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Ascending (Thoracic) Aortic Aneurysm
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txrepub4god posted:
I'm scared out of my wits here and not sure what to do. I've been very ill for the past year and have been in the hospital 4 times for heart-related issues. I'm a 40-year-old female with Wegener's Granulomatosis, Addison's Disease, and a chronic kidney disease. My heart either becomes extremely tachycardic or sometimes bradycardic out of nowhere and lasts for days.


After an ER visit for tachycardia last week, the doc did a CT scan of my chest and found a 4 cm ascending aortic aneurysm. I was told these are not surgically fixed until you're at 5 cm or bigger. I've been researching on the Internet, and found that these aneurysms can be found by echocardiograms. I had one of these done during a hospital stay in August, and this aneurysm WAS NOT THERE. So, 3 months ago it's not there, and today it's 4 cm!


Needless to say, I'm freaked out. I want the surgery done NOW to fix this before it dissects or ruptures. My big problem is, I have no health insurance. What doctor is going to do this surgery for free? No one, that's who. However, this is completely life-threatening.


I see my regular doctor on Monday and I know he'll send me to a cardiologist. Has anyone had experience with this surgery? Thanks for any information!
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cardiostarusa1 responded:
Hi:

"So, 3 months ago it's not there, and today it's 4 cm!"

Other than a fast-developing condition, sometimes, a condition can be misinterpreted, overlooked or completely missed with this or that type of diagnostic test/imaging modality.

"I was told these are not surgically fixed until you're at 5 cm or bigger."

About aortic aneurysms

The normal aorta (largest artery in the human body, shaped somewhat like a cane) is reported as being about 1" in diameter. Identifiable parts or sections of the aorta include the aortic root, ascending (goes upward) aorta, aortic arch (curved portion at the top of the aorta), descending aorta (going downward), thoracic aorta (chest area) and the abdominal aorta (stomach area).

Diseased aortic tissue is characterized by degeneration of the cells composing the aortic wall. This diseased tissue is weak, lacking sufficient elastic components to stretch and contract well.

The first indication of this abnormality may be a localized enlargement/dilation in the area of weakness. When it reaches a certain size, this enlarged/dilated area is referred to as an aneurysm.

L@@K Back in the Media

A report back in 2000 said that the risk of rupture of aortic aneurysms (more often occurring in the abdomen, AAA, than in the chest, TAA) that measure 5 to 5.9 cm was low but escalates sharply for those aneurysms that measure 6 cm or more in diameter.

Back in mid-2002 a study by the Department of Veterans Affairs reported that surgical correction is not recommended unless the aneurysm exceeds a certain size.

The researchers said that the hazards/complications of surgery can be the greater threat unless the aneurysm is larger than 5.5 cm in diameter and that most of smaller aneurysms wouldn't rupture so the ultimate goal is to repair the AAAs or TAAs that will burst.


"Needless to say, I'm freaked out. I want the surgery done NOW to fix this before it dissects or ruptures."


Other than traditional surgery, as deemed applicable to the patient, there's catheter-based endovascular stent-grafting.

Hope everything turns out as well as possible for you.

Take care,

CardioStar*

WebMD member (since 8/99)



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High Blood Pressure, Fatty Deposits Are "bit players" in Bulging Arteries - Age, gender, body size are better predictors of aortic aneurysm; genetics likely important - 9/16/03

http://www.innovations-report.com/html/reports/medicine_health/report-21510.html


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http://www.westga.edu/~wmaples/aaa.html

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James Beckerman, MD, FACC responded:
Cardiologists typically use a cut-off of 4 centimeters to define an "enlarged" ascending aorta - so it sounds like yours is right at the cut-off. It's possible that when you had your echocardiogram, the measurement did not make that cut-off for whatever reason. You might ask your doctor what the measurement was on the echocardiogram so that you can compare them.

The good news is 4 cm is far from the cut-off where surgery would be recommended. You should discuss with your doctor how often you should have follow-up tests to keep an eye on things. Take care.
 
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reneegigliotti responded:
Hi TX, I too have an ascending thoracic aortic aneurysm. It is 4.6 cm and my aortic valve is compromised. I too was shocked when I was diagnosed. For me it was a routine chest exray that spotted the abnormal aortic size. First, don't panic. Start with your PCP and ask him/her if a referal to a cardiothoracic surgeon is needed. If not, you'll probably get an echo, and either a chest CT scan or cardiac MRI on a regular basis. For me it was every 3 months until it was determined mine was stable. Now it is every year. Your Drs will observe the aneurysm to be sure it's not increasing in size. When they are satisfied that it is in fact stable, they will monitor you. You get used to it. I like my cardiovascular surgeon. He's a good guy. The things you can do are manage your weight, blood pressure, and eliminate other risk factors that increase the likelyhood that the aneurysm will increase in size. Please don't panic. It's all about monitoring and doing your part.

Renee
 
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gio9429 responded:
I was detected with an aortic anurism in Feb. 2013. The measurement at the time was 4.4 cm by early Sept. I was at 5.5 cm. I am 50 male on the heavy side, diabetic, and high blood pressure my life has a lot of buisness stress. Doctor gave me a date for Oct 2 , had it done it went well they also replaced my aortic valve. They have you walking within 24 hrs. Not painful the recovery takes time.
 
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reneegigliotti replied to gio9429's response:
Thank you for your post. I too am diabetic. I am of normal weight and have a long history of hypertension dating back to my early 20s. So far the aneurysm is holding at 4.6 cm so no surgery is planned. I'm glad to hear the surgical process was straight forward for you. I also will need both the aneurysm and aortic valve replaced when the time for surgery comes.That makes me a lot more comfortable. Knowing that the procedure can be perfomed without much incidence is really good to know. I hope you continue to heal without complication.
 
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acethestace responded:
My dad had this done 5 years ago. He had the graft/stent put it. It was one of the easier surguries that he had. It was difficult for him to watch and wait for it to grow. Once it hit 5 mm. they were right on it. It caused more worries than the others though.
 
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olytitan80 responded:
Txrepub4god,

I would be worried too. You say you don't have health insurance, but with the new Obamacare, you should be able to get it(most likely required to get it) and not have a per-existing condition problem now that Obamacare is in effect. I would look into getting some insurance and definitely ask lots of questions. Write them down in a notebook as you think of new things and take it with you to the dr appointments. Add notes about what they day when they answer too.
 
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txrepub4god replied to olytitan80's response:
Thank you all for your responses. As far as signing up for Obamacare, I have always been extremely against this bill & refuse to support it by signing up. Obamacare will destroy the amazing healthcare system the US had. Instead of making it better for a few people, it's making it worse for everyone. I do start a new job tomorrow & will get insurance there.


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