I had chest pain back the end of jan. My ER test came back ok. My family DR wanted more test an sent me the first part of feb for an echo. The echo results sad I had an aortic root anyrismy that was 3.7cm at the top an 4.6cm. I was having disc fusion surgery April 14 2012 my surgeon want another echo an it came back 4.0 cm at the top an 4,8cm .I want to know why my heart surgeon acts like I shouldnt be concerned. I think I should by the info Ive read online. MY Mom had many heart surgerys an my Dad had an aortic anyerism. I feel I should get another echo soon an my DR says in 6 more months. should i press te issue? Should I find a new DR?
First of all, Byron is not a physician, and unfortunately, most or all of the information he provided in his answer is incorrect. Cardiologists are not surgeons, and surgeons are not Cardiologists. There are cardiologists who focus on management of aortic aneurysms, and when surgical intervention is needed, they will refer to a cardiac surgeon who can perform the aorta repair surgery. Minimally invasive surgery does exist, but not for aorta surgery for aneurysm, at least yet.
Aorta size is indexed to either your body surface area or height (depending on institution). What is normal for a 5ft tall person will overlap but not completely with what is normal for a 6ft tall person, which makes sense, as the bigger person has a bigger body and organs, and needs to move the blood in larger vessels. With that said, your aorta is slightly dilated. Typically you are correct about when to intervene. There are always circumstances that would change that (pregnant women, Marfan's patients have lower threshholds).
With regard to your situation, I don't know why your spine surgeon would want another echo, considering they aren't a cardiologist. We typically would only perform surveillance on these every 6-12 months, and your dimensions would not otherwise prevent surgery on your back. Typically echo is a good screening tool, but there is less reproducibility of the results, meaning that based on the person reading the test, who the technician was, and how good the images are, there can be variability based on where they mark the edges of the aorta. A CT scan is a better test (with contrast) for measuring, however, the radiation exposure is such that they should be limited to once a year at most. There is a more reproducible result with those.
I really no nothing about heart disease, but may ask you what kind of insurance you have? An HMO, or what??
And what kind of doctor gave you this information? Can you just go see a good Aorta Cardiologist (Surgeon). They are now beginning minimally invasive aorta surgery where they enter between the ribs and perform microsurgery.
If your insurance will not approve such a Proceedure, file a complaint with the patient advocate of the parent company.
I a good hmo plan. Ive had 4 surgerys in the past year an a half I had l5,s1 fused Jan 2011 a hernia replair in Mar 2011 an had c4,5,6,7, fused april 2012 an they have had no problem with any an paid it all. I had a hospt stay in may 2012. I would like to know more info on what I should do about the aortic root anuerism. mine was 3.7cm at the top an 4.6cm at the root in Jan 2012 an in April 2012 the echo showed the top at 4.0 cm an the aortic root at 4.8cm. I also would like to know if my size has any bearing on the size? Im 48 year old male in good physical shape I wgh 195 and Im 6ft tall. Is there a certain size that is normal for my size? Everything Ive read says that anything above 3.9cm is a anuerism.Also when is surgery recommended, everything Ive read if it reachs 5.5 you need surgery or if it groes 2mm in a year, is this correct?
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