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Old 10-16-2004, 11:10 AM   #1
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Chances of thoracic aortic aneurysm?

I have been having constant mid and upper back pain for about six weeks now. It sometimes raps around to my chest area. It aches, produces sharp pains and feels like something stuck back their sometimes. It does hurt to rub along my spine to. I always think the worse and went to see my internest because I was worried it could be an enlarged aortic aneurysm. He didn't think anything of it and said I have had two chest xrays already and they should have seen something out of the ordinary. He told me to see my orthopedic surgeon and investigate and then come back to see him again. My ortho did xrays and saw nothing and decided I need an MRI. I asked about an thoracic aortic aneurysm and he said it is possible to cause referred pain but very rare for a 36 yr old man. I told him what my internest said about the xrays and he disagreed about anything showing up based on what the fact that their needs to be calcium deposits for it to show up on an xray and I was most likely to young for this to have happened. I am just worried. It does hurt to rub on my back most of the time and I think certain positions are worse than others but at the same time it hurts without even moving and is constant for 98% of the time. Any thoughts?

 
Old 10-17-2004, 01:32 AM   #2
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Lightbulb Re: Chances of thoracic aortic aneurysm?

No medical staff should try to diagnose someone with or without an aortic aneurysm with only plain X-rays!!! Usually, they don't even appear on it. An echo has to be done or a better option would be an MRI! It may not be rare to have an aortic aneurysm at your age if someone has some conditions that increase their risk like, marfans syndrome, EDS vascular type and very weak blood vessels that leads to dilating of blood vessels. If aortic aneurysm is your problem, immediate treatment(beta blockers or surgery) must take place to prevent a dissection or worse, a rupture. Hope you find out your problem soon! Good luck!

 
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Old 10-18-2004, 07:28 PM   #3
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Re: Chances of thoracic aortic aneurysm?

It doesn't sound at all like heart related pain. Do some searches on costochondritis. Pressing on your back would not cause any heart related pain. This sounds musculoskeletal.

 
Old 10-20-2004, 12:52 PM   #4
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Re: Chances of thoracic aortic aneurysm?

I agree with Angel. Noone should try to determine whether you have an aortic aneurysm by looking at an Xray. Thats about as usefull as telling as child he can determine which sweet has more sugar in by its colour.

Xrays really dont show up that much hun. Not heart related anyway. Yes they can show up lung problems, scarring, enlarged heart etc but not an aortic aneurysm. You really need to have an ECHO or some other test to investigate this. I'm not sure which test you need. Maybe someone here will be able to help.

 
Old 10-20-2004, 08:18 PM   #5
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Re: Chances of thoracic aortic aneurysm?

Tony,
I have been feeling this way EXACTLY for about 4-5 months now. Do you suffer from anxiety? I always worry about my heart and I can tell you that it is all tension and the way that you hold yourself. Please talk to me as I am feeling the same way. I am a 32 female...Take Care! Kaley

 
Old 10-21-2004, 09:31 PM   #6
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Re: Chances of thoracic aortic aneurysm?

Hi everyone, thanks for the replies. My back pain is still there. One day it was very bad in my lower mid back and then a day later near my shoulder blades. It does hurt when I press on my spine near the pain areas. It also hurts around my shoulder blade when pressed in a certain area. But at the same time the pain will wake me up because it just feels like it is boring into me. I have had an MRI of my cervical and thoracic spine and will get the result on Monday the 25th. I am scheduled for a CT of the chest for the 26th too, at my request because I am worried about a thoracic aneurysm. At least the symptoms I have seem more related to a thoracic vs. abdomen since the pain is in my mid to upper back and shoulder blade area. From the extensive reading I have done alot of aneurysm of the thoracic and abdomen are found with common xrays, although if a Dr. thought you might have one he wouldn't send you for an xray. Infact my internist didn't think an ultrasound was worth doing if I was really worried about it. I spoke with my Dr. and the aorta can be seen on an xray. Enlargement as well. It is not normally used as a diagnostic tool but that is how anuerysms of this type are found sometimes, including ultrasounds, CT's, etc for other problems. Kaley, I do suffer from anxiety. Actually a great deal now. I haven't had any full blown panic attacks in a while but I did develop those about six years ago. I hope although it doesn't really help at the moment that most of my symptoms are caused by this. I at least believe that they can be made worse. I developed a seven month long migraine/tension headache where I was checked for a brain tumor and later an aneuyrsm (in case it was enlarged and pressing on a nerve) and the whole ordeal caused me to have panic attacks and become very anxious when I am not feeling well. I have worried about my heart lately and have posted alot pertaining to heart disease and angina as I was having chest tightness, etc for a few months. Tests turned out fine. I got better and the chest tightness returned and then dissapeared and then bam the horrible back pain. I know the odds are in my favor but I am one of those people who doesn't go through life thinking it will happen to someone else. I will keep an update to what is going on and Kaley let me know what some of the other symptoms are you have.

 
Old 10-27-2004, 02:33 PM   #7
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Re: Chances of thoracic aortic aneurysm?

Well I have had alot of tests since my last post or at least news to report. I had an MRI for my cervical and thoracic spine. My cervical was fine but there was some degenerative disease in my thoracic spine and athritis in most of the discs of my thoracic spine accounting for the aching in that general area. I also have bad bursitis (?) in my shoulders as well from weight training. The orthopedic surgeon was concerned that although the arthritis would cause alot of the symptoms such as aching in my back, pain to the touch along my spine all even without movement he was concerned that it would not have covered all of the symptoms I was having such as back pain that seem to shoot through to my chest area very rarely. He thought it would be a good idea to have a CT scan w/ contrast of my chest just to make sure their was not a thoracic aneurysm pressing on a nerve. He did however not see any evidence of an aneurysm near my spine where he as seem them before on MRI's. Today I had a CT scan w/contrast of my chest to investigate further. Being the nail biter that I am I called to see if my Dr. could expedite the images with the radiologist. The nurse called at said that although the full report was not finished they were able to obtain the preliminary and their was no sign of an enlarged aorta or thoracic aortic aneurysm. This was nice to hear as I have been worried about this for a few weeks especially after having the orthopedic surgeon suggest that I have it checked out. Well this brings me up to date. As always I am very appreciative of all the posts and help from everyone. I'll see you on the boards.

 
Old 10-28-2004, 10:11 PM   #8
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Re: Chances of thoracic aortic aneurysm?

The gold standard for looking for this condition is a Tee. I had echos and ct scans but they said the only way they could see directly in behind my heart was with a tee. Thats where they run a tansducer down your throat and its very similar to an echo.

 
Old 10-29-2004, 09:31 PM   #9
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Re: Chances of thoracic aortic aneurysm?

Multiplanar trans-esophageal echocardiography (TEE) is a rapid and accurate imaging technique to differentiate ascending aortic aneurysm from dissection and to detect the presence of intramural hematoma. [62 ] Accurate imaging of the distal ascending aorta and aortic arch with TEE is compromised by the column of air in the trachea and mainstem bronchi. [63 ] , [64 ] Up to 40 percent of the ascending aorta is not well visualized by TEE, and significant disease in this distal segment may not be accurately imaged. [64 ]

 
Old 10-29-2004, 09:33 PM   #10
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Re: Chances of thoracic aortic aneurysm?

Every test has its pluses and minuses. My cardiologist and internist thought I was worrying too much as usual and nothing has turned up. I am just happy that at this stage I am not worrying anymore and feel comfortable in my diagnosis.

 
Old 10-29-2004, 09:36 PM   #11
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Re: Chances of thoracic aortic aneurysm?

The transesophageal echocardiogram (TEE) is a relatively good test in the diagnosis of aortic dissection, with a sensitivity of up to 98% and a specificity of up to 97%. It is a relatively non-invasive test, requiring the individual to swallow the echocardiography probe. It is especially good in the evaluation of AI in the setting of ascending aortic dissection, and to determine whether the ostia (origins) of the coronary arteries are involved. While many institutions give sedation during transesophageal echocardiography for added patient-comfort, it can be performed in cooperative individuals without the use of sedation. Disadvantages of the TEE include the inability to visualize the distal ascending aorta (the beginning of the aortic arch ), and the descending abdominal aorta that lies bellow the stomach. A TEE may be technically difficult to perform in individuals with esophageal strictures or varicies.

VS:

The spiral CT scan with contrast is a fast non-invasive test that will give an accurate three-dimensional view of the aorta. It is performed by taking rapid-cut radiographs of the chest and combining them in the computer to create cross-sectional slices of the chest. In order to delineate the aorta to the accuracy necessary to make the proper diagnosis, an iodinated contrast material is injected into a peripheral vein at a properly timed moment so that it will enter the aorta at the time that the aorta is being imaged.

It has a sensitivity of 96 - 100% and a specificity of 96 to 100%. Disadvantages include the need for iodinated contrast material and the inability to diagnose the site of the intimal tear.

VS:

(MRI) is currently the gold standard test for the detection and assessment of aortic dissection, with a sensitivity of 98% and a specificity of 98%. An MRI examination of the aorta will produce a three-dimensional reconstruction of the aorta, allowing the physician to determine the location of the intimal tear, the involvement of branch vessels, and locate any secondary tears. It is a non-invasive test, does not require the use of iodinated contrast material, and can detect and quantitate the degree of aortic insufficiency.

The disadvantage of the MRI scan in the face of aortic dissection is that it has limited availability and is often located only in the larger hospitals, and the scan is relatively time consuming. Due to the high intensity of the magnetic waves used during MRI, an MRI scan is contraindicated in individuals with metalic implants. In addition, many individuals succumb to claustrophobia while in the MRI scanning tube.

Last edited by Tony1; 10-29-2004 at 09:37 PM.

 
Old 10-30-2004, 06:04 AM   #12
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Re: Chances of thoracic aortic aneurysm?

I've been concerned about aortic aneurism for several years since my SECOND uncle dropped dead from a burst abdominal aorta. Dr. checked out upper aorta during angiography. I had lower checked by echogram...all normal diameter. I'd have preferred an MRI but insurance companies require pre-approval...and that would require an element of WORK from my GP, probably too much to ask for!

There really is no way to diagnosis these things from either symptoms or x-rays!

Last edited by zip2play; 10-30-2004 at 06:06 AM.

 
Old 10-30-2004, 10:15 AM   #13
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Re: Chances of thoracic aortic aneurysm?

From what I have read alot are found from xraying for something else. The aorta can be seen on an xray. It is not how you diagnose aortic aneurysm but sometimes they show up. Probably more so in older adults where calcification is involved. CT scans are cheaper than MRI's but ultrasounds are supposed to be good screening devices.

 
Old 10-30-2004, 09:20 PM   #14
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Re: Chances of thoracic aortic aneurysm?

that type of thing is every rare in a young man such as yourself, myself being 22 have nothing to worry about cause even tho i suffer the same type pain in my upper back, its always sharp and shoots across through to my chest. and it does hurt at times if i push down or tighten my upper back. try not to worry bout it

 
Old 03-29-2006, 07:23 AM   #15
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Lightbulb Re: Chances of thoracic aortic aneurysm?

I realize this is an OLD POST, however, I am going through this very thing right now.

Had STAT Cat Scan with contrast late yesterday afternoon.

Waiting on results.

This is a very scary thing..................thought I had Esophagitis/Spasms all the time and Pray still that's all it is.

This is not as RARE as one might think. Also, what John Ritter died of.

 
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