My dad passed away 06/29/2009 from a thoracic ascending aortic aneurysm, an aortic dissection, and the strokes caused by it. I have read on the Mayo website that this is most common in white men over 40 (my dad was a white man, 55) and that it is hereditary. Our father's mother passed away very young, about 60yrs old, and there was no autopsy done but the dr.'s at the time believed it to be a heart attack and now in light of what happened to my dad we think it may have been the same thing. I am a 26 yr old female and have a younger sister who is 22. Should we take preventative measures from here throughout the future to avoid this, and are there certain tests we should get on a regular basis to check for this problem? Any advice would be so greatly appreciated, and may save our lives.
my dad passed away from a ruptured aortic aneurisym which was not diagnosed and he did not survive emergency surgery. i just turned 65 and during my annual physical my doctor scheduled a free welcome to medicare ultra sound screening and they found one that was 5.7cm which is in the large recommending surgery category. i probably should have had one at least by the time i was sixty since i have a family history. some believe smoking is linked. high blood pressure and cholesteral are not good either. i had no symptoms and i watch my diet and i exercise. i quit smoking in the early eightys.
There are several things you can do. First, find out what your current aortic size is. You can do this by visiting a cardiologist at a large university hospital who is knowledgeable about aortic disease and having a CT scan or MRI of the *entire* aorta. This will identify any aneurysms on the aorta, from start to end.
You should have regular imaging done on any bulges identified. For ex, if you have an enlarged aortic root but the rest of the aorta is normal, you should have regular (at least annual) echocardiograms to check the aortic root and regular (1 per 2 years) CT/MRI scans of the entire aorta to watch for any new developments.
In addition, you should be aware of the sizes at which aortic surgery is indicated. If you have connective tissue disease like Marfan syndrome (see www.marfan.org and, better yet, www.marfanlife.net), the thresholds for aortic surgery are lower than they would otherwise be.
Limit intense exercise, especially weightlifting.
Most importantly, you need to be aware of the latest research in this area. It's nothing short of a miracle from the good Lord Himself. Angiotensin receptor blockers (ARBs) and ACEi's are drugs already on the market that have recently been shown to halt and often reverse aortic aneurysms, particularly ascending aneurysms. My own aorta has shrunk back to a normal size. There is a lot of excitement in the medical research community over this treatment; unfortunately, the VAST majority of doctors - even cardiologists at university hospitals - are either unaware of it or are afraid to prescribe it. Even those who know about it don't realize that effective results are not seen unless maximal and super-maximal doses of these drugs are taken. It's sad that people are dying or undergoing major cardiac surgery regularly when they can potentially prevent all problems by popping a pill everyday.
You can reply with questions, but I often forget to check this board. You may or may not have Marfan syndrome, but you can get more cutting edge information on aortic disease treatment (including ARBs/ACEis) on the forums at www.marfanlife.net than probably anywhere else on the internet. The posters there are extremely knowledge. In particular, visit the "Pharmacy" section under the "general" tab.
I'm responding to your comment below which I've found to be very interesting and possibly exciting news:
"Angiotensin receptor blockers (ARBs) and ACEi's are drugs already on the market that have recently been shown to halt and often reverse aortic aneurysms, particularly ascending aneurysms. My own aorta has shrunk back to a normal size. There is a lot of excitement in the medical research community over this treatment; unfortunately, the VAST majority of doctors - even cardiologists at university hospitals - are either unaware of it or are afraid to prescribe it. Even those who know about it don't realize that effective results are not seen unless maximal and super-maximal doses of these drugs are taken. It's sad that people are dying or undergoing major cardiac surgery regularly when they can potentially prevent all problems by popping a pill everyday."
I am a 52 yr old man that has a AAA measured at (depends on MRI/CT scan) somewhere between 4.7- 4.8CM. It has not changed size in two years. Because of your posting I have requesting that my cardio doctor place me on an ARB (he chose Micardis - 80MG) and took me off the Beta blocker I was on for the past two years. I'm hoping what you say is true and will also work for me but I have a question (reference paragraph below):
"Your body produces a hormone called angiotensin II that constricts blood vessels. By narrowing the blood vessels, it can make your blood pressure go up. Angiotensin II also causes your body to retain more salt and water, which again, can raise your blood pressure. Plus, it can make the walls of your blood vessels and heart thicken and get stiffer. This in turn can constrict blood flow.
MICARDIS is a type of medication called an angiotensin II receptor blocker, or ARB, a medication that blocks the action of angiotensin II. As a result, your blood vessels relax and widen, and blood can flow with less pressure. This helps your blood pressure to go down."
It seems to me that this 'relaxing' of the blood vessels would only make an aneurysm get larger, not smaller or stablize. Can this be explained? While excited about the potential possiblity, I'm also cautious and want to make sure I'm making the right decisions (not just from someone's posting). Are you a doctor? (I'm thinking yes, but want to make sure). Do you have any links that can add relevance to this claim and has there been testing with positive results yet?
I'm hoping you'll get this post and can reply back.
I don't mean to butt in. I know your question was directed to nickppatel, but I think sometimes nickppatel doesn't necessarily look at this site sometimes.
Let me offer this to you in the meantime: relaxed blood vessels tend to last longer, because a relaxed state will lessen the amount of "wear and tear" on the tissue. You can think of the blood vessel wall as being like a piece of spandex. If the material is held constantly in a state of tension, it will give out faster than if it remains in its normal, resting, relaxed state. Eventually, after it has been subjected to excessive tension for a prolonged period of time, it will get to where it can expand, but it can't contract, like worn-out elastic. An expanded vessel that can't contract is almost definitive of an aneurysm. Relaxed blood vessels tend to retain their resilience. Constantly over-contracted blood vessels wear out, and that is when they are vulnerable to aneurysm formation. That is why blood pressure control is so important in aneurysm prevention, in the first place.
I believe Dr. Hal Dietz at Johns Hopkins may be doing research on ARB treatment of aneurysms. He is an expert on aortic aneurysms, in any case. You can look up him and his work. Also, there are some good links and a Google search suggestion posted above.
Skydnsr is right on as far as the aortic flexibility. Healthy blood vessels are flexible and pliant. Don't confuse this type of "relaxing" to the kind associated with aortic aneurysms - they are different things.
I am not sure that ARBs will help your abdominal AA. My understanding is that ARBs generally help the ascending aorta and, in particular, the AORTIC ROOT. I beleive the research suggests that not all parts of the aorta respond to ARB therapy the same way. Frankly, I would be surprised if your AAA responded to this therapy. You might contact Hal Dietz at Johns Hopkins to ask about ARB efficacy with AAAs.
Finally, to answer your question, NO, I am not a doctor. I am not a nurse or even a medical student - I am just a layman. I am a bit concerned that you apparently made a medication decision based on what you read from a stranger on an online forum without doing your own research, and that your doctor went along with it! You should ALWAYS do your own vetting process to verify what people say online as the internet is full of misinformation. I guess your cardiologist thought it couldn't hurt, though, and your doc has the final say on what you do and don't get prescribed.
If you want research, check out www.marfanlife.net/bb3 (pharmacy section) - it contains numerous posts to studies on this topic. You'll have to do a little bit of digging.
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