@grandmajeannie At 76 with a 4.1cm AAO I am skipping the cardiologist unless it shows progression on next echo. I have read studies which are beginning to find that the "sag and Bag" phenomenon of aging (I am sure they would not put it that way) also applies to things like AAO size. For my age and BSA at least two recent publications suggest that is to be expected. So I have more than enough medical crap in my life right now and the stress of managing one more doc would likely raise my blood pressure. But if anxiety is gonna raise yours - get the next level of advice. The ACC guidelines do not call this an aneurysm. If mine stays stable or has small increase - I will just monitor. These calls are very individual and you do what is comfortable for you.