4cm aortic root @ 36 (male)

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CTA Scan w/ contrast Test Results:

Sinus of Valsalva = 4cm

Sinotubular junction = 3.33cm

Proximal Ascending = 3.3cm

Proximal arch = 3.1cm

Got a CTA Scan and it showed a 4cm aortic root. Test result said "no aneurysms and normal", but cardiologist seems slightly worried and is putting me on a beta blocker and restricted lifting. Couple questions.

I'm a 36 male at 6' / 200lbs and have slightly high blood pressure.

- Is this condition normal?

- What is restricted lifting? I normally lift 4x a week heavy (squats, dead lifts, bench). 

- Should I be worried?

Thanks!

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11 Replies

  • Posted

    Hi Steve,

    I have a 3.4 cm ascending aorta found on CTA in July 2017. I had suffered sudden excruciating midscappular pain in my back and chest pain. I went to the ER and was diagnosed with a Type 3 complicated aortic dissection (descending aorta). I underwent TEVAR and am now on beta blockers for hypertension as well as Lisinopril and Atorvastatin. I was told not to lift greater than 25kbs. No straining of any kind. Do not hold back a sneeze, etc. We are lucky we know about our aortic size and will be monitored closely. I see a cardiologist and my cardiovascular surgeon has routine CT scans scheduled every six months, then yearly if all looks well. I basically have a prosthetic descending aorta. I have researched this so much as should you. Good luck and listen to your cardiologist.

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  • Posted

    I think you should feel assured that you have a good cardiologist that is watching your case. Your results are within what can be deemed as normal. So yes avoid lifting over certain weights get into the habit of not automatically lifting as well Watch your diet especially keep regular - we are forever warned against the straining caused by constipation for raisiing blood presure - who'd have known! I wouldn't worry just be sensible and careful and you'll be fine you sould as if you are in good hands. It may well be that your measurements are normal for you and there is absolutley nothing to worry about. Only rapid growth and symptoms would put you in a risk category. 

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  • Posted

    Hi Steve, I am in a very similar situation.  I was recently diagnosed with Aortic Root Ectasia which depending on which cardiologist you talk to you could be consider an aortic aneurysm or the stage right before an aortic aneurysm.  I am 6'2 about 230lbs and my sinus of valsalva is 4.2 CM.  My Echo showed 4.2CM, CT showed 4.4 CM and finally had an MRA which is most accurate at 4.2CM.  I was definitely a nervous wreck about it for a few weeks but then became educated.  Yes, you should be worried but don't let it get the best of you.  Become educated and then just cautious.  Good thing is you know what you have and now you can deal with it. 

    There are several things which are consistent amongst that cardiologist when it comes to aneurysms:

    (1) Reduce your blood pressure.  Mine was 120/80 but have been prescribed losartan to reduce it even more. 

    (2) No heavy lifting.  Weight lifting used to be a huge part of my workout, unfortunately you do need to restrict how much you lift.  I had two cardiologist advise to restrict to no more than 50 lbs.  

    (3) I have also had both cardiologist suggest a low carb diet which is better for your heart and maintaining an appropriate weight.

    Im a data guy, so this might help....

    My current cardiologist suggest that your aortic root is relative to your height and weight or body service area.  Here is a link to estimate yours..

    https://www.valleyheartandvascular.com/Thoracic-Aneurysm-Program/Calculate-Your-Relative-Aortic-Size.aspx

    You can then compare to this risk chart.

    https://openi.nlm.nih.gov/detailedresult.php?img=PMC2605304_yjbm_81_4_175_g06&req=4

    when you research normal size I have found several consistent data points suggesting normal range for Sinus of Valsalva, i.e.  range from 3.4cm-4.0cm and 2.9cm to 4.5cm.  In theory you seem to fall within normal range (similar to myself) however I decided to treat as an aneurysm which means change of diet, workout routine, 6 month MRA and blood pressure meds.  I am not being paranoid about it, but cautious.  

    Hope that helps a little, good luck!  

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    • Posted

      Mike,

      Thanks a ton! My ultrasound was 4.2 and my CTA was 4.0. I also, found the same ranges online of 3.4-4.0cm being normal range, even my CTA report noted (normal, no issues on the report). Using the calculators shows me at severe risk, so that is concerning. My cardiologist said lifting was fine, but needed to keep it from being so extreme and not "exert or push myself". I'm also going back in 6 months for a repeat test to check growth. He mentioned he was more trying to get a "baseline" for my root and heart measurements to track growth. I'm 6' 205lbs and have already been changing my diet/workout routine to get down to 180-190lb range. Just hoping that it doesn't grow at all!

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    • Posted

      Hey Steve, glad the info helped.  Think you may have typed in your data incorrectly as I placed your data in the chart and it shows low risk.

      6'0 and 205lb yields an aortic index size of 1.95cm, or low risk on the chart.  

      if you want to calculate your BSA, use this calculator.  using this calculator, your BSA is 2.17.  

      http://halls.md/body-surface-area/bsa.htm

      https://openi.nlm.nih.gov/detailedresult.php?img=PMC2605304_yjbm_81_4_175_g06&req=4

      again using 2.17 and 4.0cm for aortic size, your still come up with low risk.  

      hope that helps.  I will say from a lifting perspective, two docs told me nothing over 50lbs.  I do think its extreme as I bench 220+, but just trying to take it easy from the weightlifting side.

       

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  • Posted

    thanx for links Steve

    on that chart on the second link what does BSA mean?

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    • Posted

      BSA is body service index.  A lot of evidence that shows the aortic root varies based upon one's height and weight.  The taller you are, the larger your normal values will be.  hope that helps.  

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  • Posted

    My ascending aorta measures 3.1cm. My cardiologist didn’t seem to concerned other than being upset that I smoked and am overweight. My CT scan also says no aneurysm but she said I have a minimally dilated ascending aorta. I am 36 years old and have three young daughters. I’m very worried I’m not going to see them grow up. I’m taking metoprolol tartate and losartan for blood pressure. 
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    • Posted

      Stop smoking now - get fit now - get scanned regularly to determine if there is any growth.

      I am a recently diagnosed member of this "club" and Ill swap you anytime - I am at 5.1 - non smoker and fit.

      Also, do some research - 3 is consider normal by some pundits

      Read anything you can find on the subject by Kevin Helliker - he is also in the club - former Wall Street Journalist and an exceptionally well read man on this particular subject

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  • Posted

    Hi Steve - I am recently diagnosed with a 5.1 cm aneurysm, so I'm right on the cusp - depending who you talk to .

    I was only diagnosed a few weeks ago and am eagerly awaiting my next scan in June.

    There is a former Wall Street Journo and triathlete who was diagnosed years ago at the age of 43 with a 4.1 cm aneurysm - his name is Kevin Helliker - look him up - two artivels in particular "A time bomb near my heart" and "Denying Death no more" - both very well constructed articles.

    I am just coming to terms with this - I am 61 and felt like I had at least 20 years left in me - maybe I still do? Maybe more - good luck to us all

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