I have a 4.8 cm ascending aorta aneurysm

I recently had a heart cath that measured mine at 4.3. My cardiologist is sending me to another heart doctor for a second opinion. Because at my age, 75, he thinks I need my aortic valve replaced sooner than later on in life. My aortic is regurigating, back across the inlet valve which does not have any damage but he says it could eventually cause damage. There is no stenosis. Has anyone had aoritc valve replacement?

I will say you need to pace yourself and mitigate risk. That is different for everyone. The important part is to minimize the risk of dissection but I also had to get affairs in order just in case too.

What that looked like for me as I was waiting for my surgery once it was big enough was monitoring my heart rate when biking to keep it below 120 and no fast spikes, no heavy weight lifting above 20 lbs, lots of walking, etc. Got my estate in order just incase something happened. Changed my diet. Talk to a therapist.

But if none of this rings true for you, it is understand what your risk is and how to mitigate it to your needs and feelings. I had a large morning of the lost of my athletic ability and now 4 months after my surgery I am trying to rebuilt that.

So what are you most worried about while waiting and seeing the AAA?

@pittsburghdad Thanks for all the support on this site. You're right, the month after my diagnosis was tough. The "why me", the fear of dissction and depression wouldn't seem to go away. Time passed and it become a fact of life, and I am more comfortable with it now (although I do have my moments). I plan to obtain a second opinion with the Stanford Aortic Disease Center just for clarification on a few things-my cardiologist said this is common but I'm not sure I believe him -he was very low key about it-maybe bedside manner. It's reassuring to know I'm not alone in this, and I really appreciate the support.

@bignelie My biggest worry is dissection-my blood pressure is under control but not to the new levels I have read about. My cardiologist is ordering a full echo for my heart to get a better perspective. I think I read too much about this because now I'm doubting my cardiologist because he's not ordering a Gated Ct. I want to be my own advocate, but I don't want to alienate my physicican so I'm getting a second opinion. Glad to hear you're getting back in the saddle after the surgery. Thanks!

@pconkin1 Stanford Aortic Disease Center was great and it where I had my surgery and cardiology care so can say they did a great job in diagnoses and eventually surgery and post care. Also they have a great cafeteria at the 500 building and can highly recommend for a good meal.

As with any disease, it is not a one size fits all so give yourself grace to wonder what is right or best for you. When in the learning phase, which I think you are in, I took a lot of time to get a baseline between all doctors I felt good with. Every person did offer their best knowledge on what they knew but I had to work up to the experts and even then I had to sit with what they were telling me.

@pconkin1
You might check out the "Virtual Second Opinion" from Cleveland Clinic.

I too just found this and I have a 4.3 ascending aortic aneurysm.

I suddenly went into afib in Jan of 2022. First time and apparently the hospital saw my Aortic Aneurysm then but didn’t tell me that I can recall and neither did my cardiologist at that time. Started a new cardiologist a couple years later for better care and told them I was still having some issues with chest pains and out of breathe issues when climbing stairs or carrying anything sort of heavy. He ordered a ct scan with die and found my AAA at 46mm/4.6cm. New test 6 months or so ago at the same hospital and they finally told me they saw it the first time in 2022 and that it was the same size now as it was then. Just had a CT scan done today without die for my annual checkup with my cardiologist and it said my AAA was unchanged and measures 4.8 x 4.8cm which seems like it’s gown a little to me. Waiting for my cardiologist to look at it and respond to me so we’ll see. I still have a little issues with breathing if I try to carry my grand daughter very far or climbing too many stairs. I take Metropolol and Dialtazm for my heart rate and BP which seems to be under control. Also take blood thinners and fish oil now as well as trying to walk more since I have a desk job. Always worried and stressed which affects my sleep some nights due to pressure or small pains that I have in my chest as well as bad cramps in my calf muscles. Not sure if there is anything I can do about these issues or if the AAA is causing them. Just scared of the worst case scenarios happening.

I can relate to a lot of what you're feeling. I had a Type A aortic dissection in 2015 that came completely out of the blue and required emergency open-heart surgery and placement of a Dacron graft. Ever since then, I pay attention to every chest sensation, every ache, and every new symptom, so I understand how easy it is for anxiety to take over when you're living with an aneurysm. One thing that stands out from your story is that your aneurysm appears to have been remarkably stable. If it was approximately 4.6 cm in 2022 and is now being reported as 4.8 cm four years later, that may represent little or no true growth at all. Different CT scans, different readers, and even the way the measurement is taken can create small differences of a few millimeters. Your cardiologist will be the best person to interpret whether there has actually been meaningful enlargement.

As for the shortness of breath and chest discomfort, many of us naturally assume every symptom is coming from the aneurysm, but that's not always the case. Atrial fibrillation, medications, deconditioning, lung issues, coronary artery disease, anxiety, and many other factors can produce similar symptoms. The fact that your blood pressure and heart rate appear well controlled is encouraging. The fear is real. I think most aneurysm patients spend at least some nights lying awake wondering about worst-case scenarios. What helped me was focusing on the things I could control: keeping my blood pressure under control, taking my medications, getting my imaging when scheduled, walking regularly, and avoiding heavy straining and breath-holding. Beyond that, there isn't much benefit in trying to predict what might happen years from now. The good news in your post is that you've been followed, you're getting regular imaging, you're on appropriate medications, and the aneurysm appears to be changing very slowly, if at all. Those are all things that would make me feel cautiously encouraged while waiting to hear what the cardiologist says about the latest scan. Peace.

@moonboy thanks for your response. I did hear from the cardiologist and yes it appears t be stable. The person doing the new scan had re measured my last scan and said it was slightly larger than they had measured the last time so it was around 4.8 last year and now again this year so little to no growth praise God. Asked if I would like to consult a cardio thoracic surgeon for more consults and care with them then I could. Will see what they say when I go in for my next labs and follow up.