1. < Aortic Aneurysms

Besides managing BP, what else can slow the growth rate?

Posted by bryanfox @bryanfox, Mar 13 4:14pm

I'm a 48yo M, diagnosed in 2019 with an ascending aneurysm at 4.2-4.3. I have been getting regular scans and I thought it was not growing, but today my doctor told me that the last CT scan shows it at about 4.5. My BP is controlled (small dose of olmesartan), I don't smoke, I rarely drink, and I am fairly physically active. I'm 5'10" / 197lbs, so I could lose a bit of weight.

What bothered me was that the doctor basically said, "You're doing what you can, just come back at the end of the year for your next scan", like the growth is inevitable and unavoidable.

So that's my question - what else can I do to slow the growth? I know that sometimes this condition advances rapidly without apparent reason, but that (fortunately) doesn't seem to be the case for me - mine is progressing at around 1mm a year. Nonetheless, it feels like there SHOULD be something else to do to slow things down.

What am I missing?

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oldwal | @oldwal | Apr 6 12:07pm

In the questions re" what can I do to help" I never see "avoid being constipated" as a must. In a recent Quora question a police officer was questioned on horrible things he had seen. One was the number of people dead on their toilet. I would guess a great many were upper aorta aneurysm patients.
As a 89 year old with 5.5 measured over two years ago I no longer get measured as I am a poor surgical risk. But I live and enjoy each day without worry. Spending you time worrying about a 4.3 is only going to make things worse.

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bitsygirl | @bitsygirl | Apr 7 3:20pm
In reply to @upartist "Hi Bitsy Girl. First, I am sorry about your husband's situation. It is definitely hard to..." + (show)
@upartist

Hi Bitsy Girl. First, I am sorry about your husband's situation. It is definitely hard to have a loved one living with an unpredictable condition, and looking to maximize strategies is a good thing and obviously provides some control. You might find answers at http://www.ahajournals.org and look at the 2022 publication of TAD management recommendations. It is very comprehensive, and should hold the information you are looking for. It details different kinds of genetic variants, symptoms, and progression. Always remember that the blood pressure control is the foundation treatment for the aneurysm, and that other vascular anomalies/conditions can affect or fluctuate the blood pressure. (IE: sarcoidosis, vascular spasm, bicuspid valve, etc) The way I understand it, is that some genetic predispositions can lead to early dissection. There is so much they do not know yet. The Genetics are advancing really fast. Its an easy test, and is becoming the main stream standard of care. All my kids will be getting screening echoes very soon. I hope this helps. Good luck and continue surveillance and proactive approach!
Upartist

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Thanks for the helpful information. Good luck!

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tkeys | @tkeys | May 1 12:51pm
In reply to @houston13 "My AAA was discovered as I was being prepped for leg fracture surgery, fell of my..." + (show)
@houston13

My AAA was discovered as I was being prepped for leg fracture surgery, fell of my MTB. Mine was already very large when found (5.2 and I am short 5' 6", 55 when it happened 4 years ago) and needed to be taken care of fairly soon. I had to wait while my leg healed enough for me to walk after heart surgery, but I kept working out, just that I had to take it way easy as any spike would have been catastrophic.

Even now after surgery, my Cardiologist tells me that there is a chance (small) the area of the aorta after the graft may swell and need to watch my BP. I work out frequently but as you, I use challenging weights but not excesive, and just do more reps. I'm also back on my MTB and do several spinning and strength classes every week. I practice proper breathing continually to ensure I am not holding my breath. I get check ups every year (Echo's) mainly to watch my aortic valve (bicuspid) but also the aorta itself, and get full scans every 5 years (groin, abdomen, torax and head) as I also had a brain aneurysm (also fixed).

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You mentioned brain aneurysm fixed? Where was it and how was the recovery. I also have a brain aneurysm on my MCA. Just found a year ago and we will be watching it. Thanks

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houston13 | @houston13 | May 1 1:30pm
In reply to @tkeys "You mentioned brain aneurysm fixed? Where was it and how was the recovery. I also have..." + (show)
@tkeys

You mentioned brain aneurysm fixed? Where was it and how was the recovery. I also have a brain aneurysm on my MCA. Just found a year ago and we will be watching it. Thanks

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Supraclinoid I believe, left side. The fix depends on a lot of factors, vascular access or not, shape, size and location. Mine had access so embolization was an option, mine was fixed with stents (coiling works for others), first one did not work well, had to have a second one (inside the first one) place 3 years later. Recovery when done through embolization is quick, home the same day or next day

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deedth64 | @deedth64 | May 6 10:10am
In reply to @dcopeland "What numbers does he mention for the BP managment?" + (show)
@dcopeland

What numbers does he mention for the BP managment?

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I believe everyone is different my TAA is around 4.1 CM I am having another scan next month to be sure. Mine was found on a Calcium CT scan in December so it was an incidental finding the report stated that the Ascending Aorta is aneurysmal and measures up to 4.1 cm. Anyway the Cardiologist said she wanted my BP to be no higher than 130/80. I am on meds and have been for a long time I take it a couple of days a week and it is well w/in the range. I also have been doing a lot of research about the margin of error on these scans and there seems to be some difference in the measurements depending on how it's measured and which test it's found on.

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