Aa
enlarged aorta at 33, other symptoms
Hi - this forum has been extremely helpful to me. Thanks to everyone who posts and responds and thanks in advance to anyone who's able to provide me with any information.
I'm 33 and was recently told by a cardiologist that my aorta was "barely enlarged" at 4.0cm after an echocardiogram (and EKG stress test, which was normal). He did not seem overly concerned, gave me no limits on exercise, and said we'd check again in a year to monitor growth.
I had seen him because I was having chest pains and anxiety during heavy lifting, strong emotional upset, and other strenuous activity. My whole body has basically been out of whack for about 15 years, presumably after a serious infection that may have been meningitis. Hard to tolerate exercise, weird chest pains and sensations, lightheadness, frequent sense of adrenaline rush, etc. Resting heart rate all over the place. I had an echo eight years ago that showed a dilated aortic root of 3.6 (I wasn't told and just found out). I was put on metoprolol eight years ago which helped the symptoms a lot but I still have bp of 135/85ish. I'm relatively thin and was an athlete in high school
I've researched this like crazy and know a lot about the basics of aorta size, but was hoping someone could have insight into 1) what could be causing me this dilation, 2) how much I should be worried and 3) whether it's really OK for me to jog (to 150bpm or so). Haven't really exercised at all for 15 years but I figure a green light from the cardiologist should be enough to get in shape? Or could this stress my aorta? Of course, any insight into my possible condition would be incredibly valuable.
Thanks...I know I probably left a lot out but the full story would be pages long.
Dan
I'm 33 and was recently told by a cardiologist that my aorta was "barely enlarged" at 4.0cm after an echocardiogram (and EKG stress test, which was normal). He did not seem overly concerned, gave me no limits on exercise, and said we'd check again in a year to monitor growth.
I had seen him because I was having chest pains and anxiety during heavy lifting, strong emotional upset, and other strenuous activity. My whole body has basically been out of whack for about 15 years, presumably after a serious infection that may have been meningitis. Hard to tolerate exercise, weird chest pains and sensations, lightheadness, frequent sense of adrenaline rush, etc. Resting heart rate all over the place. I had an echo eight years ago that showed a dilated aortic root of 3.6 (I wasn't told and just found out). I was put on metoprolol eight years ago which helped the symptoms a lot but I still have bp of 135/85ish. I'm relatively thin and was an athlete in high school
I've researched this like crazy and know a lot about the basics of aorta size, but was hoping someone could have insight into 1) what could be causing me this dilation, 2) how much I should be worried and 3) whether it's really OK for me to jog (to 150bpm or so). Haven't really exercised at all for 15 years but I figure a green light from the cardiologist should be enough to get in shape? Or could this stress my aorta? Of course, any insight into my possible condition would be incredibly valuable.
Thanks...I know I probably left a lot out but the full story would be pages long.
Dan
for about 4 months i had suffered a bad cold and cough, but taking medicines for coughs and colds were of no avail , so i went to a doctor and recommended me for an x-ray . the x-ray showed that i have a tortuous aorta or atheromatous aorta.I underwent several laboratory test on my blood and everything is normal. My lungs are perfectly fine.But I have an occasional attack of hard cough... is my having a coughs related to my tortuous aorta?
Nick,
Merry Christmas to you too, and thanks for the quick and terrific response. I'm 5-10, 165. I've read about Marfans and ED and it doesn't seem like I have either of these, although I've never discussed it with a doctor. Waiting to talk to the cardiologist again to ask him about a number of things I've found, including whether my high-ish controlled bp is at all acceptable given the dilation and whether the recent 4.0 describes the root or something else. I will definitely ask about ARBs and ACE inhibitors (your stuff here is helpful). His plan is to echo next year and determine whether it's growing (although he doesn't yet know about the previous 3.6 measurement, which was 9.5 years ago).
Will likely PM you later, as I'd like to fully understand the ARB/ACE details before discussing with my dr...thanks again.
Dan
Merry Christmas to you too, and thanks for the quick and terrific response. I'm 5-10, 165. I've read about Marfans and ED and it doesn't seem like I have either of these, although I've never discussed it with a doctor. Waiting to talk to the cardiologist again to ask him about a number of things I've found, including whether my high-ish controlled bp is at all acceptable given the dilation and whether the recent 4.0 describes the root or something else. I will definitely ask about ARBs and ACE inhibitors (your stuff here is helpful). His plan is to echo next year and determine whether it's growing (although he doesn't yet know about the previous 3.6 measurement, which was 9.5 years ago).
Will likely PM you later, as I'd like to fully understand the ARB/ACE details before discussing with my dr...thanks again.
Dan
It's impossible to know the true "normal" aortic size. It actually varies quite a bit. We can predict a range based on your height and weight, but you haven't provided those.
If you are an average size male, then 4.0 is a bit large. I'm assuming that both the 3.6 and 4.0 measurements were at the aortic root and that this progression of 4mm has occurred over the past 8 years.
Unless you are a very large man and 4.0 is "normal" for you, I would be wary of lifting very heavy weights with a 4.0 root. I'd also be wary of a cardiologist who puts no restrictions on exercise. You might seek out a second opinion from a cardiologist at a high-profile or high-volume medical university.
As for your questions:
Can't predict what's causing the dilatation. You said you're thin. Do you have signs of Marfan or other similar connective tissue disease? Sometimes, these kinds of diseases can cause aortic dilatation. However, often, aortic disease occurs in isolation. Generally, the causes are problems with connective tissue (for whatever reason) and age-related atherosclerosis/high BP.
I would not worry too much, particularly if you are a large-sized guy. The larger you are, the more normal a 4.0 is for you. If I was in your shoes, I would get regular imaging (CT/MRI every few years and echo every year), limit heavy weightlifting, do no more than moderate exercise (150bpm is higher than what docs currently recommend but I've never seen convincing studies/evidence that establish precisely why a higher pulse rate is necessarily bad), and MOST IMPORTANTLY OF ALL, I'd read up on the latest research with angiotensin receptor blockers (like telmisartan) and ACE inhibitors (like perindopril). When taken at maximal or super-maximal dosages, these drugs have been shown to reverse or at least halt aortic dilatation. You sound like a potentially good candidate. Click on my screenname and read my many posts on the topic. Send me a private message if you'd like to discuss more. This is not pie-in-the-sky stuff. Clinical trials are underway, many studies have been done in the past year or two on the topic, and knowledgeable cardiologists around the world have begun this treatment for their aortic patients with great success.
Merry Christmas,
N
If you are an average size male, then 4.0 is a bit large. I'm assuming that both the 3.6 and 4.0 measurements were at the aortic root and that this progression of 4mm has occurred over the past 8 years.
Unless you are a very large man and 4.0 is "normal" for you, I would be wary of lifting very heavy weights with a 4.0 root. I'd also be wary of a cardiologist who puts no restrictions on exercise. You might seek out a second opinion from a cardiologist at a high-profile or high-volume medical university.
As for your questions:
Can't predict what's causing the dilatation. You said you're thin. Do you have signs of Marfan or other similar connective tissue disease? Sometimes, these kinds of diseases can cause aortic dilatation. However, often, aortic disease occurs in isolation. Generally, the causes are problems with connective tissue (for whatever reason) and age-related atherosclerosis/high BP.
I would not worry too much, particularly if you are a large-sized guy. The larger you are, the more normal a 4.0 is for you. If I was in your shoes, I would get regular imaging (CT/MRI every few years and echo every year), limit heavy weightlifting, do no more than moderate exercise (150bpm is higher than what docs currently recommend but I've never seen convincing studies/evidence that establish precisely why a higher pulse rate is necessarily bad), and MOST IMPORTANTLY OF ALL, I'd read up on the latest research with angiotensin receptor blockers (like telmisartan) and ACE inhibitors (like perindopril). When taken at maximal or super-maximal dosages, these drugs have been shown to reverse or at least halt aortic dilatation. You sound like a potentially good candidate. Click on my screenname and read my many posts on the topic. Send me a private message if you'd like to discuss more. This is not pie-in-the-sky stuff. Clinical trials are underway, many studies have been done in the past year or two on the topic, and knowledgeable cardiologists around the world have begun this treatment for their aortic patients with great success.
Merry Christmas,
N
Have an Answer?
You are reading content posted in the Heart Disease Community
Is a low-fat diet really that heart healthy after all? James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines.
Can depression and anxiety cause heart disease? Get the facts in this Missouri Medicine report.
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
Learn what happens before, during and after a heart attack occurs.
What are the pros and cons of taking fish oil for heart health? Find out in this article from Missouri Medicine.
How to lower your heart attack risk.
