Slightly Dilated Aortic Root

[losty815]

My daughter 7 years old, born July 7, 2001, had a electrocardiogram and ultrasound on May 12, 2009.  The electrocardiogram showed normal.  The ultrasound showed a slightly dilated aortic root.  A scheduled appointment is set up for July 28th with a cardiologist from London, Ontario.  

Could you please describe in layman terms what slightly dilated aortic root is?????

Should she still play soccer, running etc?

Thank you.

[cranioNheartmom]

My 9 y.o. son was just dx'd with an aortic root dilatation of 2.7 on May 13th and his cardiologist hasn't really put him on any real bad restrictions other than the ones the doctor here has mention(contact sports,push-ups,sit-ups,pull-ups,weight lifting ect) but do stay active.She also spoke with me and my son about working on his diet(lowering fat intake and lowering salt intake) as they can raise blood pressure which in turn puts more pressure on the dilated section.Also keep up with good dental care.
My son has done well with the limited restrictions so far mostly b/c he has been dealing with the contact sports one since he was a babe as he was born with a VSD and Craniosynostosis(both repaired).We are now awaiting results from being tested for Loeys-Dietz as that as well as how well does and the f/u echo in Nov. will determine when he will have to add blood pressure meds or repair his aortic root.
It can be scary when you child is dx'd with anything especially when it deals with the heart BUT educate yourself,find a good doctor who deals with ped cardiac issues and last but not least go with your gut.If you have questions ask them as doctors can not read our minds and have no problem answering questions even if they might sound dumb to us..
Please keep us updated on your daughter..{{{HUGS}}}

Martha

[Marie M Gleason, M.D.]

Dear losty815: Echocardiography is an excellent non-invasive tool for looking at the heart structure in great detail.  I am not sure why your daughter was referred for an ECG and echocardiogram, but common reasons include: heart murmurs, family history of inheritable heart problems, and other symptoms such as chest pains, passing out and palpitations. It is not unusual to have things noted on an echocardiogram that are unexpected.  The notation of aortic root dilation is one of those.  

The left ventricle is the pumping chamber that ejects blood out to the body; blood flows across the aortic valve into the aorta, which is the main blood vessel that carries blood to the body.  The “root” is the part of the aorta just above the aortic valve, in the ascending aorta.  There are norms for size depending upon the body size of the patient (body surface area (BSA) takes into account both height and weight).  If the measurement of the aorta on echocardiography exceeds the upper limit of normal for the patient’s body size, then it is considered to be enlarged.  It can vary in degree of dilation from very mild, all the way to severe.  

Sometimes this is seen in patients with no other structural abnormalities of the heart and is usually mild.  It can also be seen in a variety of congenital heart conditions, most commonly a two-leaflet (bicuspid) aortic valve.  The more serious conditions that are associated with dilation of the aortic root involve abnormalities of the body’s connective tissue, and include syndromes such as Marfan syndrome, Loeys-Dietz syndrome, and Ehlers-Danlos syndrome.  These are inherited conditions passed from generation to generation, but in some families there is a new mutation of a gene, and the patient is affected even though no other family members are involved.  In these patients, the connective tissue that makes up the walls of the blood vessels has abnormal fibrillin, and the walls become weak, and can develop aneurysms (bulges) over time.  These blood vessels are at risk for tearing.  This can lead to internal bleeding called an aortic dissection, and can even cause death.  Surgery is indicated when the aortic enlargement is severe.

The degree of activity restriction depends upon the amount of aortic root dilation, and whether there is an underlying syndrome or valve problem.  It is always best to avoid contact sports and isometric activities (heavy lifting, weight training, pull ups, chin ups, push ups) when the aorta is dilated, as these activities may pose an undue risk for further stretching or even tearing the aorta.  Your cardiologist will do a thorough evaluation and, discuss their thoughts about the underlying cause and what restrictions are required, if any.  Some patients are recommended to undergo evaluation by a geneticist, to see if they are patients with a syndrome that predisposes to this aortic problem.  In the meantime, speak with your primary doctor regarding activity restrictions.  It would be reasonable to refrain from contact and competitive sports until the cardiac evaluation is complete.