1. < Aortic Aneurysms

Dilated Ascending Thoractic Aorta- Growth from 4.0 to 4.3

Posted by jameslawrence @jameslawrence, May 25 7:35pm

I have recently recieved a CT Scan result which shows my dialted ascending thoratic aorta has grown from 4.0 to 4.3 in two years. My previous cardiologist just told me to limit weight lifting to 35 pounds or less and that I should keep getting scans every six months . I have never been on blood pressure medicine (usually 120/80) or cholesterol medicine. My blood pressure has been rising recently to 130/85 or so.
I pursued a new cardiologist and he has put me on Rosuvastain 20mg/daily and Losartin 25 mg/daily and said we will watch it (similar to the previous cardiologist). Everyone seems to feel that my physical activity can be maintained. I workout with a trainer for an hour twice a week, take tennis lessons for an hour twice per week and walk five miles three or four times per week. I'm a 60 year old male, 5'8" and 176 pounds.
The biggest issue for me is trying to find the right perspective on this. I don't want to be an alarmist but I also don't want to be stupid about a serious heart issue especially since both of my parents died of heart disease. How do I most effectively find the right way to manage this condition? How do i keep my weight down without putting undue stress on my heart when I am exercising? If there is no way to stop this dilation from growing should I push for something more procedural/invasive when I am younger and healthier vs. waiting for it to get to 5.0?
This support group seems to have a lot of great insights from those with first-hand knowledge so thanks in advance.

Interested in more discussions like this? Go to the Aortic Aneurysms Support Group.

tim1028 | @tim1028 | Jun 5 9:27pm
In reply to @hsminc "With an aneurysm measuring at 4.9, you need to see a cardiologist at a major academic..." + (show)
@hsminc

With an aneurysm measuring at 4.9, you need to see a cardiologist at a major academic center that specializes in aortic aneurysms. Following up in a year with another echocardiogram sounds pretty "dicey" to me. I think that you are on dangerous ground if you follow this advice - just my opinion from our experience over the last three years and lots of reading of the medical literature. You definitely seem to be pushing the envelope particularly with your resistance training and the high plaque burden.
My husband is 80; his 4.8 thoracic aneurysm was diagnosed in 2021. He has been followed yearly (now) at Mayo with a CT angiogram with contrast. The echo is not as accurate as other modalities. My husband's aneurysm has been stable but the first year we came back every three months just to make sure it was stable.
Some surgeons would consider doing surgery with an aneurysm at 4.9 -- if other factors made it appropriate.
Best wishes and good luck. You need a second opinion from an expert in thoracic aneurysms.

Jump to this post

Thanks for your helpful reply. I reread the report and discovered that I made an error in the size of the ascending aorta--it is 3.9, NOT 4.9! (I looked up my last Echocardiogram results from 2018 and the ascending aorta size was 3.8.) My apologies. I am following up with a CT angiogram scheduled for the Fall. I have several concerning issues going on, and hopefully my cardiologist can sort out the results from the 4 heart studies I am having done: ECG, echocardiogram, Zio Patch 14-day heart monitor, and CT angiogram.

REPLY
bitsygirl | @bitsygirl | Jun 6 9:02am
In reply to @charlanepj "I was 67 when had been diagnosed with a 4cc aortic aneurysm by accident. They were..." + (show)
@charlanepj

I was 67 when had been diagnosed with a 4cc aortic aneurysm by accident. They were doing X-rays for a kidney condition when it was found. I was told they don't do anything until it reaches a 5. We did do blood tests, looked at family history, heart health, and an TEE. All was good. Let's get you scans once a year. A year later while waiting for the appointment card for scans I had an emergency aortic dissection and was life flighted to Mayo. I went to my ER because I was sweating quickly, lightheaded, and my eyes felt funny. Eventually I began to vomit. My Mayo surgeon said my aorta measured 4.5. I had three repairs done. My point is you never know. An aorta problem does not mean a heart problem. I have no heart problems. From what I understand is they want the blood pressure down so blood flow does not beat against the wall of the aorta. Sudden lifting raises the blood pressure. But when you walk, bike, swim, etc. and gradually increase your heart rate that is a different issue and it is good for you to keep active. I recommend you visit with your doctor and ask questions until you understand what he thinks would be to your benefit. I am now 70.5. I feel good. I walk, bike or swim daily. My weight wasn't terrible but I have kept 10 pounds off. I will live daily with it could happen again. But every day is a gift anyhow. This is an unpredictable condition. Trust your medical staff.

Jump to this post

@charlanepj - What were you doing when the aneurysm dissected? How far away are you from Mayo? Did you have any input into where they sent you? I live in a very remote area. The nearest hospital that does any kind of cardiac surgery is two hours away. There is a local hospital that does stabilization ... there is a cardiologist. So I worry about what would happen if I had a dissection. The hospital two hours away does do cardiac surgery. I know they have done emergency dissection surgery before. Yet I would prefer to go to a larger center if I had any input. Of course, I imagine it's dictated by the severity of the dissection. I have also heard that sometimes there is no bed at a hospital you might prefer the surgery to be performed at.

REPLY
brendacarr | @brendacarr | Jun 6 10:37am

Does anyone know if you fly with 4.3 thoracic aneurism.

REPLY
1 reply
bobbyknik | @bobbyknik | Jun 7 3:04pm

They usually don't fix aneurysms until they reach 5.0. Mine was 5.1 and I had surgery in February 2 at Mass General. I Also hypertrophic cardiomyopathy as a complicating factor. I can recommend Mass General.

REPLY
hsminc | @hsminc | Jun 8 10:25am
In reply to @brendacarr "Does anyone know if you fly with 4.3 thoracic aneurism." + (show)
@brendacarr

Does anyone know if you fly with 4.3 thoracic aneurism.

Jump to this post

Depends on many factors. My husband had a CT scan in 2007 that showed a 4.3 aneurysm. No one mentioned it to him. Guess they thought based on his height and weight at the time that this was normal??????? He did not know he had an aneurysm until January 2021 when Mayo saw a 4.8 mid level ascending aortic aneurysm on an echo. They ordered a CT Angiogram with contrast.
In 2007 and until 2021, he was flying in airplanes on a monthly basis (maybe more frequently); was lifting very heavy "stuff," e.g., a 1000 lb garage beam, with the help of friends; boards for our dock; etc.. Thank goodness, he is still alive.
Two cousins have had mid level aortic aneurysms. One (a first cousin) desiccated (he survived finally) and the other had prophylactic surgery. Both were health "nuts" and did a lot of weight lifting. One cardiologist thinks that was the cause of the desiccation.

REPLY
View MoreView Less
Please sign in or register to post a reply.