thoracic aortic aneurysm

55 y/o WM 5’11” 205lbs. 10/07 echo Mayo: aortic annulus 28 mm, sinus of valsalva 42 mm, prox ascending AO 33 mm, distal ascending AO 34mm. mild MVR, aortic valve sclerosis no stenosis no regurg. 5/08: MDCT cardiac scan showed “normal ascending aorta” patent coronaries. 06/08: underwent EECP with diagnosis microvascular ischemia. 09/08; echo stress test was excellent with no ischemia and I went 11 minutes. 12/08: echo with local cardiologist showed aortic root aneurysm of 4.4 cm. 12/18/08 abdominal ultrasound: 3.03 cm. ectasia. 12/22/08: return to Mayo Jacksonville. EKG, blood work  and CT w/o contrast of chest to evaluate aneurysm. F/U visit Mayo 01/05/09 for results. Are sinus of valsalva finding of 42mm in 10/07 and aortic root aneurysm of 44 mm in 12/08 referring to the same thing? Could EECP have contributed to the development of these findings? Will CT w/o contrast be good enough to reveal the aortic root dimensions. (have had mild rxn to dye in the past). Should I have a MRA? Should I repeat the echo at Mayo? The echos done locally are not well done. I am a jogger of 3.5 miles/day. Can I continue to run? BP controlled on Diovan 160 mg qd. Why did this not show up on MDCT in 5/08? What do you recommend? Thanks.

[Cleveland Clinic]

The echos performed all cut the aorta at different angles, so the different dimensions of the aneurysm. The CT will cut the slices axially ( at least reconstruct them this way) and is more accurate in sizing the aneurysm. You can continue to exercise if your exercising blood pressure is well controlled, and in particular you should be on a beta blocker to slow the progression of the aneurysm. The MDCT was probably performed looking for coronary stenosis and not looking at the aorta. One more important thing to find out is whether or not you have a bicuspid aortic valve.