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Ascending Aortic Aneurysm Size Discrepancies and Update
Hi All,
Recap of my history:
Sept 2022 Ascending Aorta 3.74cm on Echocardiogram
Sept 2024 Ascending Aorta 4.0cm on Non Gated CT scan
Sept 2025 Ascending Aorta 4.2cm on Non Gated CT scan
Sept 2026 Ascending Aorta 4.0cm on Echocardiogram.
I know to only compare apples to apples and not apples to oranges here. My question is for the Echocardiograms is this representative of true growth or could this be margin of error. Same question for CT scans... is it growth or margin of error. I have significant health anxiety and during the time of these scans I have tachycardia and my blood pressure is mildly to moderately elevated around 120-130's / 80-90. I know this because the technicians always comment on it and they tell me they can tell I am nervous. I have read that it can result in inaccuracy of a couple mms. due to timing the measurement with a rapid heart rate, motion artifact, and timing of measurement captured at diastole or systole. I'm hoping I am just stable and that there hasn't been any growth. Another thing that is frustrating to me is I have had diastolic dysfunction on my echo reports for several years. My blood pressure does spike into the 130's / 90 when I am stressed, anxious or at the doctors and sometimes in the afternoon. but mostly at home especially in the morning my blood pressure is 115-120/75-80. I addressed this with my cardiologist this month and he does not want to prescribe me any bp medication at all. He knows my measurement history and I told him my concerns and he acts like this is not a big deal saying you're talking about 1-2mm difference.. What's the difference? He has me scheduled to repeat the echo in one year. I am also getting low dose chest ct scans annually because of some lung nodules we are monitoring which is how this Ascending aorta was discovered in the first place. What should I do in the meantime? Is it time to look for a new cardiologist? I like the one I have, he's knowledgeable and nice enough. He's one of the highest rated in my area as well. Should I push for the bp meds? I am trying to lose a few lbs to see if that will help my bp and I am looking to start meditation as well. I exercise. Brisk walking 30 min per day. I am not overweight. My bmi is at the top of the healthy weight range however and I hope losing 5-10 lbs will help. I don't smoke or drink. Any advice is appreciated. Thanks
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@cyfanter2024
Thank you for sharing your story. It’s quite shocking, really, what complications can arise from this type of surgery.
Fortunately, thanks to your good health, you came through it all just fine.
May I ask why the surgeons decided to operate when the dilation was 50mm, rather than waiting until it reached 55 mm?
And do you have any regrets about choosing to have elective surgery?
@ctflyr my dr calls mine a dilation and not an aneryism. It has pretty much stayed the same these past 3-4 years no increase at all. First it was 4.1 then 4.0 then 3.9. The dr says it hasn’t shrunk it is just measurement variations .
I had an echo that didn't show a TAA. A few weeks later, while getting ready for the cath lab, a CT showed a 4.5 x 4.3 TAA. I find it hard to believe that the TAA developed while I was sitting at home doing next to nothing while waiting for Cath Lab.
I think your instinct is probably right. A 4.5 cm thoracic aortic aneurysm almost certainly did not simply develop from nothing over a period of a few weeks while you were sitting at home. Echocardiograms are excellent for many things, but they do not always visualize the entire thoracic aorta well, and measurements can depend heavily on the imaging window and exactly what portion of the aorta was seen. CT is generally much better at defining the size and anatomy of the thoracic aorta, so my suspicion would be that it was already there and simply was not seen or measured on the echo. I would ask your cardiologist to look at the actual echo images—not just the report—and compare them directly with the CT. It’s always a good idea to get a second opinion and to consult with a thoracic surgeon, because they’re the ones who will ultimately go in and repair an ascending aortic aneurysm if surgery becomes necessary. I survived a full ascending aortic dissection in 2015, so I know a thing or two about surviving this. Don’t ignore it. Get a second opinion. Peace.
You’re doing all the right things. Don’t worry so much even though it’s normal. I was like you. My number stays between 4.1 and 4.3 every year when I get my testing done. One doctor says this and one doctor says that. If it stays stable and no drastic increase I think you’re good. Wish you the best.