I posted about a week or so ago (quick recap) sharing that the ER had told me they saw I had a Dilated Aortic Root (my GP calls it a Dilated Throacic Aorta) show up on my CT scan. The ER doc sort of rid it off and said I was probably born with it and most likely will not give me problems. My GP said it was a potential anneurism and I need to get more help on this.
Went for another EKG - normal. Went for an Echiocardiogram and just got the results today. The report said all was normal and no dilation was found?!
But the CT scan measured this "dilation" (anneurism?) at 4cm.
So, now my GP wants me to go talk to a Vascular Surgeon!? I am confused - the Echo came back great but I still could have this problem b/c the CT scan showed it?
Also, if you have a Dilation of your aorta - does it always mean an anneurism?
The problem with all of this is that at NO point has a Cardiologist sat down with me to talk about this....I feel my GP keeps getting all the test results (understandably) but then relaying information that he is not a specialist in?
Any help/insight on this would be great....thanks in advance
Thoracic aneurysm is in the genearl area of the chest above the diaphragm and below the neck. Aorta root aneurysm is specific and just above the heart's aorta valve. A 4.0 is usually high normal, but if one has a smaller aorta diameter and then there is a 4.0 that could indicate an aneursym (a bulge that may indicate a weak vessel wall in the area of question).
An echo would only measure aortic root so if the echo was normal that would indicate normal root size and the alleged aneursym is in the chest area shown by a CT scan.
A dilated root size could be more serious as it could develop a valve problem.
I guess my ultimate question (and if no one can say anything about this, understandably) is what I am up against? If the ER doctor said "you have a dilated aortic root" could that just mean its abnormal? He (the ER doctor) never even said the size. When I got to my GP's office 2 days later, he read me the report saying it was 4cm.
(1) Is 4cm always an aneursym?
(2) Why didn't the Echo say anything about this?
Any abnormal size of a portion of the artery would almost always be an aneurysm. To give you some perspective an aneursym can develop from blood getting between layers or coats of an artery, there can be embolism from a blood clot, a root aneurysm can be an extension of inflammation from an infected valve breaking down the vessel wall, etc. and it can be congenital. The 4cm is just a guide to compare to normal size. One can have a high normal size and including the possible margin of error a 4.0 it may not be significant.
(2) Why didn't the Echo say anything about this?
The echo is limited to the area of the heart, valve integrity and that includes the aortic root. A CT scan would take images of other areas aside from the heart.
Not sure if you are still on here or not (Keith) -but its been a year since my ER visit (see first post above). I ended up also getting an MRA done in Feb of 2007 and it came up crystal clear. My cardiologist said the original CT Scan that showed I had a dilated aortic root must have been taken wrong (i.e. the machine was at the wrong angle). I am rewriting because I am not 4.5 months pregnant and even though after my Cardiologist bid me adieu after the MRA was negative (in his mind, the test of all tests) - something in me just worries. The surgeon I met with a year ago was absolutely convinced I had an aneurysm. The Cardiologist and Perinataologist (special pregnancy doctor) took one look at the Echo results and were like "there is nothing wrong here"
In your best judgement, what do you think of all this?
Just curious - its been in the back of my mind for about 8 months now....
Out of curiousity what exactly was the situation when you went to the ER a year ago? I saw in your posts about you being pregnant. Just wondering what types of symptoms you were having and things like that.
I went to the ER on Dec 4th, 2006 because I had this chest pain right on my sternum (but I also had a bad cough) - so my GP sent me to the hospital for a chest Xray because he was worried about pneumonia. So, they did a chest Xray - came up clean. Then did a CT scan. Came up clean for lung issues but the ER doctor came back to me and and said "has anyone ever told you you have a dilated aortic root? yours is measuring at 4.1cm" this visit was my first in the ER so I was like "no, never had a Chest Xray done or a CT scan" The ER doc then said "its probably something you were born with and shouldn't be an issue, but tell this to your GP, we'll send the report. Go see him in about 2 days."
So, 2 days later, head to the GPs office and he sat me down and said "this is more serious than you may think. This could indicate a thoracic aneurysm, but we should test theories to see what we are dealing with." At this point in time (dec 2006) he forbid me from getting pregnant (we were trying) because he didn't know what we were up against. Of course I got scared immediately. I was 28 at the time and never heard of any of this
He issued me referrals to a cardiologist and a thoracic surgeon. AND a perinatologist to talk about pregnancy if I did have a condition. Went for an ultrasound of the heart which showed a NORMAL anatomy. The perinatologist said he believes ultrasounds more than CT scans. The surgeon said he believes CT scans more than ultrasounds. The cardiologist was pretty convinced there was nothing wrong either so he orderd "the test of all tests in his mind" which was an MRA.
A 45 minute scan of my heart with dye and the test results came up negative for any abnormalities. The Cardiologist said to me after getting the results "have a good life"
I am now 29. NEVER smoked in my life...believe it or not, never even tried a cigaratte. My Blood pressure has always been ~109/75 or around there. Even now that I am pregnant - my BP has been 110/78 (last checkup).
The MRA was in Feb - and my husband and I believed the cardiologist. But once in awhile I just think back on how adament the surgeon was that there was an issue with my aortic root. I don't know if surgeons look at this info from a different angle (i.e. they want to cut you open)....but now that I am pregnant the thoughts are back in my mind.
The Cardiologist was CONVINCED that the CT scan was taken wrong (ie. the machine scanned at an oblique angle) therefore, giving false tests results. He thought there was no need to repeat the CT scan after the MRA although I would have liked it....but he never gave me an RX for the CT scan. Now that i am pregnant - cannot get this test
Sorry this got so long - just wanted to make sure all the details were here. I am 5'8" but do not have lanky features about me - so physcially they did not think I had marfans. AND I never needed glasses - in fact my vision is better than 20/20
I FULLY understand what you are going thru. 4/06 I was told I had an anersuym 3.9 and another at 3.2cm. I didnt feel comfortable with the first, second or third cardiologist until I found the fourth doctor. I wasnt looking for any "illness" I had many questions (1) my family history no one "cared" (2) it was in my head even the ct scan proved it (3) change of life. For me if they found something there is something there. THere are more test angiograms, echos. Well to make my long story short 6/07 I had major heart surgery my anersuyms grew to 4.8 within 4 monthjs. I AM NOT saying this will happen to you, I am saying women heart issues are not the same as Man. I strongly suggest to contact different facilities around your area. Also I have never been a "sickly" person still to this day I have not gotten sick. Oh one more fyi. because they are specialist does not mean they are perfect. We live in the greatest country and we have the great doctors. The one thing my parents stated "questions are free". Be strong be your own advocate. Good luck. It will work out. I'll be thinking of you
Thanks for your reply - it definately gave me something to think about. I am just so torn. What I didn't put above in my post to you (but was on a different page) is that I am 4.5 months pregnant. I am limited with some of the tests I can get - or at least that are safe for me.
If you don't mind me asking - what type of tests did you get done to determine all this for you? Did your 4th Cardilologist "really like" one test over another for measuring your aneurysm? Just curious
4/06 I had a ct scan with the die to determine why my esophagus was not allowing me to swallow different foods at different times. that is when the first Cardiologist I went to saw the aneurysms, gave me a lengthy stress test on a tread mill. Of course I passed within the low-normal range. I did not have any signs of heart issues my cholesterol levels were and still are better than text book numbers. So if I am repeating myself. This doctor #4 looked at all my ct scan,angiograms, echo cardiograms, mri's stress test. He also paid 1000% attention to my families health history and wrote down everything, What he did tell me "its not in my head, It's not in my, It's not an early stage of menopause. My Dad died of an aneurysm at the age of 47 when I was only 15 years old. Look into your family history on your Dads side(uncles,brothers,sisters parents) as well as your Moms side. To go back a little bit I used my health plan to the fullest on getting opinions( one thing I did find out that the health plan would rather "me" find out the truth it saved them lots of paper work) When I found Doctor #4 it was 10/06 then 3/07 I had more tests on my esophagus and again 4/07. My heart issue is something that is now in a medical book (no kidding). I'm doing fine I am very inpatient with myself. I went to a go red luncheon for women I believe it is a part of American Heart Association, because I needed to no more info before I could understand what I was dealing with. As I stated before if you do not feel satisfied with your answers dont stop!. CONGRATULATIONS on becoming a Mom. I dont know what part of the country you come from but find a cardiologist that specializes in pregnancies. Everything will work out.