Aneurysm grew 4.1 to 4.7 in one year - which questions should I ask?

@scottbliz My husband was recently diagnosed with 4.6cm ascending aorta aneurysm and just last week consulted with cardiologist. My husband has no family history of aneurysms, normal BP and calcium CT score a year ago was zero so no worry about cholesterol. Given all the positive aspects of my husband's health the cardiologist wasn't concerned about his 4.6cm scan. He was very reassuring about my husband's case and said typically these types of aneurysms grow slowly ... a rescan w/ contrast in 1 year was advised. With your family history you are likely in a higher risk category therefore a different protocol might be in order. Nonetheless, the one thing the cardiologist stessed to my husband is to be very careful of lifting heavy weights/objects and activities that require "straining" ie. holding your breath and then lifting ... think body builder techniques used for lifting. The cardiologist actually said they see a higher number of ascending aorta aneurysms in body builders and weight lifters.

Below, I've listed the talking points we were prepared to discuss with the cardiologist during my husband's initial visit. I hope in some small way these talking points can help guide you.

1. Imaging Follow-Up
- Repeat CTA or echocardiogram every 6–12 months (confirm exact interval).
- Use the same imaging center/protocol if possible for consistent measurements. Ask if echocardiography can substitute for CTA/MRA between detailed scans.
- Frequency of follow-up CT scans? Longterm affects of CT w/ contrast on kidney function?

2. Blood Pressure Goals
- Target: below 120/80 mm Hg.
- Discuss whether a beta blocker or ARB (e.g., losartan) is appropriate or necessary
- Monitor blood pressure at home once or twice daily at rest.

3. Lifestyle & Activity
- Avoid heavy lifting, straining, and high-intensity contact sports.
- Continue moderate aerobic activity (walking, swimming, cycling)
- Ask for safe lifting limits and guidance for playing sports eg. pickleball, hiking etc.
- Ask about acceptable exercises - dumbbells, pushups, planks, squats, yard work, mowing, mulching, topsoil, raking leaves, snow shoveling etc.
- Sleeping habits - snoring, mouth breathing, chest/head elevation on adjustable bed - do these sleeping habits affect aneurysm growth?

4. Risk-Factor Management
- Maintain healthy cholesterol and inflammation control
- Ask if statins or other medications are recommended even with normal cholesterol.
- Follow a heart-healthy diet rich in vegetables, fruits, and lean proteins, low sodium, sugar etc.
- Ask about coffee, alcohol?

5. When Surgery Might Be Needed
- Typical threshold: 5.0–5.5 cm, or earlier with certain risk factors (bicuspid valve, rapid growth, family history).
- Ask your doctor about your personalized surgical threshold considering: age, family history, height/weight, overall health and fitness level
- Ask about genetic testing - if there is a family history of aneurysms (not just aorta aneurysms but anywhere in the body)
- Consider a baseline consultation with a cardiovascular surgeon specializing in aortic aneurysm?

6. Red-Flag Symptoms
- Seek emergency care for sudden severe chest, back, or upper abdominal pain (especially tearing).
- Watch for fainting, shortness of breath, or new hoarseness.
- Call 911 immediately if any of these occur
- Consider a personal medical alert ID such as a bracelet or necklace to alert others in case of emergency situation.

@lori555 hi, pretty scary stuff huh? I personally expect human error somewhere in the whole process but at the same time just totally unacceptable when we’re talking about your heart! So I think it might be prudent to double if not triple check those results- passes through a lot of hands, different people’s opinions and well, lots of room for error- plus you have every right to know “exactly” what’s going on so you can make “exactly” the right decision for you. Best wishes

@chebo1954 had a cta chest w/contrast 2weeks ago since i had a ct scan for something else in july '25 it showed my dilated aortic aneurysm root measuring 5.3 cm. so i went to cardio surgeon and got the above mentioned procedure and it showed my aortic root to be only 4.9cm, ascending aorta 4.5, and descending being only 3cm. should i be concerned.? doc told me to have similar tests next year at this time again.

@flaxxy703 I would always be concerned especially when you are getting different numbers/readings I’d want to get it nailed down close as I could. My cardiologist seems so indifferent that I spend a lot of time doing my own research & asking people here cause they’re pretty knowledgeable

I recently heard of a blood test, through Cleveland Clinic called TMAO (Trimethylamine-Oxide), results of which that can predict aneurysm growth in order to monitor and manage aneurysms. I am currently trying to find where I will have this done as my current cardiologist knows nothing about it. I will ask my secondary cardiologist with Mass General/Brigham Women’s to help me if he can. Check out the article I will attach and see how that goes. Good luck!
https://consultqd.clevelandclinic.org/tmao-can-predict-growth-of-abdominal-aortic-aneurysm

You need to consult with a cardiologist AND cardiovascular surgeon that specializes in these things. Unless that hospital that is 52 miles from you happens to be Mayo Clinic or Cleveland Clinic, its a moot point. I live in Tallahassee Florida. My only 2 options in north Florida were UF/Shands in Gainesville and Mayo Clinic in Jacksonville. I went to Mayo. I had a CT Scan with Contrast that led to an catheter procedure with possible intervention that wasn't able to address any of my problems but found more which led to a cardiac MRI and open heart surgery. This all happened between Jul 22 and Sep 10, 2024. I was told in January of that year by a local cardiologist at the local Tallahassee hospital to come back in over a year. If I followed his advise, I would have been dead. my ascending aorta was 4.7 and root at 4.8 at the time. However, there were other issues that were flat missed by the local cardiologist. I got a second opinion from a congenital cardiologist at Mayo and she found 3 additional critical things. I was 60 at the time of surgery.

@rlhix I am possibly looking for a second opinion. I live in SC and my husband goes to Mayo in Jacksonville, but are also from Ohio near the Cleveland Clinic. I am debating on getting a second opinion from the Mayo and interested in your experience.
Thank you!