Stress and Aortic Dissection

[Ultrarunner]

While I wait for my this balloon in my chest to expand to a diameter large enough for surgery, I have a question. I've read that 40% of dissections occur following emotional stress. I get stressed pretty easily as I'm a bit OCD. Is the reason that stress can be a problem for aortic aneurysms because it can raise blood pressure, or is there more to it than that? I run, so my BP is normally only 100 over 60, I''m not too concerned that pressure will cause dissection. But if there is some other mechanism at work where stress could possibly speed the degradation of the aorta, I should take this seriously.

Have any of you with dilated aortas been told that stress reduction is important in dissection prevention? Or if any have read something on this topic I'd be very interested.

 

[pellicle]

I was just told that its related to blood pressure. Perhaps the anxiety correlates to BP?

There is this: https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy
which may be a related issue (the emotional stress)

I also think that there are issues with magnitude. Like if I say "that hurts" ... if I drop a hammer on my thumb (instead of the nail) that hurts, equally when I have had a motorbike accident where I broke my ankle, three ribs and a bone in my hand (hit by a car head on) that hurt too.

so when they say "emotional stress" I wonder what levels they are meaning? Like I'm worried, or like my son died.

I'm quite OCD (I'm a database admin and developer) and I don't think that is the sole issue. I think its an illusion of control that leads people to stress. I'm not sure if this blog post has anything in it for you: http://cjeastwd.blogspot.com/2015/09/denial-or-delusion.html

Have you ever done any meditation courses?

 

[MethodAir]

As I said before, the surgical intervention point in Canada is lower when valve is bicuspid...check your pms.

 

[Ultrarunner]

As I said before, the surgical intervention point in Canada is lower when valve is bicuspid...check your pms.

It is 50-55 mm in Canada for patients with BAV, depending on risk factors. But please, that can be discussed in the other thread I started on diameter. I'm hoping to get feedback on stress in this one.

 

[MethodAir]

It is 50-55 mm in Canada for patients with BAV, depending on risk factors. But please, that can be discussed in the other thread I started on diameter. I'm hoping to get feedback on stress in this one.

No...not according to the 'reputable medical professional' who had some involvement with my surgery. Anyway, I've said my piece, believe what you want. Just trying to help someone who self describes as 'OCD' from blowing a gasket.

'Stress kills'.

 

[RobThatsMe]

Hi,
Well thought I would add my 2 cents, especially since I am one to have survived major dissection rupture. My aorta dissected from my aortic valve, all the way down through the abdomen, then branched down to my left knee cap area. They gave me a 3-6% chance of surviving, told my wife to say her good-byes to me, but instead she said everything will be all right to me as they rushed me into surgery. That was in March of 2000. Stress was a big factor in that time in my life, as I was a Lead in a YTK manufacturing software project trying to convert 9 plants over to a new software. Also, my aortic valve was bicuspid. So, after surgery, I awoke to having a mechanical heart valve ticking away, but hey, I was alive.
The stats on these ticking time-bombs is not so good. 80% of those that rupture, never make it to the hospital, and of those that do, only 50% survive the emergency surgery.
Since that time, I have had to have the valve replaced due to pannus tissue growth around it, so I switched from the St. Judes, to the On-X valve, They repaired an aneurysm where my carotid artery connected to the aorta, I have a Dacron graft, and an elephant trunk stint with graft descending my thoracic aorta to help support the dissection.
My latest issue, is that I now have a new aneurysm that has developed just below all the repair work they did in Sept of 2010. So, Next week, I have surgery at the Cleveland Clinic to repair this area. My surgeon told me after my annual checkup that it is best to be proactive and fix it now while I am in relatively good health, and not wait for this to become an emergency situation.

I would suggest the same to anyone that has a dissection. They are called ticking time-bombs for a reason. One never knows when they will begin to expand or rupture.
I was in good shape prior to my emergency surgery, I worked out at the gym 5 days a week, ahd had a very active in my life-style. I never knew I had a bicuspid aortic valve, or a developing dissection issue. I was also told that Squats and Leg Press exercises put the most pressure on your system. I dissected in the morning, while sitting, watching the news, and enjoying a cop of coffee at home after getting up for the day.

As my doctor told me, "It is best to be pro-active and address the issue". I hope all goes well for you too, and please stay on top of this issue until it is resolved.

Cheers,
Rob

 

[W. Carter]

Just trying to help someone who self describes as 'OCD' from blowing a gasket.

'Stress kills'.

God forbid someone "Blow a Gasket".

 

[Ultrarunner]

Rob, that's terrible about a third round of open heart surgery. I'm still just getting used to the idea of one surgery. Like you, I work out about five times a week, mostly running. And my career is stressful. Did you change your job after the dissection to reduce your stress level? Or since the dissection already happened, was it not a concern?

 

[RobThatsMe]

Rob, that's terrible about a third round of open heart surgery. I'm still just getting used to the idea of one surgery. Like you, I work out about five times a week, mostly running. And my career is stressful. Did you change your job after the dissection to reduce your stress level? Or since the dissection already happened, was it not a concern?

Hi,
No I didn't change my job after the first surgery, I retired early from work after my second surgery.
You kind of look at life differently after surgery, and, as the old saying goes, Ya "Don't sweat the small stuff" any more.
I realized that all the stress of the job was not worth it, If there was something that was out of my control, then it was in the other guys court, and up to them to move the ball.
In fact, I went overseas to work in Europe after my first surgery for the dissection. Two weeks overseas, then two weeks in the states. I did this for 5 years and really enjoyed it.
I took full advantage of seeing and being in part of the world that I previously never visited.
I have had a great life since my first surgery, and enjoy living, not sitting. I am very active, still jog and work out, although I don't push it like I used to.
Hopefully you too will see life in a new view, and enjoy it too, after you have your dissection repaired in the future.

Rob

 

[AZ Don]

Have you seen the thread on this: http://www.valvereplacement.org/for...2576-exercise-and-stress-with-aortic-aneurysm
As I recall, Dr Elefteriades' team from Yale measured blood pressure during heavy weight lifting and got numbers as high as 300. So I think BP is the primary issue. That said, there are examples in the thread of aortic dissection from things like strenuous swimming, tennis, shoveling snow, lifting boxes, etc. So I don't think it is just BP. While some situations are obviously more stressful than others, ultimately I think stress is one's reaction to external events. While events may not be controlled, we can have at least some influence over our reaction to them. Meditation is generally recommended to help with this.

 

[Ultrarunner]

Yes, I did read the thread Don (after you posted it in response to my first post). I think I've got a pretty good handle on the dangers of increased blood pressure due to strenuous exercise. It's the "I don't think it is just BP" part that I'm hoping the find more information on. Neither my cardiologist or surgeon could offer much on the effect of emotional stress on dissection (other than if it caused high blood pressure).