Aneurysm grew 4.1 to 4.7 in one year - which questions should I ask?

@dlc1953 Mine was a 3.9 3 years ago and my cardiologist said he probably would never have to do anything about it. They are slowing growing but then the next yr it was 4.1 then 4.4 then boom 4.7 so I was referred to a surgeon. Will see him next week. Thank you for the info

@chrisn61I'm seeing a good surgeon. I'm willing to take my chances with him. People die in every hospital. So I'm satisfied. Thank you for your response

@scottbliz A lot more die in my local hospital than Mayo by a lot.

@rlhix and not all aneuysms dissect or rupture

@scottbliz My husband was recently diagnosed with 4.6cm ascending aorta aneurysm and just last week consulted with cardiologist. My husband has no family history of aneurysms, normal BP and calcium CT score a year ago was zero so no worry about cholesterol. Given all the positive aspects of my husband's health the cardiologist wasn't concerned about his 4.6cm scan. He was very reassuring about my husband's case and said typically these types of aneurysms grow slowly ... a rescan w/ contrast in 1 year was advised. With your family history you are likely in a higher risk category therefore a different protocol might be in order. Nonetheless, the one thing the cardiologist stessed to my husband is to be very careful of lifting heavy weights/objects and activities that require "straining" ie. holding your breath and then lifting ... think body builder techniques used for lifting. The cardiologist actually said they see a higher number of ascending aorta aneurysms in body builders and weight lifters.

Below, I've listed the talking points we were prepared to discuss with the cardiologist during my husband's initial visit. I hope in some small way these talking points can help guide you.

1. Imaging Follow-Up
- Repeat CTA or echocardiogram every 6–12 months (confirm exact interval).
- Use the same imaging center/protocol if possible for consistent measurements. Ask if echocardiography can substitute for CTA/MRA between detailed scans.
- Frequency of follow-up CT scans? Longterm affects of CT w/ contrast on kidney function?

2. Blood Pressure Goals
- Target: below 120/80 mm Hg.
- Discuss whether a beta blocker or ARB (e.g., losartan) is appropriate or necessary
- Monitor blood pressure at home once or twice daily at rest.

3. Lifestyle & Activity
- Avoid heavy lifting, straining, and high-intensity contact sports.
- Continue moderate aerobic activity (walking, swimming, cycling)
- Ask for safe lifting limits and guidance for playing sports eg. pickleball, hiking etc.
- Ask about acceptable exercises - dumbbells, pushups, planks, squats, yard work, mowing, mulching, topsoil, raking leaves, snow shoveling etc.
- Sleeping habits - snoring, mouth breathing, chest/head elevation on adjustable bed - do these sleeping habits affect aneurysm growth?

4. Risk-Factor Management
- Maintain healthy cholesterol and inflammation control
- Ask if statins or other medications are recommended even with normal cholesterol.
- Follow a heart-healthy diet rich in vegetables, fruits, and lean proteins, low sodium, sugar etc.
- Ask about coffee, alcohol?

5. When Surgery Might Be Needed
- Typical threshold: 5.0–5.5 cm, or earlier with certain risk factors (bicuspid valve, rapid growth, family history).
- Ask your doctor about your personalized surgical threshold considering: age, family history, height/weight, overall health and fitness level
- Ask about genetic testing - if there is a family history of aneurysms (not just aorta aneurysms but anywhere in the body)
- Consider a baseline consultation with a cardiovascular surgeon specializing in aortic aneurysm?

6. Red-Flag Symptoms
- Seek emergency care for sudden severe chest, back, or upper abdominal pain (especially tearing).
- Watch for fainting, shortness of breath, or new hoarseness.
- Call 911 immediately if any of these occur
- Consider a personal medical alert ID such as a bracelet or necklace to alert others in case of emergency situation.

Everything you say is excellent. Very good points and i agree with all of them. I will say this, though, the single most important thing for you is for you to know that an aortic dissection generally feels like someone is tearing the skin off your back. The pain is excruciating and disorienting. If you start to feel that, the only thing to do is call 911. I survived a complete aortic dissection in 2015 in San Diego. The hotel I was staying at was kind enough to call 911 for me because I did not have the common sense to be able to get an outside line from my hotel room when it happened. Courtyard by Marriott old town San Diego gets all the credit for saving my life. So I just picked up the phone and dialed zero instead. I always think it is worthwhile to remember that the best advice you can get about aortic dissection comes from somebody who survived one. I’ve only connected with a few people who have gotten through to the other side and I think it’s imperative that you connect with a good thoracic surgeon and monitor your Aneurysm.

I get a CT scan with contrast at the same imaging center at the University of Minnesota once a year. Every other year, they use contrast in order to reduce the damage of the contrast to my kidneys. There is life after an aortic dissection – – if you survive it. The key is to survive it by reducing the risk and monitoring it. I had absolutely no idea that I had a problem until it was an overwhelming crisis. To put it in perspective, from the time I started to feel the tearing inside my chest, I was cracked open 42 minutes later for the start of my three week open heart surgery odyssey. This is nothing you want to mess with.

That said, become best friends with the oldest thoracic surgeon in your major metropolitan area and you and I will be talking 10 years from now. I was right back in old town San Diego on Friday where that dissection took place. I kiss the ground every day. Peace.

@scottbliz My husband was recently diagnosed with 4.6cm ascending aorta aneurysm and just last week consulted with cardiologist. My husband has no family history of aneurysms, normal BP and calcium CT score a year ago was zero so no worry about cholesterol. Given all the positive aspects of my husband's health the cardiologist wasn't concerned about his 4.6cm scan. He was very reassuring about my husband's case and said typically these types of aneurysms grow slowly ... a rescan w/ contrast in 1 year was advised. With your family history you are likely in a higher risk category therefore a different protocol might be in order. Nonetheless, the one thing the cardiologist stessed to my husband is to be very careful of lifting heavy weights/objects and activities that require "straining" ie. holding your breath and then lifting ... think body builder techniques used for lifting. The cardiologist actually said they see a higher number of ascending aorta aneurysms in body builders and weight lifters.

Below, I've listed the talking points we were prepared to discuss with the cardiologist during my husband's initial visit. I hope in some small way these talking points can help guide you.

1. Imaging Follow-Up
- Repeat CTA or echocardiogram every 6–12 months (confirm exact interval).
- Use the same imaging center/protocol if possible for consistent measurements. Ask if echocardiography can substitute for CTA/MRA between detailed scans.
- Frequency of follow-up CT scans? Longterm affects of CT w/ contrast on kidney function?

2. Blood Pressure Goals
- Target: below 120/80 mm Hg.
- Discuss whether a beta blocker or ARB (e.g., losartan) is appropriate or necessary
- Monitor blood pressure at home once or twice daily at rest.

3. Lifestyle & Activity
- Avoid heavy lifting, straining, and high-intensity contact sports.
- Continue moderate aerobic activity (walking, swimming, cycling)
- Ask for safe lifting limits and guidance for playing sports eg. pickleball, hiking etc.
- Ask about acceptable exercises - dumbbells, pushups, planks, squats, yard work, mowing, mulching, topsoil, raking leaves, snow shoveling etc.
- Sleeping habits - snoring, mouth breathing, chest/head elevation on adjustable bed - do these sleeping habits affect aneurysm growth?

4. Risk-Factor Management
- Maintain healthy cholesterol and inflammation control
- Ask if statins or other medications are recommended even with normal cholesterol.
- Follow a heart-healthy diet rich in vegetables, fruits, and lean proteins, low sodium, sugar etc.
- Ask about coffee, alcohol?

5. When Surgery Might Be Needed
- Typical threshold: 5.0–5.5 cm, or earlier with certain risk factors (bicuspid valve, rapid growth, family history).
- Ask your doctor about your personalized surgical threshold considering: age, family history, height/weight, overall health and fitness level
- Ask about genetic testing - if there is a family history of aneurysms (not just aorta aneurysms but anywhere in the body)
- Consider a baseline consultation with a cardiovascular surgeon specializing in aortic aneurysm?

6. Red-Flag Symptoms
- Seek emergency care for sudden severe chest, back, or upper abdominal pain (especially tearing).
- Watch for fainting, shortness of breath, or new hoarseness.
- Call 911 immediately if any of these occur
- Consider a personal medical alert ID such as a bracelet or necklace to alert others in case of emergency situation.

@dew88
That’s what I’m wondering.. We’re these both CT’s with contrast? We’re they read by the same radiologist? I thought mine had grown 4 mm in 6 months and it was a gated CT.
Turns out it was measured wrong and lucky me, it was still 4.5 cm!