Aortic aneurism

[Dd852]

So the exciting news of today is during a routine echo cardio gram for something else entirely (the occasional extra beat) the cardiologist found that my aortic root is dilated. He says not so much that we need to do anything now (c. 4.1 cm) other than test again in six months but I can’t help feeling a bit disturbed … for a control freak to have something so completely out of my control that there weren’t any symptoms!

Wondering whether any of you have had this experience? Did the watch and wait period last years? Decades? What happened once you decided to take action? Full surgery? Keyhole?

Thanks

 

[braumeister]

That's why the "AAA" (abdominal aortic aneurysm) screening is often recommended. A simple ultrasound scan that only takes a few minutes, but it's designed to detect abnormalities that can go unrecognized.

https://www.mayoclinic.org/tests-procedures/abdominal-ultrasound/about/pac-20392738

https://www.medicare.gov/coverage/abdominal-aortic-aneurysm-screenings

 

[VanWinkle]

I was screened in 2019 during my age 65 Medicare check up and determined to have an Abdominal Aortic Aneurysm measuring 4.6 . The vascular surgeon advised that they don't recommend surgery(through the groin stint) until it reaches 5.5cm. I have had 2 scans since then and no changes. My brother also has one that was at 3.6 for 4 years, went to 4.0 last year, and up to 4.7 this year. The prognosis was still to wait and have the yearly checks. The risks of surgery outweigh the benefits until the 5.5 cm size is achieved. It is a fairly common problem with former smokers and family history.

I hope that helps you,

VW

 

[billnd01]

I had a small stroke in 2013 (on my 59th birthday) and while trying to determine the cause they found I had an Ascending Aortic Aneurysm. A freebie they said as they explained that many people have them but are unaware until it ruptures, and then many times it's too late. Now it can be monitored. Mine was 4.5 cm when discovered and is now 4.7 cm. They felt the change in size was due to updated more sensitive equipment then actual growth. They started monitoring every 6 months but went to 12 months after the first couple years because of no growth. I am going back to every 6 months now because of my age - 67. It worried me for the first year or so but now I don't think about it. Just live my life as usual.

This has been my experience. I hope all goes well with you.

Bill

 

[Another Reader]

The first trip to the hospital for the "mystery illness" in May 2020 required a chest CT scan that turned up a substantial thoracic aortal aneurysm. 4.7 x 4.5 cm. As a small person, this was of immediate concern. Surgeons were consulted, meaning an extra 24 hours of hospital food. Conclusion: Looks stable to us. Second trip with chest pains and near syncope at the end of September, they assumed this was the cause, new CT scan, same result. Third one a month later for the same symptoms. Conclusion: Stay the hell out of the hospital, because this was the only thing these folks would look at.

Somewhere in all this, I remembered several years back the PAMF cardiologist discovered this aneurysm and said it looked stable and unremarkable. Said it was not uncommon.

With Long Covid and a lot of vascular issues, this probably needs another look, although between all the chest x-rays, and CT scans since April 2020, I have probably exceeded my lifetime quota of radiation, but there is agreement that annual monitoring is required. So that should go on the "to do" list...

 

[P.S.]

Conclusion: Stay the hell out of the hospital, because this was the only thing these folks would look at.

b/c a ruptured AAA is the closest thing to a SHTF in a hospital.

Not medical advice if I had an AAA, I would exercise moderately, keep BP and sugar under control, maintain an ideal BMI, learn how to relax and de-stress. This happens to be the same advice for most chronic medical conditions, esp in COVID era.
And stay within driving range of a hospital with blood products. Just kidding.

 

[RetiredAt55.5]

b/c a ruptured AAA is the closest thing to a SHTF in a hospital.

Yes, my father died at 63 from one. The hospital was only 1/2 a mile away when it happened.

 

[Alan]

So the exciting news of today is during a routine echo cardio gram for something else entirely (the occasional extra beat) the cardiologist found that my aortic root is dilated. He says not so much that we need to do anything now (c. 4.1 cm) other than test again in six months but I can’t help feeling a bit disturbed … for a control freak to have something so completely out of my control that there weren’t any symptoms!

Wondering whether any of you have had this experience? Did the watch and wait period last years? Decades? What happened once you decided to take action? Full surgery? Keyhole?

Thanks

A dilated aortic root is very close to the aortic valve and when my SIL had something very similar a couple of years ago the immediate advice was to stop high intensity exercise until more tests and scans were done.

She also had no idea it was there as it was picked up on a routine body scan (she had volunteered to be a test subject for this new machine). In her case, after more tests and scans the decision was to replace that section of the aorta along with her aortic valve. This was January 2020 and her recovery has been quite remarkable.

It's good that it has been spotted so early.

 

[eytonxav]

DW's grandmother died from that, so DW has hers checked every couple of years. So far no indications of a problem, but just another one of those things to worry about.

 

[Dd852]

Thanks all. This was not anywhere on my list of things to think about/worry about! I appreciate the input which helps put it in perspective

 

[Another Reader]

b/c a ruptured AAA is the closest thing to a SHTF in a hospital.

Not medical advice if I had an AAA, I would exercise moderately, keep BP and sugar under control, maintain an ideal BMI, learn how to relax and de-stress. This happens to be the same advice for most chronic medical conditions, esp in COVID era.
And stay within driving range of a hospital with blood products. Just kidding.

Agree about the SHTF. If it goes, you need a surgeon right now. A helicopter nearby to get you to the surgeon would also be helpful...

My frustration is that they would not look at the other issues that qualified as "emergent." My issues were related to Covid, but without a positive PCR nothing Covid related was considered.

 

[swakyaby]

b/c a ruptured AAA is the closest thing to a SHTF in a hospital.

And stay within driving range of a hospital with blood products. Just kidding.

So true. Something tells me you’ve had some personal experience dealing with a rupturing AAA.

 

[gauss]

Mom has been between 4 and 5 cm for over 10 years. At age 89, I am starting to think that they may never treat it.

The key thing to take note of is the year over year change in size. I think if it is below 5 cm (at least in Mom's case) they don't actually treat it. Once it reaches 5 cm, surgical correction may be on the table.

-gauss

 

[jabbahop]

They found my ascending Aorta aneurysm 6 years ago (55 at the time) during a scan to figure out the extent of my Hodkins lymphoma (a scary health stretch for sure). They also did a genetic test for marfans and similar genetic traits and had my three sons all get their aortas measured as a baseline (none were abnormal).

It was measured @ 49mm and has been +- 1mm ever since. For the first year or so, my cardiologist watched my blood pressure (normal) and asked me to cut down peak efforts when biking. Year 2-3 loosened the exercise reigns a bit and still no change.

Now I am playing a lot of pickleball vs cycling these days and just had my echo in September and again no change. I play pickleball with a guy that had the surgery (he had a larger one that involved the valve) and he has recovered completely.

My grandfather died of an aorta dissection but that was apparently abdominal and am not sure if there is a relationship between the two.

Good luck to you and hope that yours doesn’t require surgery.

 

[Ian S]

Everyone on Medicare should avail themselves of the free test for this. My husband's aunt died of this in her early 70s. Obviously she never had the test. Not a hint of a problem before she was stricken. Initially doctors thought she was having a heart attack and by the time they determined what it was, it was too late.

 

[Scratchy]

There's some confusion in this thread between ascending aortic aneurysm, (which is in the chest) and abdominal aortic aneurysm. Some similarities but also some very important differences.

 

[Mr._Graybeard]

I believe the abdominal aortic scan is recommended for anyone who has a history of smoking.

 

[Alan]

I believe the abdominal aortic scan is recommended for anyone who has a history of smoking.

In the UK it is recommended for anyone with a history of being male.

The NHS invites all men over the age 60 to go in for one. I was given the all-clear and won’t be invited back for more routine screening.