aortic aneurysm

[abbs]

My husband recently had chest pains and we thought it was due to his anxiety because he had stopped taking his paxil.  he went to a cardiologist who did stress test, blood tests, echo, and ct scan.  long story short it was found that he has a slightly enlarged aortic root and then further found an aortic aneurysm at 4.6cm.  we are seeing a surgeon on dec. 7.  the cardiologist said that most like the surgeon will not do anything right now.  the odd thing is that my son who is 7 years also has a slightly enlarged aortic root.  my son went through a genetic clinic.  they both show no signs of a connective tissue disease.  they are both shorter and stocky.  what is the outlook of these conditions?

[CCF-M.D.-MJM]

Hi Abbs,

It is good know there is no sign of connective tissue disease.  Aortic aneurysms of this size and no other confounding factors like bicuspid aoritic valve or connective tissue disease are usually followed over time for progression.  Some aneurysm progress faster than others, time is the only answer.  It may be years or decades or never before he needs a surgery, but unfortunately all you can do is wait.

The outlook depends on risk factors (mentioned above) and the need for surgery.  The younger you are for your first surgery the more likely you will need a second or third.  While the risks increase with each subsequent surgery, it is generally a pretty safe procedure in a high volume surgical center and experienced hands.

Thanks for posting and I hope this helps....

[Avel]

It is very difficult to receive this diagnosis, but I want you to know you are not alone. There are conditions affecting the aorta that still are "nameless", generally termed as familial aortic disease.

I want to share these resources with you.

http://www.bicuspidfoundation.com (this deals with all aortic diseae, not just the bicuspid version!) I can be reached via email at this website.

http://www.cedars-sinai.edu/aorta

Best Wishes,
Avel

[pbanders]

I sympathize with your concerns and problems. Early this past year I had elective surgery to repair a 5.0 cm ascending aortic aneurysm, which was discovered during an echocardiogram (I had some PAC/PVC issues that I was having looked into). I am 46, very fit and do not have Marfans or have been diagnosed with other connective tissue disorders. Like you, this was a shock to me and my family, I was very depressed and afraid. Luckily, I had a friend who was a perfusionist for 20+ years who assisted me in finding an excellent surgeon, and a month after my diagnosis I had surgery. I am writing to tell you that while this is a dangerous and risky condition, and that the surgery has its own risks, that the vast likelyhood is that things will go well and your husband will come out of this in excellent condition. I feel as if I never had the surgery at all, for the most part. I used to race bicycles and I am still able to ride my bike in difficult terrain on rides of 1 to 3 hours as I did before surgery. I'm on a beta blocker (metoprolol), which takes a bit of the edge off of your aerobic capacity, but you get used to it and it becomes a non-factor quickly. I <strongly> recommend you review the information and the Cedars-Sinai link in the earlier posting, it's probably the best summary of information on this topic that I've seen, and I've been all over the web researching my condition. Good luck, you and your family will come out of this fine, we did and others have, too.

[I'mallheart]

hello sorry about whats going on..hopefully all will be good..i am 28 overweight by about 35 pounds..i take a beta blocker for tachycardia.. i have a pulsating stomach and neck(both sides of neck,i can see my pulse) i have no bulge as far as i can tell in my stomach but can see it go up and down to the beat of my heart...its wierd...should i be conserned
thanks
DAVE

[bob_sixsix]

Hello Abbs,

Sorry about your husband's condition.  I too have been going through the echocardiograms, CT scans, Holter monitors, nuclear stress test and today I went for a MRI (MRA with contrast).  I had the CT Scan done and they noted that the ascending aorta at the sinotubular junction was 44.5mm, 36.8mm at the take-off of the left coronary artery and a prominent sinus of Valsalva.  I have had four echocardiograms and they all show the aortic root to be approximately 38mm.  The doctors did not call the 44.5mm section an aneurysm, they said it was "slightly dilated".  This CT scan was done 2.5 years ago and I had another one done last month at the same facility.  The results of this last CT Scan did not measure the area that was in question - the sinotubular junction 44.5mm - but did give a measurement of 44mm at the take-off of the left coronary artery which was previoulsy recorded at 36.8mm.  I questioned the doctor on this and he told me that they have updated their equipment from 2.5 years ago and that it is difficult to know if they were measuring in the same location????  I immediately went for a second opinion to a larger university medical center (Yale New Haven) where they repeated the echocardiogram and found what appears to be a "bulge" in the aortic arch that he wanted to confirm with the MRI.
I'm kind of confused as to whether or not this should be considered and aneurysm.  I have been told that it could be because of my height, size and weight that I exceed normal ranges but I do not feel too comfortable with this.  I am 6'6" tall and weigh 220lbs.  All this testing was started to rule out Marfan's because I had some physical characteristics of Marfan's - arm span vs. height ratio greater than 1.07, high arch to roof of mouth and flexible thumb slightly overlapping palm.  There is no history of Marfan's in family and I am a triplet (three boys) and nobody else has any characteristics.
Sorry for being so "long-winded" here, but I'm just really nervous about this MRI I had today and thought I would get some feedback here.  I asked the radiologist if I can view my images after the test and she allowed me.  She said the aortic arch looked slightly larger than normal but it was difficult to confirm without performing the measurements.  It was kinda' cool and scary seeing my aorta lit-up like a Christmas tree on that computer monitor.

I hope everything turns out alright with your husband.  I wil keep you posted with my MRI results if you are interested.

Take care.

~Bob

[noreaster]

Hi - I can relate. My stomach pulsates with every heartbeat :-) I asked my family doc about it but she said it was because of the tachycardia. Personally, I don't think that's the case as I can see it with lower heart rates too.
I understand your concern because I know how I felt when I first noticed it and I still feel uneasy about it sometimes.
But since we're both too young for AA, maybe it's just normal for us?
Take care. :-)

[abbs]

thanks everyone for your comments.  i really appreciate all the info.  i feel sometime i get more info from the computer than from doctors.  all the info is encouraging yet a little scary.  everyday we just count our blessing and we are sooo blessed that this problem was caught before something bad happened.  we were visiting my husband's 90 year old grandma and grandpa this weekend and through conversations it had come up that some of his past relatives had just died suddendly while doing outside work with no explanation.  not much more info than this.  his relatives are from south eastern kentucky where medical care and money are few and far between.  

to bob-six six,  i hope all goes well for you.  you should try to post a question to the doctors on this site.  it is hard to get on but they might be able to give you some insight into your history.  good luck!!  take care and i am sure all will be ok.  

abbs

[I'mallheart]

thanks for the imput..it sux to why we have this as all my frieds brother etc dont have this..i too can see it with any type of heart beat(slow or fast) i try to ignore it but every once in awhile i am like what the heck, but my insurance is now cancelled so just have to deal with it..ive noticed it for about 2 yrs now,,why all of a sudden it comes on like that, who knows.. where are you from? whats your age? hope all is well
DAVE

[Dave 1652]

My husband has had the exact experience!   10 years ago, when he was 42, an echo showed a 4.7 aortic root.  He has had this measurement for 10 years on the echo.  This past year, the echo showed an enlargement at the arch, so he had an MRA. This showed a measurement of 4.0, which is what the same test showed 4 years ago.  Only then, his Dr. assumed the test was misread.  We had this one reread to be sure.  

My husband's echos measure larger because he has a slightly enlarged heart because of being a runner. This causes the test to be inaccurate.  

We became experts at Marfan during these 10 years, going to many conferences. Now, it appears he probably doesn't have it! Your husband and son could possibly just have an enlarged aorta with no other connection to marfan.  

Don't jump into surgery!!!! It's way too soon, unless he has full blown Marfan,which is unlikely.    They need to have yearly echos and possibly be on beta blockers, which slows the progression of enlargement.

Hope this helps!!

[abbs]

thanks so much dave.  i will definitely show my husband your posting.  he is sooo down in the dumps.  my son went to a genetic clinic this summer and the genetic specialist took one look at him and said that no way does he have Marfans.  he is a chunky little thing who wears glasses.  a lot of people say he looks like the kid on "the christmas story" movie.  we go to the heart surgeon on tues of this week and we will definitley seek second opinions no matter what.  my husband is not a runner but does suffer from depression in which he takes paxil for.  he goes off of it periodicly and then the anxiety and chest pains come back.  we are going to stay on the paxil from now on.  

my son will be monitored on a yearly basis as he had a congenital heart defect when he was born.  (Ebstein's anamoly).  the heart doctor said this has resolved and the last person that read his echo said they could hardly tell anything was wrong with his heart.  no mumur or anything.  then the cardiologist read it and said that his aortic root was slightly enlarged thus leading to the genetic testing etc.  he sees a good Cardiologist at a Children's Hospital in Columbus Ohio.  

thanks again for your input. i love this site.

have a wonderful christmas.

abbs