Pediatric Heart Expert Forum
Please explain this to me!
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Please explain this to me!

My son had an ECHO test performed three weeks a go due to an emergency hospital trip. The trip was totally unrelated to his heart but they ran an ECHO just to be sure and by chance they found something abnormal. We drove three hours yesterday to a "specialist" who could only tell me that a part of his aorta is bubbled out. She said his aorta is normal size and then extends out a little then goes back to normal. She said "I don't know what it is" I asked her several questions and she said "I don't know" or "I can't be sure." She said he will either grow into it, it could be just a different style of development, or that it could get bigger. She didn't offer to do another echo test until three months from now. I'm nervous to wait that long. I AM going to ask his pediatrician to refer me to someone else for a second opinion and to run another Echo. To me this sounds like an aneurysm, but being a cardiologist wouldn't she know this? She never mentioned the word aneurysm to me, then again she was not compassionate at all. Have you ever heard of a condition where the aorta is normal size then dilates out then goes back to normal? He is 14 months old. Also, if the second opinion I receives does say it is an aneurysm, are aneurysms common i young children? How long do they take to grow and burst? Thanks ahead of time!
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Dilation of the upper aorta can be seen with bicuspid aortic valves.  Or it can be related to connective tissue disorders of a familial nature.  You should ask your pediatrician to refer you to a geneticist.  A follow up echo in 3 months time should be fine as long as the doctor felt the enlargement was mild, and not severe.  If the aorta is moderately to severely dilated, then your doctor could also consider doing a cardiac MRI and MRA of the entire aorta.  The prognosis for aortic dilations is good, but in part depends upon the presence of any underlying connective tissue disorder (hence the need for a genetic evaluation). The cardiologists follow the aorta to see the rate of change to determine if a tear or rupture is likely.
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Update: We went to see the cardiologist we were referred to and we were terribly upset that she had no answers for us. She said he would either grow into it or it would grow to be too large and we would have to replace it. Her bedside manner was terrible. I called a pediatric cardiologist in a different area and scheduled an appointment with him for a second opinion. We went tot he appointment yesterday. He was wonderful! They ran an EKG on him and then the Echo right in front of us and explained everything as he went along. Turns out there is absolutely nothing wrong with this baby's heart. His measurements were perfect. He said there could be several factors as to why we got a negative result last time, but his measurements are good and there is no concern.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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