Dialated ascending aorta

[dominic64]

Hello all...

I am a 45 year old male 6' 200 lbs. and was recently told I have a mildly dilated ascending aorta.  The doctor suggested for me to take Cozaar 50mg/day with yearly follow-up testing.   I have to say I am scared out of my wits.  I am a otherwise heathy person.  I do not smoke or drink.  After reading some of the posts on this web site I do not feel so alone.  My concerns are physical limitations and the eventuality of surgery.  I am a police officer and need to be physically fit for duty.  This has humbled a tough guy like myself.  My dilation measured 40.1.  The doctor discussed avoiding lifting extreemly heavy weight.  Is that it?  I feel fine.  Does someone with this condition eventually confont surgury in the future and when?

I would appreciate any feed back.  Thank you.  

[Trackermom]

The doctor did my blood pressure at it was 110/70.  we kept everything the same Benicar 20mg/12.5mg. and Topral XL 25mg.  I need to get moving again.  I haven't pushed myself past my comfort range but my food intake is going well.

I don't know if you read my aortic dilation posts. But it was found via a CT scan with contrast.  I presented with chest pains. Turns out to be a issue from recent surgery and the and my esophagus and stomach are hurting and out of whack,
long story short.  One view from the CT showed a mild dilation of 4 cm.  I was hoping and the cardiologist said that sometimes if the measurement is measured on the oblique it could be read larger than it is.
So he wants and MRI in a few months.  

Would getting an MRI  a good test to confirm or disprove the CT?  Should I get an MRA. OR should I get a CT with contrast again?
Comparing an MRI to a CT scan seems like it is compairing apples to oranges. But I am a lay person so it may not matter.

My BSA is 2.53 I am just about 6'2"  and weight 280 (down from 310)
My blood pressure is now controlled.

Any thoughts are greatly appreciated.

Be Well

[cardiobill]

Well nice to hear the feedback trackermom. Every once in awhile I look something up online and run across something I can answer and have the time to do so.
Benicar hct is a fine combo. My favorite is lisinopril/hctz as its cheaper but all works on the same kidneys whether its an ACE inhibitor or an ARB. The HCTZ is there to keep the kidneys from outsmarting the medication by holding onto salt and fluids to keep the bp high. The kidneys are like a thermostat just set too high.

I, however, take Benicar/Hctz combo 40/25 and working out. Last Monday after I started my grueling new years resolution on the treadmill and at my office I took my bp and it was 80/60. I was wrecked the whole morning. So periodic adjustments may be needed as you lose weight.
But LOWER is the key to aortic dilatation from keeping it from progressing. Unless you have some connective tissue disorder which is much rarer than hypertension


Dominin, a second opinion is never a bad idea, but if its larger on studies, the second opionion will tell you the same thing as the first doctor. They base it on measurements primarily.

So if one has an increased measurements from one test to another. Thats still only 2 points on the curve. A couple more would be more helpful, just to see the slope of rate of change. And of course, you will have above optimal control of your blood pressure before the next testings of the aorta

[dominic64]

I just reviewed the artical you refered me to authored by Yale Journal of Biology and Medicine.  The artical was very informative as you said.  I greatly appreciate your post.  Thank you again.  

[dominic64]

Cardiobill, Thank you!  I appreciate you responding to my post.  You have definately answered some dire questions that I have been agonizing over.  I do have another question about getting a second opinion.  My doctor showed me the images from the CT scan and I could clearly see the aorta was larger then the other one.  Would a second opinion be a waste of time?

Thanks again.      

[Trackermom]

Cardiac Bill-
Where were you when I first came here?  You just said everything I needed to hear. :)
That took me a month to find here and there and some stuff that spells it out. It doesn't have to get bigger.  Monitor and take care of yourself and one should be okay.    So, Thank you for posting!!

I have a doctor appointment today for my blood pressure.  It is around 112/88 if I have salt it goes to 120/90.  I want it lower. SO maybe we'll increase the Benicar HCT.

[cardiobill]

I run a cardiac imaging lab, not a physician but I have 10 years experience in this field. I've seen it go both ways with ascending aortas measuring large. Some progress, many do not. It bears following up and get a few points on the curve as to if it is continuing to enlarge and the rate. Just had a patient, interesingly enough, was a physician whose aorta has been 4.5 cm for many years with no progression.
It is absolutely imperative to keep a low blood pressure, there really is no floor to blood pressure, it directly correlates to less heart attack and stroke. THe lower the better as long as it doesnt happen too fast where you would get dizzy or lightheaded. That actually happens to me when I start an exercise program and lose weight, I have to go off my blood pressure meds or cut them in half.
I aim to keep my blood pressure under 110/70 and currently at 104/60. Which I think is ideal for me based on what I know. Not a bad goal for you.
After it dilates over 5 cm then you would start considering surgical intervention where they put in an aortic valve conduit.
That could take decades if at all for that to occur or it could progress quicker, thats why following it over time and keep a watchful eye over it is the way to go.
Hope that helps, btw, personally, I wouldnt be too overly concerned with that measurement, it may just be the size of your aorta

[dominic64]

Thank you so much for the reply.  That really means a lot t me.  I will check out the web sites you noted and review the reports.  I do not have high blood pressure.  In fact, all the other test results from the blood work, x-rays, and stress test were all negative.  I have just begun this journey.  There is a lot to learn and it is overwhelming.  At times I just shut down.  I guess I am altimately looking for someone to tell me it will be all right.  But I know that is not going to happen.  Again, thank you for your reply.  Good luck to you.  

[Trackermom]

Hello Dominic-
I was also found to have a mildly dilated ascending aorta.  I was told cardio is good heavy lifting not good.  I however wasn't told exactly the limit.  I have/am actively losing weight and worried that if I can't even do light weights my weight loss will slow.

It was hard for me to find anything on the internet about whether a person can be stable and never require surgery.

I have high blood pressure, which I may have waited too long to treat so that could be the cause.  Do you have high blood pressure?  The medication your on will help decrease the blood pressure thus less pressure on your aorta.

My doctor did say that if this was caused by HBP it wouldn't necessarily get any bigger and I may never need surgery.

I have a high BSA (Body Size Area) so for being a 6 foot 1 and 3/4 of an inch woman and carrying more weight than I should my aorta could be bigger than most and it isn't necessarily an aneurysm.  

I just posted a great report here.  Here are the links.  It helped calm me down.

Also my doctor said that the CT scan only shows one picture (slice) where the aorta is 4 cm.  He said it is possible to get an overestimate if the radiologist measured on the oblique portion of the aorta.  So I will be getting a MRI in a couple of months. Meanwhile it is blood pressure medicine and more cardio and trying not to get freaked out :)

I found this very interesting and it has helped me emotionally calm down.
Hope it helps someone else.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2605304/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2605304/figure/F6/

Hopefully, this helps in some way.  I was new here in Dec 09 and know what it is like trying to find out anything about what is going on with your body.