aneurysm growth rate (any of you have VERY stable aneurysms?)

[chris4point2]

i will try and make this as brief as possible but i am covering many years here.  i am a 35 year old male with an aortic root of 4.2, first found in 2004.  In 2004, i felt like i was having a rapid heart beat and palpitations, for which among other things an echo was performed.  an aortic root of 4.2 was found and to be honest in my 20's I didn't really understand the impact.  I continued to workout, lift VERY heavy weights (boarder line body building), etc. all against doctors orders.  as more time went by i actually forgot about this diagnosis, and just happily did whatever i wanted.  i was ~168 pounds and benched nearly 300#'s.  in 2011 i had an echo for some chest pain, which was 100% normal (aortic root was 3.7).  I was shocked because I recalled the 4.2 reading from years earlier, only after the doc mentioned it was a normal echo....  meh, i kept lifting (heavy) though the heaviest i did was ~ 100# dumbells on bench press...

In 2012 i went for another echo to follow-up and the 4.2 reading was again there (likely an error in 2011).  This 4.2 was confirmed via CT.  cardiologist was not very concerned but limited me to reps of 12-15 on weights.  told me to go see a surgeon if i was that uneasy.  i did exactly that and now have a much more serious set of limitations (from surgeon) and as a 35 year old I understand the severity.  i was also told these things usually grow .1cm a year and surgery would be a likely outcome in ~7 years.  to be honest i can't mentally get it out of my head, i was much better off with the ignorance is bliss approach i had from 2004 to 2012...  i did just send the records from 2004 to the surgeon this past friday and i am awaiting response.

just curious if anyone else has one which is very stable.  is it possible a 4.2cm root can stay 4.2?  is there a way to assess wall thickness of the aorta?  what is the best resource for my questions?

with the costs of medical appt's its not like i can go see 5 different cardiologists...

i want to run, i want to jog, i want to lift... arg...

[Johncope71]

You may want to check out a study which seems to show that taking Curcumin may halt or even reverse the growth of aortic aneurysms.
I have been taking it for several months and my last scan showed no increase in size; the first time this has been the case.

[skydnsr]

There is no way to know how long your aorta will stay at 4.2.  It might stay that size for many years and then suddenly start growing rapidly.  It might measure slightly larger the next time you have an echo and then continue to grow slowly over the years.  It might stay the same size for a number of years and then start to either slowly or rapidly get bigger.  These things do what they want to do.  That is why it is important to keep up with your regular checkups, because there is no way to guess what the aorta is doing without measuring it .  

As far as I know, the thickness of the aortic wall is not of particular interest.  It is the diameter of the aorta that is considered important.  Outright ruptures are rare at any size aneurysm.  What is more predictable is that, if the aortic root gets too large, your aortic valve may start to leak blood backward into the heart (because the leaflets of the valve are getting pulled apart).  The other danger is that of an aortic dissection, in which the layers of the aorta separate, and you get blood intruding between the layers.  

Ruptures similar to the popping of a balloon do happen, but a rupture does not represent the usual outcome.  Those other outcomes, though -- the valve dysfuction and the possibility of a dissection -- are bad enough.  Any one of those three types of outcome can be fatal.  The result of a rupture is obvious.  Victims of a dissection will usually die from shock, and valve dysfunction is a slow death by heart failure, if not treated.

With an aortic root that was measured at 4.2cm when you were 27 years old, IMO you can pretty much count on having to have some kind of intervention at some point in your life.  There are always exceptions to the rule, and you might turn out to be the exception who can go your entire life without medical attention and never have any type of aortic catastrophe happen to you.  But the odds are against you, because your aorta was found to be enlarged at an early age.

I had the opposite experience to yours, meaning that I only found out that I had this problem when I needed surgery.  I got the diagnosis and the recommendation for surgery at the same time.  In my opinion, it is better to know about it beforehand, so that you can think about what you want to do and make your longterm plans.  My condition was a virtual emergency on the day I found out about it.  There was a lot of frantic running around and panic involved in just trying handle the situation.  I don't wish that on anyone.

You have a chronic medical condition that right now is not causing you any significant discomfort, and the fact that you feel well is fantastic.  But ignorance is not bliss.  There have been people who dropped dead because they had no idea they had an enlarged aorta, and their aortas dissected without warning.  Had they been routinely monitored by a doctor, perhaps they could have been successfully treated and lived long, healthy lives.  

Because you do need regular medical attention and monitoring, it will be important for you to secure a good means of having reliable and affordable access to medical care.  It's something to think about.  It might require making some big changes in your life, such as a change in employment.  But the situation is what it is.  Good luck.

[malteseman]

Chris,

It can blow at 3.5, it can blow at 3.8, it actually can blow at any number!! But, your enlargement is very, very small and the risk of it blowing, is actually negligible. Doctor's only start to get worried over the 5.0cm mark....

I have 45mm, Cardiologist orders are to carry on living normal, encourage me to run, jog, swim etc... but, no very heavy weight lifting (Very heavy!!)

Relax buddy!... Oh, check your valve is not bicuspid (aortic), it could be a reason on enlargement. If your aortic valve is bicuspid, then this is the most common congenital heart defect, around 2% of the population have it, Majority will require replacement at some point, due to stenosis or regurgitation or both, but, it's fixable, and should lead you to normal life, life span etc.....

[Eddie1994]

The downside is that it can still blow at 4.2.  My Dad was at 4.3 at age 78.  At age 65 he underwent open heart surgery and no aneurysm was visible.  I was probably more worried than my Dad about his aneurysm but unfortunately cancer took his life.

My wife had a ruptured brain aneurysm in 1994.  She survived but not without complications.  I guess the moral of the story is that you can ignore it but someday it may catch up with you.  If it were me, I'd be dealing with it because I've seen the downside.  Good luck!