Aortic Aneurysms Support Group.

@scotty45

A CT scan in May 2024 showed my AAA at 4.6cm. Another scan a few weeks ago, has shown it still at 4.6cm. My surgeon doesn't want to see me for another 2 years. He said he wouldn't do anything until it reached 5.5cm anyway. I am 80 years old, & I was told that I was more likely to die with it, than from it. In a way I guess that's encouraging, as i'm still reasonably active. I walk up to 3kms, 2 or 3 times per week. I go to the gym for an hour, 3 times per week. I'm also an active fly fisher and wildlife photographer. So I am regularly out and about doing something.
What has disturbed me, is that when I asked the surgeon what my limitations should be, re strenuous exercise, weight lifting etc. He said there are no restrictions. I can lift weights & do cardio sessions without any limitations. It won't affect the aneurysm in any way.
This advice seems to be contradictory to anything i've read here. So, i've decided to throw caution to the wind, & keep up with the cardio, but restrict any weight lifting or pulling to a minimum, as I have been doing.
I do need to lose some weight, & the 16/8 diet i'm on, is helping with that. Since beginning, 2 months ago, i've lost 5 kgs. I want to lose another 5kgs, but the weight loss seems to have plateaued, but i'll keep at it.
I live in regional area of Victoria in Australia. The surgeon has to travel over 300kms once a month to see patients here. So it's not like I can make an appointment with another surgeon for a 2nd opinion.

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Depends on the anatomy of the aneurysm, not all aneurysms are the same. Some AAs come with an aortic dissection component that only the doctor/radiologist will be able to know about.

Both come in different shapes and sizes, most AAs come without a AD component; just depends on each individual case. Thickness and size of the artery wall is but one of many dimensions to be considered when assessing "danger" and what activities one would be safe doing.

That is the reason you are seeing conflicting views on this website.

If you are 80 and going strong, and trust your docs - you are your own person and can make rational decisions.

When and if an aortic aneurysm or dissection "goes" you will know it.

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@msturcken

My aneurism as-sending arortic
I have my yearly CT tomorrow. The last one was 4.1. It had grown .1 in one year. My cardiologist is not worried. I am 69 and he said I will probably die from something other than the aneurism .
So I don’t understand the worry about a 4.3. My dr said he doesn’t even call it an aneurism. He calls it a dilation . I hope we all will be okay.

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My aneurism went from 4.1 to 3.9 in my last CT scan!!! It is no longer an aneurysm

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@slarson14

Depends on the anatomy of the aneurysm, not all aneurysms are the same. Some AAs come with an aortic dissection component that only the doctor/radiologist will be able to know about.

Both come in different shapes and sizes, most AAs come without a AD component; just depends on each individual case. Thickness and size of the artery wall is but one of many dimensions to be considered when assessing "danger" and what activities one would be safe doing.

That is the reason you are seeing conflicting views on this website.

If you are 80 and going strong, and trust your docs - you are your own person and can make rational decisions.

When and if an aortic aneurysm or dissection "goes" you will know it.

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My surgeon told me that he doesn't act on a AAA until it reaches the same diameter as the patients spine. Apparently my spine is 5.5cm wide.
I'm sure the diameter of the spine is just a guide for him. I doubt it has any bearing on the actual condition of the aneurysm.

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@scotty45

My surgeon told me that he doesn't act on a AAA until it reaches the same diameter as the patients spine. Apparently my spine is 5.5cm wide.
I'm sure the diameter of the spine is just a guide for him. I doubt it has any bearing on the actual condition of the aneurysm.

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Am sure each doc has his or her method and comfort level and expertise, exactly where the aneurysm is, etc.

Watching and waiting is very common. Hope yours goes well.

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@booklover71

Meanwhile back at the ranch I am concerned however my 4.3 has remained stable. I wear a health alert bracelet which along with TAA also includes the message "No fluoroquinolones" . This med can increase the risk of aortic aneurysm and dissection. Every year my adult daughter and I cruise and enjoy vacation time together. We sailed first with my granddaughter when she was younger and now just the two of us. Planning and cruising keeps my mind on creating more happy memories. After the first blush of nerves the wonderful people on this thread gave me great words of wisdom. I took the advice and now concentrate on enjoying every moment of living. Please try to stay positive.

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Thank you for posting about Fluoroquinolones, I had no idea about the risks of taking it.

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