1) Anurysms really dont tend to form overnight. Would it be unreasonable to screen you again in the future? No. But that said, there really would be no need for frequent screening. If you are worried about a AAA, an easy screening test would be an abdominal ultrasound looking at In patients over the age of 65 only 1 percent who have a negative ultrasound will develop an abdominal aortic aneurysm in the next five years aorta. Once detected, the standard of care is yearly ultrasound, if the size of the anueysm is under 5.5 cm, usually repair is not indicated, unless there is rapid enlargement. So I would basically get an ultrasound in about 5 years if you continured to be concerned and aggressively monitor your risk factors.
2) Very unlikely.
3) Ace inhibitors are good for hypertension. Listen to your doc.
good luck
thank yu for your speedy, thorough reply;
although I'm concerned about AAA in view of family history, I am put at ease by easy availabity of ultrasoud testing for it; the tech at recent ECHO stress test, at guidance, of cardilogist also checked for AAA (no signs found); however, the symptoms nearby the bottom of left shoulder blade keep me a bit anxious about aortic arch/thoracic site(s);
(1) I've also heard/read that these scapular pains can be an unusual/rare indication of angina and considering the PET scan dx of 'diffuse CAD' (mild regional heterogeneity of radiotracer uptake throughout the left ventricular myocardium with a moderate longitudinal base to apex gradient of flow mostly in the anterior segment), what would you think ?
(2) per cardio's advice, I'm on daily 81 mg aspirin (anti-thrombolytic), B-100 vitamin and 4 mg Folic acid (for high Hcy - possibly from Tricor; was 17, now 7), Tricor 57 mg (pre-treat TG was 275, HDL 30-35, TC 190, LDL 109), multivitamin, Vita E 400 mg, Vit C 1000mg, plus modified (fish, LF dairy) -vegetarian diet;
anything unusual, contra-indicated therein ?
(3) while my resting Bp was in the 13x/8x range in 2001, after a gradual 4 yr hiatus from regular exercise and increased life stress, it is now (with 1 hr walk/run per day, 6x per week plus upper body strength train w/ lot of reps with low weights -sometimes on machine, sometimes free weights, as well as some meditation/relaxation technques) back in the 12x/7x range at rest as it had been always before; sometimes at O.V. it is 11x/7x and sometimes 13x/8x; 24 hr ABPM showed it to be 'normal' although I have no more detailed data than that; resting pulse 6x BPM;
given all that, is ACE inhibitor still indicated with aneurysm family history ?
and what might the resting on-medication BP 'target' ?
1) I cant answer without more data. Probably not. A catheterization would answer exactly what you anatomy is. If you have ischemia on the PET and symptoms that would be the next step.
2) no. It is a good regimen. Except I would not take vitamin E, it isn't helpful and may actually be harmful in coronary disease.
3) A low dose ACE would probably be beneficial. Target your BP as low as possible without symptoms. Usually aroun 100.
good luck