Ascending Thoracic Aorta Aneurysm , Part 2 of 2

Hi, I am a 34 year old mother with two children, a boy of 8 and a daughter aged 4. In March last year I was diagnosed with an ascending aortic aneurysm measuring 3.9cm X 4.4cm. In June I was hospitalized for Pericarditis and the scans revealed that the aneurysm now measured at 4.5cm X 4.5cm. The diagnosis was done by a different cardiologist. My cardiologist however, after doing my follow up, told me that he was doubtful whether or not the diagnosis was accurate but admitted to a pericardial rub. My cardiologist is not in the least bit worried and has on more than one occasion suggested that I might be suffering from anxiety disorder. I have had this checked by a Psychiatrist who does not pick up any signs of anxiety disorder. At the end of November my Cardiologist performed an angiogram as the chest, shoulder and back pain still did not cease. They also performed an Aortogram where they measured my aneurysm and found that it is in fact 4.8cm X 4.5cm. My cardiologist is still not worried and convinced that I suffer from unnecessary panic attacks. I am 1.58m tall and of small build. I feel like I want to whack my cardiologist against his head. It is quite clear that this aneurysm has grown by almost 1cm in 8 months. Their measurements with the previous ECHO's were out by more than a few mm's. As a young mother of two, should I not be concerned about this? I have cancelled my follow up appointment with my cardiologist and am seeking a second opinion. If there is anyone who had a similar experience, please share, because this is really a thought consuming time bomb, and even though I do not want to be a typical hypochondriac, I DO have two kids to worry about.
Maybe I should also mention that I cannot get additional life insurance at this stage due to this condition.

I am a very active 67 year old with an aortic aneurysm about 4.6 cm in size.  I grew about 1cm over the past year.    I've been engaged in athletics all my life and have been lifting weights since the 7th grade.  My doctor didn't instruct me about exercise, but when I asked he said not to lift more than 20 pounds (don't know why he didn't advise on that if my condition is so fragile to be limited to 20 pounds).

 I find that advise superficial at best and not tailored to my unique situation.  It seems obvious to me that weight lifting guidance should be governed by a person's size and strength--20 pounds may be heavy for some people and light for others.  I'm 6'1", 185 pounds.  Logically, it would also seem that the amount of weight lifted should depend on the type of exercise and the number of reps relative to "failure".  My weights vary from 225 pounds to 50 pounds depending on the exercise and because of my condition I do about 80% of maximum (to failure). That seems logical to me, but wanted to run this by the group for other experiences and possible validation.  

Poopster

Thank you for your reply. I think it's interesting the forum doesn't have folks who lift weights---something that's not uncommon and in fact is encouraged for seniors to maintain and improve good health.  I didn't describe myself as a "body builder". 

In our senior community here in Arizona we have hundreds of folks who lift weights to keep themselves healthy with good body fat control and metabolism.  I wonder why the medical profession doesn't have scientific expertise about something that health professionals encourage us to do--they obviously have some scientific reason for recommending a 20 pound lifetime lifting restriction so how about an extrapolation of that rationale based on individual

circumstances.

But I guess I'm just ranting if this issue is irrelevant to the forums members. 

Thank you much.

Poopster

Poopster

Oops, sorry about that, it was the member right after your thread that posted "Body Builder". 

I took the time to find the answer to your questions - It certainly sounds as though you have an active lifestyle.

"With an aneurysm of 4.6 cm in general we would recommend no vigorous exercise or heavy weight lifting; not activity that requires straining or valsalva maneuver and no exercise that includes risk of body trauma or collision. As for specific heart rate, a common medication to control blood pressure for people with aneurysms is a beta blocker; which has a significant blunting of heart rate response to exercise and rest. To pick a specific target heart rate for exercise, we recommend you discuss having a graded exercise test on medication with your physician to determine your functional capacity and heart rate response to activity. With an aortic aneurysm it is recommended that you discuss participation in regular activity with your cardiologist since there are other contributing factors that should be considered." ^{Research: Cleveland Clinic} 

You may have hundreds of folks in your community that lift weights and I find that normal as long as they are consulting with their physicians. However - I doubt they have a 4.6 cm aortic aneurysm.

I wish you the best and I understand what it feels like to be dx with a condition that affects the lifestyle to which you have become accustomed.

Blessings,

Kitt

I've been doing research on young people that have an ascending aortic aneurysm, but I haven't found any my age. I was wondering if anyone else who is 21 has an ascending aortic aneurysm. I just learned that mine has grown to a 4.3 cm since my last CT scan back in 2012, I also have high blood pressure and I'm on 3 different medications for it. I have my first appointment with my surgeon Oct 30th 2014 and I'm so nervous that he will want to do surgery, I've been trying to do research on it I still have so many questions for him. I've also been having chest pain of and on for weeks now, is that normal?

It could be because I'm worried, but it also hurts when I'm carrying my backpack up the hill to my school. I also have high blood pressure and a bad back.

I'm new here - so glad to find this forum.

I'm 49 years old, 5'11", and overweight. BMI puts me in the obese category but I don't think I look or feel like it; anyways, I'm not one of the marathon runner TAA people on here. I have sleep apnea and I use a BiPAP machine nightly.

I went to the family doctor in Oct. for an unrelated issue, they did an EKG, and I was referred to a cardiologist.

The cardiologist sent me for regular/stress echo tests. When I went to follow up with him, he was very jovial and thrilled about the fact that my stress echo was squeaky clean, my blood pressure is normal, and my cholesterol is good, and....oh by the way, you have a 4.4 cm aneurysm on your ascending aorta. He was so casual and nonchalant about it - "This thing might never get any bigger". He said that surgery would be indicated when the aneurysm reaches 5.5 cm. We're going to do echo tests every 6 months to check on its status. He told me I could do cardio (no HR restriction mentioned) but no weights.

Of course, as you all know, Google is not your friend. I have done a lot of reading on this topic, and "this thing might never get any bigger" is probably not really how these things work.

I've also found out that my maternal grandmother, her father, and her grandfather all died of aortic aneurysms, and my uncle (maternal side) has had an abdominal aortic aneurysm repair.

I knew that my grandmother had died of a heart issue, but I wasn't aware until recently that it was an aortic aneurysm that was leaking. She was 88 at the time (May, 2002), and woke up in the middle of the night in terrible pain. Luckily, she was in assisted living, so she was able to get immediate help and she was rushed to the hospital via ambulance. She ended up in the ICU at Yale, where she was given a 20% chance of surviving surgery. My mother and her siblings went back and forth for several days about this surgery and they finally decided to do it. She couldn't survive outside the ICU without the surgery, so what choice was there? My spunky old grandma did survive the surgery but she was paralyzed from the chest down, and she died a few days later of pneumonia after the family decided to discontinue any heroic measures.

So, the idea of having this same surgery is kind of terrifying. Walking around with a time bomb in my chest is seriously terrifying.

I went to urgent care last week for the flu. I was very shocked and dismayed to see that my BP was 150/105. My cardiologist was closed for the holiday from the 24th thru the 26th, so I went to see my regular physician on Monday of this week about this BP issue. Due to a front-office screw up at the dr.'s office, I ended up with a PA who seemed pretty cool as a cucumber at first. My BP was registering around 130/90. He stepped out to consult with an MD and came back after about 10 minutes, looking pretty rattled, "You need to see your cardiologist and we made an appointment for you".

Yesterday morning, I woke up with pain in the upper part of my sternum that occurred when I moved. I hadn't done any working out so I didn't think it could be muscular. I called the cardiologist's office and spoke to a nurse. I told her about the recent BP issues and she said that this pain is muscular. The pain did fade later in the day but the sternum is sore if I press on it.

So, I'm going to see my cardiologist today about the BP issue, armed with a list of questions about my aneurysm that I didn't know to ask the last time I saw him.

I have some questions for you all:

Do you have any recommendations on questions that I should ask my cardiologist?

How many of you have had a consultation with a surgeon & are in "watch & see mode"? I think I'd like a consult with a surgeon to get him in the loop, but I don't know if it's "too soon" for that step.

What types of imaging are your doctors doing in order to monitor your aneurysm's size?

It seems to me, from all the reading that i'm doing, that surgery is kind of an inevitable thing. Why don't they do it while someone is young and healthy and able to bounce back quickly, instead of waiting for it to reach a certain size? It's like playing Russian Roulette if you ask me.

I think I'm going to push for surgery at 5.0 cm because of my familial history. Does this sound right? I know that my relatives aren't first-order relatives but it's close enough for me.

Is there anyone here in the Dallas/Fort Worth area? I live in McKinney/work in Plano and I'm seeing a doctor in Plano.

Post Edited (KayBee718) : 12/31/2014 9:02:22 AM (GMT-7)

New to the forum, and happy ( I guess) to know there is a place to share questions as well as support. Three years ago a CT scan for a super bad cough that lasted too long showed a 5.2cm aneurysm of the ascending aorta and after consulting with a surgeon at Hopkins, watchful waiting followed. It stayed that way in subsequent 6 and 9 month scans, but this February had suddenly become 5.5-5.7 depending on who read the scan. Saw the same doctor at Hopkins, and of course now the recommended action is surgery, which of course scares me and leaves me wondering re recovery time etc. In all other ways, I am a very healthy active 82 yr old female. Involved in community activities, care-giver for husband, responsible for all housekeeping, driving, etc. Have spent last week figuring out which children could come to help husband and also be with me at hospital 3 hours from where we live. I have to gather up the courage to call Monday and hopefully be able to set a surgery date in May when it will work out to have the help. But of course every little smidgon of discomfort in my chest that feels like I swallowed too big a bite of food, leaves me holding my breath and looking for the Xanax tablet. And the fear makes the blood pressure go up.... over the past three years with meds it averages 115/54, but it is bouncing all over the place now. I need some positive feedback to keep away the panic attacks and calm myself to do what needs done. How do the rest of you cope with this??

Hi KayBee I can't answer any of your questions, but I wanted to respond to let you know I had read your message, and that I hope the questions get answered soon, and that you hang in there till then, trusting that you will have answers and that all of us on the thread can keep focused on calmness and mindfulness of the enjoyment of each moment. It isn't easy to do, is it! I got up the nerve this morning to call to get on the surgery schedule and am waiting to hear back. Meanwhile I listen to the birds beginning spring songs an sit where the sun is warm.

Kaybee and Hickory tree. I'm glad you found this forum, it is a good place to cope and share hope and information. I'm back, coming up on my annual CTA, following a 4.6 ascending thoracic aneurysm close to aortic root. It has been two years now since a fluke diagnosis during chest CT for pulmonary issues. I know I'm lucky to know, receiving medical management for BP and regular monitoring. But it is also hard to have it hanging out there, especially as I start making plans for the time post scan. So far , no significant change and next scan is scheduled for March 26. I've been on the forum for 2 years, amazed to watch many go through their surgeries with great recovery. I Hope there is no change, but I'm confident the surgery is a good option if it has gotten too large. I have confidence in my cardio and cardio/thoracic surgeon, but I'm also very grateful to the participants here who have shared and encouraged.
It is a good place for questions and venting. Good luck to both of you.

I've had my aneurysm for a year now. Just took an MRI last week, it's 4.4 mm and staying stable as my cardiologist reassures me that they won't operate until it gets 5.0mm. I just wait and hope that I keep it stable. I lost 30 pounds and I keep my blood pressure at 103/68. eating a lot of soups and vegees and stop eating sweets.See my cardiologist in 3 months again.Hopefully all the others that postes in 2011 & 20012 are still with us.They did tell me not to lift more then 25 pounds. How long can I live with an 4.4mm ? Anyone know ? Hopefully a long time.

I'm a congenital patient, BAVD with a bio prosthetic valve and 3.9 AA. My cardiologist says nothing over 20 pounds. I do a lot of strength and circuit training, but 20 pounds is about what I CAN do.

However, it feel it's relative to your fitness and strength level, in my opinion of course. What you are trying to avoid, is to much straining which can surge your blood pressure and heart rate. I think of my aorta as a balloon and when you have a diseased aorta, the elasticity isn't as it should be, so it doesn't retract the way it should, so you want to avoid expanding it.

That being said, my guess is you are able to lift more weight than me without straining. I do a lot of TRX and other body weight exercises where I can't gauge the weight amount as well. My rule of thumb is to push myself but not to much. A happy balance to continue to improve and get stronger without overly straining.

Best of luck to you and welcome to the site.

I also read an article that stated it is important to warm up before lifting weights or engaging in cardio exercise.

Most other opinions are to do higher reps and lower weight, relative to your size and strength.

20 lbs is carrying a laptop in a briefcase, it seems way too light for a restriction.

I've been working out at about 80 - 90% and feeling just fine.

I'll be a guinea pig for the weights for a while and see if there are any adverse side effects.

I guess I'll know more next year if there have been any changes.

Expowerlifter - I'm curious as to what your vascular specialist has to say - keep us updated.