I also live in the mitten state and I was diagnosed with a thoracic ascending aortic aneurysm in May 2023 of initially 4.2 but with additional diagnostic testing it was determined to be 3.8.

The discrepancy was because the first measurement was done with a non gated CT. You must insist you have a gated CT with contrast. When the CT is gated the imaging works with the electrical activity of the heart to capture images that are not blurred by the motion. You will not feel any difference during the actual test but the images with the gated CT will be easier for the radiologist to read and very often the measurements with a gated CT are lower.

Additionally, I have obtained second opinions from both Cleveland Clinic and Mayo Clinic. I was seen in person for both of these evaluations but I do know they offer virtual second opinions if you are not up for the traveling. The downside is you may have to pay out of pocket but they offer detailed review of your records and the option for a zoom call with a specialist.

I was seen by Dr. Kim Eagle the Director of Cardiology at U of M but ultimately decided to have surveillance care at Mayo Clinic but again I am at 3.8.

Finally, you question the reason for the development of the condition. This is completely normal but you did the right thing but seeking education on your condition. The knowledge will calm the anxiety and help you focus on the present and the actions that need to be taken. One thing I have found based on my research is that people who have elevated Lp(a) a genetic condition and some history of hypertension even mild tend to develop more thoracic ascending aneurysms. It has to do with how the Lp(a) forms plaque and how it attacks the interior lining of the vessels. Lp(a) is an independent risk factor and is something your surgeons should be aware of based on your aneurysm diagnosis. A simple blood test can reveal this result.