My aorta is getting bigger!

[ryen0]

Hello everyone,

I used to frequent this site quite often, but have faded away in recent years. I had my mitral valve repaired four years ago and have since been getting it checked every year with an echocardiogram. Well, the valve is doing fine but my cardio is now noticing that my aorta is getting larger. It was on the top side of normal before, and it has apparently gotten bigger since last year's check up. I wanted to check in with you guys as I just know absolutely nothing about this. I've had valve issues my whole life, so i'm kinda used to all that but this is new to me. He said that this is usually the result of high blood pressure (which i don't have) or being really tall (which I'm not). So we have no idea why my aorta is enlarging. He wants to do a full scan and keep an eye on it. My biggest fear is that I have to start worrying about it rupturing. If i need surgery in the future for it, could anyone that has had this type of surgery fill me in on what it entails? Are there any silver linings here? I'm trying to look at the positives, but i'm not having a lot of luck in that area at the moment.

Thanks for any help/advice you can give!!!

 

[UWMike]

You wouldn't happen to have a bicuspid aortic valve would you? That is probably the most important factor that would predispose you to an enlarging of the ascending aorta. Since you've only just been diagnosed with this I would venture a guess that your aorta still hasn't enlarged too much and you're probably quite a bit away from having to worry about surgery. One option may be to be prescribed some form of Beta blockers (I don't know if you're on any meds already) which may help slow down the rate of enlargement if not stop it all together. I've heard that, especially after any kind of valve surgery, it's not all that uncommon for this kind of enlargement to occur. In some cases the enlargement will eventually plateau as your heart gets used to its new condition and you won't ever need surgery to fix it. On the other hand, if surgery does become necessary, it's actually one of the more common operations as far as OHS is concerned. Exactly what it would entail depends on your specific situation but maybe this link might help: http://cardiacsurgery.ctsnetbooks.org/cgi/content/full/2/2003/1123?ck=nck#Ascending_Aortic_Aneurysms

Personally, I'll be having a similar procedure done while my aortic valve is being replaced (kind of a 'while we're in there' deal since my ascending aorta has also lately started enlarging) but I'll have more specifics after I meet with my surgeon next week.

Hope this at least helps a bit.

 

[ryen0]

Thanks UWMike, this does help a lot. The weird thing is that I don't have any issues with my aortic valve. I've only had to deal with my mitral valve, and the aorta thing is apparently completely unrelated. I just find it odd that I have none of the risk markers for developing an enlarged aorta and it was apparently fine just a few years ago when I had heart surgery. The cardio did perscribe some beta blockers, but i have to be careful they don't lower my pressure to much because my blood pressure and heart rate are already at normal. I'm really hoping it is just a possible growing pain and will plateau as you mentioned. I assumed the fixed valve would take any strain off the heart, so this aorta issue has just got me completely confused. Anyway, thanks for your response. It's just hard because after a few years I finally felt as if I had gotten over the mountain and now I feel right back to where I started. I don't want to start feeling scared all the time again. I'm just thankful for this community. Please keep me posted on what you find out from your surgeon.

 

[Lynlw]

Do you have reports or at least the actual numbers for your echos? Also are your echos done at the same place? Where and how different techs/docs measure can have slightly different measurements with echos. They arent an exact sience. It would help alot if you dont have them, to get them and keep track of how things are year to year, Since "It was on the top side of normal before, and it has apparently gotten bigger since last year's check up" it would help to know what not only what the measurements were last year and earlier years, but to see how much larger it has gotten this year, AND what part of the Aorta (root ascending etc) is enlarged & by how much can make alot of difference. It might just be the "normal" rate of enlarging that is common for mosst people. Also having the measurements would let you know IF the enlargement reached the point where it would even be considerred an Annuerysm or still "just' a dialated aorta.

Since you have been having yearly testing and this is the first they said it is even above "normal" I'd say the silver lining is most likely it would be quite a while- if ever, it get to the point you would need surgery or close to a point where it could rupture or dissect. FWIW Justin is 24 now, he had alot wrong with his heart from birth, but his past few surgeries have been on the right side, pulmonary valve and conduit. A few years ago about the time he was fullgrown, but before his last surgery he was diagnosed with an enlarged aortic root around 4.3. We keep an eye on it, but pretty much it is still at the point we just mention it more or less in passing, its pretty much been the same size in the past 5 years, but most of our discussions and concerns are on other things with his heart. The other thing I would suggest asking about when you get the measurements if you dont have them now, would be any restrictions on lifting. Justin isnt on any meds at all, but because of the size of his Aortic root, they strongly reccomend not lifting anything heavy enough that he would have to bear down or "grunt" but he's had that restriction since he was old enough to understand, because of the other problems with his heart.

hopefully you will be like Justin in that it pretty much stays the same for many years.
also the good things is since they did find it so soon they will be watching it which is so much better than not knowing about it

 

[ryen0]

Hi Lyn,

I don't have any reports or actual numbers. I know I should probably be more proactive about that. I'm probably going to wait until we see what the results of my CT scan are. I do get my echo done at the same place every year, but there are usually different techs. The cardio said that he can only see the tail end of the aorta through the echo, so a scan should give him a better picture. I will keep what you said in mind, thank you. The only restrictions that were mentioned were to not do any really heavy weight lifting. He said I could still do cardio exercising.

 

[ryen0]

Soo... I talked to the doctor again to get a clearer picture of things. My aorta is dilated but there isn't an aneurysm. My aortic valve is fine. He wants to do the ct scan to see why it is getting bigger.

In the mean time he gave me some samples of bystolic to take, but since my blood pressure is normal he said if I feel fatigued to just stop taking them. Took them for two days and i'm feeling really crappy today. I'm assuming it's because of the beta blocker. I feel a bit faint and am having trouble focusing. I guess i'll stop, but i wonder if i should wait it out.... Anywho, thanks for listening. Any advice is always appreciated.