Aortic Aneurysm

[affected_daughter]

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.

Thank you

[eaglehawk]

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.

[nickppatel]

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.

Best wishes.

[nickppatel]

Besides www.marfanlife.net, you can also run a Google search for the terms "losartan" and "aorta."

[skydnsr]

You will also find excellent info about familial aortic disease on www.bicuspidfoundation.com.