Is it enough to look at the aortic root to rule out an aneurysm?

[Missing7]

I have an echocardiogram, stress echo, and holter monitor a few months back. The cardiologist discovered I had a bicuspid aortic valve and whats to screen me for an aneurysm in February of next year. She said she didn't think I had an aneurysm because my aortic root was normal sized. The cardiologist I got a second opinion from basically said the same thing. If an aneurysm where do develop along the aorta, would there we signs else where such as an enlarged aortic root? I did have a chest CT with contrast about 8 months ago for a different reason that came back perfectly normal. Could an aneurysm develop that fast?

[skydnsr]

Thanks for the update.  Hope it heals well.  Take it easy on yourself.

[Missing7]

Convinced my cardiologist to due a CT scan. All clear. Turns out it is probably a torn rhomboid muscle. I put a lot of strain on my upper back when I work out and am stressed.

[skydnsr]

I'd be shocked if your pain was from the aorta, but I hope you will get expert care from a cardiologist who has a special interest in aortic medicine.  That is the type of doctor who you need to follow you for the rest of your life.  

A good resource for general information about thoracic aneurysms is www.bicuspidfoundation.com.  I advise checking out that site, and you should feel free to press the Contact button.  The people at the Bicuspid Aortic Foundation know a lot more than I do.  Good luck.

[Missing7]

What has me so worried is that I have a pain between my left shoulder blade and spine, and I read that thoracic aneurysms sometimes cause this pain. My cardiologist does not know about the chest CT scan I had. I know the ascending aorta can be vaguely visualized on an echocardiogram. She did say she doesn't think I have an aneurysm, but I don't know why. I've had the pain for several months now. It initially became so bad it made me nauseous, prompting me to leave work and go to the ER. Since I'm 25, they took their sweet time. All they did was a chest X-ray and give me a pain shot that didn't help at all. The doctor told me he wouldn't run anymore test because I was too young to have any problems. His diagnosis was a muscle knot. But I'm still having this pain months later.

I'm just worried because I've been under a lot of stress, including having panic attacks, and I just don't know how fast a life-threatening aneurysm can develop. Hopefully not within 8 months?

[skydnsr]

Yes, you can get an aneurysm of the thoracic aorta that does not involve the aortic root.  Most of the BAV-related thoracic aortic aneurysms probably do involve the aortic root, but not all of them.  Maybe your doctors knew that you had had the recent CT scan and that it was normal.  I hope so, anyway.

It takes CT or MRI to image the entire aorta.  Since you are young, you can expect to have many more scans.  You might want to talk to your doctors about using MRI for your routine check-ups, so as to minimize your lifetime exposure to ionizing radiation.  

No, thoracic aortic aneurysms don't usually show up suddenly.  When the aorta enlarges, it tends to do so slowly and gradually.  You generally have years to know that an aneurysm is forming and to make plans for what you are going to do about it.  This is an advantage that you have from being diagnosed young.  

When one does hear about a case of sudden death from a BAV-related aneurysm, it usually involves a person who did not know that he or she had a condition that needed to be monitored.  In your case, your ongoing care will give you the opportunity to be treated before there is a crisis.