Moderate dilation of the aorta?

Question

I have been diagnosed with what the cardiologist called a moderate dilation of the aorta. From the scan they did, they measured what they said was a normal section of the aorta at 2.5cm. The dilated section measured 4cm. I am 6'4" and the doctors said this would be more serious for a smaller person. I am being treated with anti-hyperternsive medications. He also said that I will need to come back in for a scan every year so that they can monitor the dilation and make sure it doesn't get any larger. The doctor said he doesn't think it will return to normal size, that the best we can hope is that it doesn't increase and require surgical repair. Can anyone offer their experience? Thanks.

Answer 1

Here is an article from a patient and I will not disclose his name, you can benefit from it:

Your problems with metoprolol are common. I'm still a LOT more sleepy than I used to be, I take 50 mg in the morning and 25 mg at night. You could try the time-release version (Toprol XL), or a different BB. Personally, I just am accepting it and tolerating it. I also stopped caffeine at the same time as I went on it, so it's been a double-whammy.

Typical growth rates for aneurysms are very slow. Get a copy of the Sept. '05 Scientific American, there's a good article on aortic aneuryms in it. They quote a rate of 0.12 cm per year. Yearly checkups after an initial 6 month scan to rule out rapid expansion are just fine.

Personally, I'd get a cardiologist who is experienced with aortic disease. My cardio is extremely experienced with them, and my surgeon has written a dozen articles on the subject, and has performed over 8,000 cardiac procedures. This condition is complex and requires expert care.

If you have not had a CT with contrast I would insist on one. Echo is not definitive in diagnosing aneurysms. You need to have your entire thoracic aorta imaged and assessed.

Be glad your condition was detected. Most aren't and progress asymptomatically to a disasterous dissection or rupture. I think your situation is more difficult than mine. When mine was discovered, I was already at 5.0 cm, the threshold for surgery. I had my operation in a month and didn't have to wait for years for the aneurysm to progress to the threshold for surgery. In your case, I would strongly suggest that you not let this rule your life - within prudent restrictions, do what you want. While being under 5.0 cm is not risk-free, the risks are quite low (as long as there isn't a family history of dissection). Don't let your aneurysm stop you.

As for post-surgery, in my case, I have no complaints. I raced bikes for years before surgery, I still ride a lot and at a high level. I did a solo ride this morning of 20 miles with 1,000 feet of climbing, and averaged 18.5 mph. I finished the ride by mixing it up with two domestic D3 pros who were probably younger than 25. Not bad for a 48 year old guy who's had his chest cracked and is take a drug (metoprolol) that cuts your aerobic capacity by 10-15%, huh?

Best of luck with your treatement.

Answer 2

I had a patient who had a dilatation of the right coronary artery. The problem was it was diagnosed late and he had a lot of complications after the procedure he had.

It is good that your dilatation in the aorta is diagnosed this early. all you just have to do is go for an echocardiogram of a scan annually.