@charlie2025 given your extensive familial history I would absolutely schedule a consult with a cardio thoracic surgeon. I would also ask them to look at your current scans and make sure that you are doing everything you can to minimize any progression you might have of that ascending aorta. You have to advocate for yourself. Most general practitioners and even a lot of cardiologists are not going to refer you unless you insist on it. you want to meet with the surgeon that will ultimately have to open you up and repair this. As hard as it is to hear, that’s the reality. Unless the doctor sitting in front of you is a surgeon with decades of experience repairing dissected aortas, the pill prescribers aren’t going to do any good. Everybody plays a role in these cases, but in your circumstance, you definitely want to have a cardio thoracic surgeon who is familiar with your case. Think I would like this: you might go to the oil change place to get a Think I would like this: you might go to the oil change place to get an oil change, but you would never go there and expect them to replace an engine. Both have a purpose, but they do not do the same thing and they are not equivalents. The same goes for doctors. Peace.