Aorta enlarged

Hi. hubby had over last 2 yrs had dissection.

speak to go and cardiologist .they prob will.monitor it .

an aneurysm is a bulge which can grow .a dissection is a burst .

Hi James - I volunteered for a sports cardiology research project back in October 2018 when I was 59, and had an echocardiogram which revealed that my ascending aorta has a bulge, which was then confirmed with a CT scan three days later. I then went on a massive learning curve about aneurysmal disease. It matters greatly, how large it is. My most recent scan, on a state-of-the-art machine at St Thomas' Hospital, assessed by surgeons who operate regularly on aortas, came in at 4.7cm and my doctors won't operate on me until/unless it hits 5.0cm (other doctors may take a different view of the figure, some would advise waiting to 5.5cm, and if you have a high-risk genetic condition, which seems very unlikely at your age, it could be lower). So your first three questions need to be: how big? exactly where? and when and how will the scan be done to confirm it? You also need to ask if there is any sign of a bicuspid aortic valve (mine is tricuspid); if it's bicuspid, that's the most likely explanation. You will need either a CT scan or an MRI; echos don't give accurate figures. I also very strongly recommend that you get referred to a cardiologist with a specialist interest in aortic disease and who can also assess whether you need genetic testing. If your enlargement is in the ascending aorta, the root and/or the arch, then there probably is a genetic basis, even if none of your family have had problems. If it is in the descending aorta or abdominal aorta (which wouldn't have been picked up in an echocardiogram) then it's probably a completely different disease, more related to general cardiovascular issues, so I won't go on about that. The most appropriate specialists are likely to be found in Adult Congenital Heart Disease teams, they may be in regional centres which support people with Marfan Syndrome and related conditions; you'll find yourself learning a lot about Marfan and even though I don't personally have it, I've had some wonderful support from people who do. The Marfan Foundation in the USA has some great online resources about aneurysmal disease, and there's a toolkit put together in Sweden by a dissection survivor called Timo Soderlund which you'll find on LinkedIn and points you to all the medical guidelines. The biggest ones are Hiratzka et al 2010 endorsed by the American College of Cardiology and a host of other bodies. In relation to sports, the only really important restriction is on the heavier end of weight lifting, although when I was diagnosed, I was firmly told to pull out of all competitive sport, keep training to a maximum of 80% of my maximum heart rate, avoid any maximal effort training. There are two Facebook support groups, one for Thoracic Aortic Aneurysms and one for Aortic Aneurysms more generally, which I've found very helpful (though somewhat US dominated). There is also an Aortic Dissection Awareness UK and Ireland group which is free to join and open to people at risk as well as survivors. Hope that's all helpful as a starter! In relation to Covid-19, the British Heart Foundation has some great resources. The bottom line is that an enlarged aorta should make no difference at all to your risk, and if your blood pressure is normal, the chances are there's no specific problem. My cardiologist has told me I'm not in the group that needs to shelter, but you need to have that discussion with your own doctors.

Dear James,

You should speak to your cardiologist. Nothing prior could have caused this except stress. I had an acute aortic dissection 2 1/2 yrs ago. In the US they usually will operate at 5.25 cm. They will follow up with with tests if the size is smaller, monitoring you as they do a friend of mine.

I would find out the size and how they intend on proceeding. You are lucky that they found it early.

Hi James,

My aneurysm was at the arch and when it was discovered, it was 5.2 cm. I was told to avoid lifting more than 10 pounds and come back to have it checked in four months. My husband and I were in the midst of packing up to move out of state, and i had been up on a ladder painting when my heart started racing...that was my first symptom.

I did a lot of research and found that some doctors now operate on women at 5.0 cm. I told my doctor that I felt uncomfortable waiting, but he didn't budge. I got a second opinion a couple of weeks later, and the measurement was 5.3 cm. It was either growing or it was just a difference in the technology but after a lot of discussion, the second surgeon agreed to operate. Thankfully he did, because my aortic walls were found to be thinner than originally thought. I had genetic testing, which was negative. I had owned my own stressful business for 25 years, and I'd had some hypertension that wasn't being addressed. I had my surgery on a Monday, and went home from the hospital on Friday. I actually attended church on Sunday and my pastors couldn't believe it when they saw me. My surgeon had me on a strict regimen of lots of protein and exercise and life soon returned pretty much to normal. we lived at sea level before, and now we are at 5100 feet in altitude. I'm not quite where I should be with my endurance, so I feel out of breath sooner than I should, but I am working that.

You'll need to be monitored and your cardiologist will discuss keeping your blood pressure low. You may never need surgery if the aneurysm stays on the smaller side.

From my research, it's the medications for high blood pressure which put one at more risk with COVID-19. I could be wrong, but no one has stated WHY patients with hypertension are at greater risk so I read a lot of medical journals to finally figure it out.

I hope that your bulge is minimal and stays that way, but just know that there is normal life on the other side of surgery if it becomes necessary.

Sandy

Thanks all.

Requested GP appointment over the phone and that'll be Monday afternoon so will ask questions then.

I don't remember much from the phone call only that they are writing to cardiologist for advice.

Funny old times... 🙄

Panic over just received this...

Dear Mr Maloney,

I got a very quick reply from cardiology who were really not phased by your scan result - they just said to keep your blood pressure below 120 and do a repeat scan in 5yr! Let's make sure that we keep an eye on your bloods pressure. If you are not sure what it is, then it may be worth getting a home blood pressure monitor.

Thanks, Sarah Giles

Birchwood Medical Practice