Aa
Hypertension & Asending Aortic Dilation
I can't seem to find information on hypertension and Ascending Aortic Dilation specifically that once hypertension is treated that dilation stops. I was diagnosed with a 4 cm ascending aorta dilation in December. I had started Benicar HCT about 4 months before this then was but on Toproal.
I am set for a MRI in June. Now here is another idea. The cardiologist wants me to have a MUGA scan, even though no tests indicate I have a function issue, but he doesn't want me to have a radioactive MRI for the Ascending Aortic Dilation because too much radiation. My feeling is I'd rather have the MRI with contrast that will highlight my current medical issue. This will be the first MRI since the CT scan in December. Any thoughts on that?
If you come across any links about what I talked about above please post them here. I am still searching, but figured I'd reach, again.
Thank you.
I am set for a MRI in June. Now here is another idea. The cardiologist wants me to have a MUGA scan, even though no tests indicate I have a function issue, but he doesn't want me to have a radioactive MRI for the Ascending Aortic Dilation because too much radiation. My feeling is I'd rather have the MRI with contrast that will highlight my current medical issue. This will be the first MRI since the CT scan in December. Any thoughts on that?
If you come across any links about what I talked about above please post them here. I am still searching, but figured I'd reach, again.
Thank you.
The CT 64 slice was done in Dec 09 and I just read it that it was mildly dilated on one slice it didn't show up anywhere else.
My cardiologist says he prefers the MRI and that if the person reading the CT reads on the axis or something they could read it larger then what it is.
In that link you posted it said:Anuerysms of the aorta are even defined even better then dissections with mri and in stable patients are the gold standard at some institutions for defining aortic pathology.
What if the MRI says it is 3.4 should I doubt that because of the variables or should I skip out of the doctor's office thinking I don't have a problem?
Are CT scan and MRI apples and oranges or can you compare them to form a overall diagnosis?
Hopefully, the cardiac cath measured it.
I just can't stand this. The possible condition, what is the best test, the uncertainty, that every time I have a twinge I think my god this is it? Actually I was doing well till my daughters recent surgery and I was stressed about that so I am hypersensitive again.
I feel like if I research everything and make a great case against aortic dilation some panel will say you have made your argument and you are right you don't have this condition. This will not be what does you in.
IF only it worked that way, right?
My cardiologist says he prefers the MRI and that if the person reading the CT reads on the axis or something they could read it larger then what it is.
In that link you posted it said:Anuerysms of the aorta are even defined even better then dissections with mri and in stable patients are the gold standard at some institutions for defining aortic pathology.
What if the MRI says it is 3.4 should I doubt that because of the variables or should I skip out of the doctor's office thinking I don't have a problem?
Are CT scan and MRI apples and oranges or can you compare them to form a overall diagnosis?
Hopefully, the cardiac cath measured it.
I just can't stand this. The possible condition, what is the best test, the uncertainty, that every time I have a twinge I think my god this is it? Actually I was doing well till my daughters recent surgery and I was stressed about that so I am hypersensitive again.
I feel like if I research everything and make a great case against aortic dilation some panel will say you have made your argument and you are right you don't have this condition. This will not be what does you in.
IF only it worked that way, right?
True, the definition of an aneurysm is not a hard definition but most surgeons would agree that if the aorta is twice the normal size of that segment that is an aneursym.
Also, the normal size of the aortic root is dependent on your height and age. It should not be more than about 3.5 cm. Similarly for the ascending aorta. The average size of the first part of the descending aorta is approximately 2.3 cm. The best way to diagnose an aneurysm is CT scan.
For some insight regarding tests. There is often a discrepancy in the size of measurement between CT scan, MRI and echo. The reasons include whether the internal or external diameters are measured, the axis of the aorta that is measured, and the site of measurement. Generally, a 3D reconstruction of the aortic root is the most accurate. However, echocardiography is a safer method for regular follow up because of the radiation dosages with CT. The state-of-art CT scan 256 slice has a low dose of radiation and provides a view comparable to looking at the heart directly (4D is 3 D with movement).
Also, the normal size of the aortic root is dependent on your height and age. It should not be more than about 3.5 cm. Similarly for the ascending aorta. The average size of the first part of the descending aorta is approximately 2.3 cm. The best way to diagnose an aneurysm is CT scan.
For some insight regarding tests. There is often a discrepancy in the size of measurement between CT scan, MRI and echo. The reasons include whether the internal or external diameters are measured, the axis of the aorta that is measured, and the site of measurement. Generally, a 3D reconstruction of the aortic root is the most accurate. However, echocardiography is a safer method for regular follow up because of the radiation dosages with CT. The state-of-art CT scan 256 slice has a low dose of radiation and provides a view comparable to looking at the heart directly (4D is 3 D with movement).
I have just requested my cardiac cath report and my EP study and ablation report. I think (HOPE) the cardiac cath report has measurements of the whole aorta.
My echo from 12 years ago are the same as the one I had in Dec and the 2001 Echo was even larger then the one from Dec. 09.
One would think that with all these results over the years it could be determined that maybe this is my size and I am not in any danger of anything happening from it.
My echo from 12 years ago are the same as the one I had in Dec and the 2001 Echo was even larger then the one from Dec. 09.
One would think that with all these results over the years it could be determined that maybe this is my size and I am not in any danger of anything happening from it.
Marfan isn't even a consideration. I would be the first person in the family to have an issue with my aorta especially at my age. I had high blood pressure 140/100 for about a year.
How do they determine those other factors you mention? The infection?
What about those other questions about the testing? I think I'd rather risk the radioactive injection for the MRA instead of the MUGA which wouldn't tell me anything other then function, which none of the tests so far even indicate my function is a concern.
I just want the best test for this particular situation. Granted the first test was a CT scan with dye but he said sometimes a reading can be read larger then what it really is so that is why he went with MRI. The question is MRI vs. MRA?
Thank you enjoy your evening.
:)
How do they determine those other factors you mention? The infection?
What about those other questions about the testing? I think I'd rather risk the radioactive injection for the MRA instead of the MUGA which wouldn't tell me anything other then function, which none of the tests so far even indicate my function is a concern.
I just want the best test for this particular situation. Granted the first test was a CT scan with dye but he said sometimes a reading can be read larger then what it really is so that is why he went with MRI. The question is MRI vs. MRA?
Thank you enjoy your evening.
:)
QUOTE: "I can't seem to find information on hypertension and Ascending Aortic Dilation specifically that once hypertension is treated that dilation stops."
The underlying cause maybe the determination of an outcome of lowering blood pressure.
The most common cause of ascending aortic aneurysms is a condition known as idiopathic cystic medial degeneration. The elastic fibers which make up the outer wall of the aorta normally break down as we age, making the aorta more prone to dilation. HPB certainly would exacerbate the condition, but normal blood pressure may also be a factor!?
Genetic disorders.
Marfan syndrome is a genetic condition which is transmitted from parent to child that affects the connective tissues throughout the body. The defect is in the gene that makes fibrillin, a major elastic fiber protein found in the wall of the aorta. Nearly all patients with Marfan syndrome develop aneurysms of the ascending aorta and subsequent leakage of the aortic valve. These aneurysms are prone to rupture at smaller sizes when compared to aneurysms of other etiologies. Blood pressure doesn't appear to be a factor.
Other Causes:
Infection of the aortic wall can rarely result in an aneurysm known as a "mycotic aneurysm." Inflammatory aortic aneurysms are a special type of aneurysm associated with a vigorous fibrotic and inflammatory response and require special surgical interventions
YHes, I did miss your post, sorry, but I don't know if what I have written provides any relief from anxiety. I can understand the stress of not knowing for certain any future outcome. If you have any further questions, feel free to ask.
The underlying cause maybe the determination of an outcome of lowering blood pressure.
The most common cause of ascending aortic aneurysms is a condition known as idiopathic cystic medial degeneration. The elastic fibers which make up the outer wall of the aorta normally break down as we age, making the aorta more prone to dilation. HPB certainly would exacerbate the condition, but normal blood pressure may also be a factor!?
Genetic disorders.
Marfan syndrome is a genetic condition which is transmitted from parent to child that affects the connective tissues throughout the body. The defect is in the gene that makes fibrillin, a major elastic fiber protein found in the wall of the aorta. Nearly all patients with Marfan syndrome develop aneurysms of the ascending aorta and subsequent leakage of the aortic valve. These aneurysms are prone to rupture at smaller sizes when compared to aneurysms of other etiologies. Blood pressure doesn't appear to be a factor.
Other Causes:
Infection of the aortic wall can rarely result in an aneurysm known as a "mycotic aneurysm." Inflammatory aortic aneurysms are a special type of aneurysm associated with a vigorous fibrotic and inflammatory response and require special surgical interventions
YHes, I did miss your post, sorry, but I don't know if what I have written provides any relief from anxiety. I can understand the stress of not knowing for certain any future outcome. If you have any further questions, feel free to ask.
My hypertension and my weight are the two risk factors. I have no signs of cholesterol build up (my chol. is 150 with good ratio and has been like that forever) I have dropped 35 pounds and kept it off. I still have weight to lose which is harder because I can't use weights and I am on the beta blocker. I stopped smoking 10 years ago.
My measurements have been the same for the last 11 years. Because I had a previous heart issue related to pregnancy. But for some reason this time they said something.
I had a cardiac cath, an EP study and a cardiac ablation. I should get a copy of that also. I have copies of all my echo's and MUGA's.
Would a cardiac cath and EP study show aortic measurements?
I am 6 feet 1 and 3/4. with a weight issue, but active.
My measurements have been the same for the last 11 years. Because I had a previous heart issue related to pregnancy. But for some reason this time they said something.
I had a cardiac cath, an EP study and a cardiac ablation. I should get a copy of that also. I have copies of all my echo's and MUGA's.
Would a cardiac cath and EP study show aortic measurements?
I am 6 feet 1 and 3/4. with a weight issue, but active.
"I can't seem to find information on hypertension and Ascending Aortic Dilation specifically that once hypertension is treated that dilation stops"
That's because dilatation doesn't necessarily stop once the hypertension is treated. HTN is one among many possible culprits that can affect aortic expansion.
That's because dilatation doesn't necessarily stop once the hypertension is treated. HTN is one among many possible culprits that can affect aortic expansion.
Have an Answer?
You are reading content posted in the Heart Disease Community
Is a low-fat diet really that heart healthy after all? James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines.
Can depression and anxiety cause heart disease? Get the facts in this Missouri Medicine report.
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
Learn what happens before, during and after a heart attack occurs.
What are the pros and cons of taking fish oil for heart health? Find out in this article from Missouri Medicine.
How to lower your heart attack risk.
