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Ascending Aortic Aneurysm/Pulmonary Arterial Aneurysm
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Ascending Aortic Aneurysm/Pulmonary Arterial Aneurysm

Hi,

I have been dealing with frequent, chronic chest pain for the last 3 or so years, which at the time I first began complaining to my health care provider, an echo and ultimately a chest CT was done in 2011.  The echo showed the possibility of having an aortic root aneurysm.  The CT revealed an ascending aortic aneurysm of 4.2cm, and a pulmonary arterial aneurysm of 3.9cm to 4.4cm.  I also have some mitral regurgitation.  My cardiologist also noted that in general my heart is enlarged.

I am not an athletic person, nor have ever been.

Here's my question - I have seen references to this, but want some confirmation.  Can the ascending aortic aneurysm and pulmonary arterial aneurysm cause frequent nagging chest pain to the center and right of the breastbone - not enough to drop me to my knees, but just a frequent pain, and also a heaviness in my chest.  Can it also cause discomfort in the same area when taking a deep breath?

Can it also lead to chronic fatigue?  I definitely don't have the level of energy I used to have - it's taken a marked dip in the last couple weeks or so.  I just had an echo done in the past 2 weeks, and am scheduled for another in 2 years.

Thanks,

~David
Avatar_dr_f_tn
It s unlikely that your symptoms are from the aneurysms. Generally, they are asymptomatic and incidental findings, and cause issues if they tear or rupture. Some people have discomfort related to the aneurysm pushing on something else, but they are usually very large in those settings, much bigger than yours. Serial follow up exams are important, because if they are growing quickly or get above a certain size, their risk of tear or rupture is higher, so they are usually operated on to prevent that from happening. If they aren't big enough yet to meet criteria for operation, then they are probably not what's causing your symptoms.
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Thank you for your reply.  Does leave me wondering what is causing the chest pain.  I am not in a stressful position, and consider myself low stress.  I have had my esophagus looked at, and found no abnormalities, and both OTC and prescription antacid medications have been tried with no success.

About the serial exams - do you think once every 2 years as my HMO is doing is enough, or should they be done more frequently?  I can say that as far as what I was told for size, there was some increase in the past couple of years.
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