dilation of ascending aorta

[Pam Alexson]

My question is if anyone has noted or been told about their aorta and aortic root dimensions. As I have a strong family history of aortic aneurisms both my maternal GM and maternal great uncle( her brother) had them and died from them, my maternal GF had the HCM as it is theorized, I have noted on my reports, over the last several years that my ascending aorta has dilated as it is interpreted mildly @ 4.0 cm..aortic root is 3.0 cm.

I have not alerted my cardiologist to my family history of this medical issue. So I realize it may have to be looked at differently once I discuss the family history. I have read that this dilation would be of concern based on different factors esp..weight and height and baseline measurements. I will be digging out my old records to see if I can find some comparison prior measurements. My aortic valve similarly has mild insufficiency; which has come along with the dilation since myectomy in 2003.

From what I have read they start to look at things quite seriously when they call "it" an aneurism or the measurements get to 5.0- 5.5 cm.
This of course is concerning to me and as it seems to be by fate I met a man last week who had a dissecting aorta ; discovered in Dec, and operated on; had had a dacron section put in and now he has to have the entire aortic arch replaced because it was not done at an experienced center and not investigated properly. ( very serious , very dangerous not very common procedure.) He went to his local hospital in Maine an now is going to Brigham and Womens.

It was an amazing almost karmic meeting as it unfolded. This man has gone on to develop many similar cardiac issues that he and some of us/ I experience. We spoke with ease and understanding.. he has done his homework in trying to understand the complexities of the heart and all the things that can occur as a result of a compromised condition. He has a stiff left ventricle w/ diastolic heart failure, mitral regurgitation elevated pulmonary pressures; secondary pulmonary hypertension and atrial fibrillation from the widening of his left atria. All changes that have effected his heart remodelling due to the issues with his aorta. He even had to have a thoracentesis; drainage, of his left lung from fluid after his first open heart surgery.

It was just a strange encounter but I think meant to be. He had no one who he could discuss freely these issues with other then doctors and felt another patient encounter was supportive. He had a very positive attitude but his poor wife and family were overwhelmed with their concerns and uncertainties about what lay ahead.

Soooo.. back to my question .. Does any of this make sense or apply? Would love to have any input information experience .

Thank you..

Pam

[MissyH]

Pam,

I happened upon this article by trying to find the Dr. who preformed Tony's 1st myectomy (Dr. Jameison-not sure of 1st name or if this is correct spelling, who studied under Dr. Shumway who we were told was one of the most knowlegable Drs. for IHSS back in the 70's) and thought you had posted something about aneurysms.

I don't know if this has anything to do with your or your family members situation or not but I know from your past posts that you do a lot of medical reading/research so thought I would pass it along.

http://www.chestjournal.org/cgi/reprint/113/2/552.pdf

-Missy

[shirleymahoney]

Pam

I have Atherosclorosis is that what you are talking about I have it in the abdominal aorta and in my illiac vessels going down both legs, something I inherited from my dad along with HCM

Shirley

[Pam Alexson]

Thank you Missy for the link it is not the same but I found it an interesting read. All info is helpful and so I weed through. Thank goodness that is not what I have!

Shirley artheriosclerosis can lead to widening of the aorta in the decsending and the ascending segments. In the descending segment it could result in abdominal aortic aneurism. I do not have this issue as it is one I have escaped to date.
I have read that hypertensive disease can be a precursor to ascending aorta dilation to someone who has not had management of their disease and of course since the 2 present similarly the individual w/ hypertension would have left ventricular hypertrophy. Another interesting entity is having bicuspid aortic leaflets. I have 3 so that is fine also. It seems that if aortic insufficiancy increases and/or if mitral valve regurgitation increases that can increase dilation of the aortic root and the ascending aorta as well. Mine is / has been stable for a couple years so I am just now watching this dilation of aorta which has been a newer reporting for me. It is more common in men and aging also results in dilation of the aorta. Maybe I am just old before my time or at least my heart is.

Interesting side bar...when my brother was being diagnosed with HCM in 2001 by the same team that had diagnosed me in 2000 the electrophysiologist who was doing his cardiac cath. and who had also done mine told my brother that they saw in my heart what they only see in very old hearts of old women. I was 47 @ the time and now @ 55 that ugly story comes back to me.

I guess we will just have to wait, watch and hope for the best that it also stays stable over the next few years....4cm is not horrific just something to watch .. from what I have read 5- 5.5 cm is of great concern. The only additional increase concern is a smaller measurement like mine with a strong family history of dissection and rupture/ death resulting. So this is something I must inform my doctors of.
There has been so much complexity to my medical history over the years that honestly, I did not even bring it up or think that I would need to ever mention my grandmothers/ families issues with her aorta. They were of course much older then I, nana died @93 and her brother about 63 . Of course I do not know what their measurements were.

I will continue to read a do research. Thanks....

Pam