Finding the right cardiologist

In my opinion it makes a big difference to have a cardiologist who is an aortic disease specialist, the answers are different, clearer and they understand the right follow up protocol. In my case I found mine as I was referred to him by my surgeon, but I saw the surgeon first because my aneurysm was very large when found and needing repair, I was having surgery for a broken leg and they advised me to see a surgeon.

Remember that the surgeon will see you before and a couple of times after surgery but the cardiologist will follow you up for the rest of your life.

As you say depending on the size of your aneurysm and other factors, if surgery is not imminent, I would see the right cardiologist first. But seeing a surgeon also as you start finding out who you would want to perform the surgery if and when needed is also something to consider.

All the best

To add to the comments of @houston13, It is very important to find a cardiothorasic specialist, with experience. My local cardiologist is good but only sees 2-3 AAA cases a year and did not take my condition very seriously. I contacted a specialist with a lot of experience at a university hospital and got very specific lifestyle guidance to prevent growth. So far it has worked and has being stable for about 3 years. This is also important to have if you need surgery at some point. Apparently AAA surgery is very complex and it is recommended that it is done at a hospital with a lot of resources and experienced cardiothoracic surgeons who have done this kind of procedure a lot. My local hospital cardiology unit does heart surgery but does not have the resources to do AAA repair.

I discovered 2 years that have a 4.2 dilation in my ascending aorta, and a 4.8 aneurysm at the root of the ascending aorta. My advice is to go to a hospital system that does a high volume of aortic aneurysm surgeries. They will have experienced aortic cardiology specialists on staff. And experienced techs who do the imaging. These are not easy to measure because the heart never stops moving and initially I got a measurement at a local hospital that measured the root aneurysm at 4.2. I went to Mayo and they said it is 4.8, I got a virtual second opinion and they confirmed it is 4.8. While, i wish I didn’t have this issue, I feel very fortunate that I have the gift of knowing about it in a non-emergency time frame. In the absence of family history or connective tissue disorders, it is highly likely that you will be monitored to see if it get’s bigger. Both Cleveland Clinic and Mayo have advised me to monitor it until it gets to 5.0 before considering surgery. I have normal blood pressure, and valves. So for me the risk of dissection is very very low at this size. Lower than the low single digit risk inherent in open heart surgeries. I was in a panic initially (for several months!), because mine was discovered in a CT scan I got a month after my brother died of an sudden unexplained heart event (no autopsy..) But now I don’t worry about it much. I follow the cardiologist advice, and am on annual imaging cycle to measure growth. (Mine hasn’t grown from 4.8 in 2 years) Best of luck! You are doing the right thing by being proactive. There are certainly hospitals beyond Mayo and The Cleveland clinic that have expertise in aortic surgery. But it is critical to not settle for a nearby hospital just because it is convenient. Best of luck!!!

Mayo would like you to have a local cardiologist to prescribe Rx, monitor care/tests before and after surgery, etc. I would find one that specializes in aortic diseases and aneurysms. My PCP monitored me for several years, but when I got to 4.9cm, I went to Mayo. I saw a cardiologist and a surgeon there. They told me to get a local cardiologist too. I will be scheduling my surgery for April.