dianosising heart disease

I was looking for some information. Can you a doctor diagnose symptoms for the following conditions through routine physical exam and ecg. Aortitis, aortic valve insuffiencey, and particularly aortic and thoracic aneurysms. I know the last 2 can have no symptoms at all but would an ecg or exam be able to detect them?  Thank you.

[Lee Kirksey, MD]

Hello
Physical examination and historical information from a patient is helpful to identify medical conditions. Of the conditions that you listed, aortic valve insufficiency is the one that could be most easily identified by physical examination. The defect within the aortic valve with this condition creates a characteristic sound (murmur) which can be heard with a stethescope. Additionally, some of the patients complaints may be consistent with the type of murmur-assisting the physician to make the diagnosis. Aortitis is not a diagnosis that can be made by examination or ecg. In fact, it is more accurately described as a histologic finding (ie the true diagnosis requires tissue sample)  And as you know, enlargement of the aorta (aneurysm) is a silent process that requires a degree of suspicion which prompts a test such as CT or MRI in the chest and ultrasound in the abdomen. An abdominal aortic aneurysm AAA may be palpate on physical exam if the patient is very thin, the aneurysm is large and the examiner is experienced.  Many studies have shown that less than 10% of aneurysms are identified by physical exam. Most are found incidentally when a CT scan is done foe some other reason like evaluation of prostate problems

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Generally, do you have any symptoms with these conditions, especially the aneurysms?

[Lee Kirksey, MD]

In general, the only symptoms associated with aneurysms are chest or abdominal pain that is associated with rupture or bursting of the aneurysm.  This is why screening tests are so important to identify these problems in time for them to be managed electively. Greater than 90% of people who experience rupture of an aneurysm at home will die from the incident