Question about Ascending Aortic Aneursym

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Ysidro
New Member


Date Joined Nov 2010
Total Posts : 8
   Posted 11/4/2010 6:19 PM (GMT -7)   
 I'm a 47 year old male, 6'4 and 300lbs.   I was diagnosed with hypertension at age 15 and i've been on medication since the age of 19.  My BP has been controlled fairly well till the last year.   In the last year i've had occurences of uncontrolled hypertension.   This has continued on in spite of numerous changes to my med regimen.  One year ago after having readings as high as 220/139 I was referred to a cardioligist.  He performed an echo which revealed my aorta diameter as normal at 3.7 cm.   After more changes to my med regimen produced no results, I was tested for sleep apnea.   I was diagnosed with apnea and started using a CPAP.   My BP normalized to some extent(avg reading 150/90)  Two months ago my BP returned to the old high levels, which has led me to be diagnosed with malignant hypertension.  In spite of taking a regimen which now includes atenolol/chlorathiazide, cardizem, minoxidil, clonidine, lisonipril and tekturna, my BP continues to be uncontrolled.  During a recent hospital stay I was diagnosed with an ascending aortic aneurysm of around 4.3cm.   My cardioligist has recommended a wait and see approach on this.   During my own research I've discovered that it is recommened that if surgery should be performed if there is an increase of 0.4 cm in a year.   I have more than exceeded this.  I'm not really comfortable with waiting.  I'm scheduled to see another cardiologist at Shands teaching hospital for a 2nd opinion.   I'm currently on a strict diet, but my dr. doesn't think that my weight will have much of an effect on my BP as i'm in pretty good physical condition(former athlete and avid weightlifter)  As of now i'm on a LOA from work and my life is at a standstill.   My wife and kids are terrified.    I"d welcome any thoughts/suggestions/comments from the forum.
 
thanks

Ysidro
New Member


Date Joined Nov 2010
Total Posts : 8
   Posted 11/7/2010 6:36 PM (GMT -7)   
WOW!  Not a single comment...   I must REALLY be in bad shape!LOL!

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 11/8/2010 8:31 AM (GMT -7)   
Hello and welcome to HealingWell.  I am sorry,  I did reply to your post but for some reason it is missing.  I had even done some research for you.   I will give it another go. 
 
I ran a check on ideal weight for a male your height and came up with approximately 202 lbs. I calculated your BMI as  36.5.  Obesity is measured by body mass index (BMI), which is determined by weight and height. BMI is highly correlated with direct measures of body fat in most populations. Normal BMI is 20-25, overweight is 25-29.9 and obese is greater than 30. Not only is BMI important for determining hypertension risk, but fat distribution is as well.   Obesity and hypertension (high blood pressure) is intimately connected.  As your Dr. knows you and your physical physique his comment may be correct re your weight.  However as you are on a strict diet that makes me feel that your weight may be a cause in your hpertension issue.
 
I am very glad to read that you are seeking out the opinion of a second cardiologist and I feel you are truly advocating for yourself.  Your concern is very legitmate. 
 
I know this can cause a lot of anxiety for you so please try to stay in the moment and take it one day at a time.  There are many threads here in the forum re PFO repairs and I am sure you have read them.
 
I have read many good things about Shands so I will be very interested to hear what the second Cardiologist has to say.  Remember this is your life and disorder and to keep on taking care of you.
 
As a wife I understand how your wife is feeling.  Give her my best and stick with us.  I was hoping another member would be along to post so hang on and know we are here to support you.  We care !
Kindly,
Kitt
~~Kitt~~
Moderator: Anxiety/Panic, Osteoarthritis, GERD/Heartburn and Heart/Cardiovascular Disease.
www.healingwell.com

"If you can't change the world, change your world"

Ysidro
New Member


Date Joined Nov 2010
Total Posts : 8
   Posted 11/8/2010 5:34 PM (GMT -7)   
Kitt,
 
Thanks for the reply.   I did see the Thoracic Surgeon at Shands.  As it turns out he says that the actual size of an aneurysm can't be accurately gauged with echocardiagrams. To do this he needs to have a CT of my chest.   So.............  more waiting while I get the CT scheduled.  He did indicate that he would normally consider someone a candidate for sugery only if the aneurysm is 5.5 cm or greater, and said he would be very surprised if mine were that large.  He said I shouldn't be concerned about the .5cm growth and said barring an unexpected finding on the CT,  the plan is to have the CT now and a follow up in 6 months.   Now I find myself truly at a quandry.  The last thing I want is heart sugery, but my regular physician(not a heart specialist) has indicated that she is very concerned about the .5cm growth in the last year combined with my malignant hypertension and seems suprised the surgeon would want to wait 6 months due to the exacerbating hypertention issue.  I'm being referred to ANOTHER cardiologist at Shands to check out my ongoing hypertension issue.   All of this is extremely difficult  on my family.   I don't want to be fixated on this issue, but by the same token I want to be sure that my issues are not being overlooked.   I lost my mother to a negligent cancer diagnosis 5 years ago and this has taught me to be pro-active and unfortunately not very trusting of the medical profession.   I know you aren't a medical professional, but do you believe  my concerns about the growth rate of the aneurysm to be warranted?
 
thanks!

TAAaway
New Member


Date Joined Dec 2009
Total Posts : 2
   Posted 12/14/2010 2:39 PM (GMT -7)   
Hi Ysidro,
I don't know if you are still checking these posts or will be automatically
notified of this one. I have read that a .5 cm dilation increase over a 6 month period
warrants concern and signals surgery eligibility regardless of size of the overall dilation
and also that 1 cm over a one year period warrants concern. The average increase
I have read is about .1cm per year.

I can understand what kitt says about posting in response and not seeing the post since
I have posted twice before in the TAA threads and have never been able to locate
even one of my posts! Oh well. I've certainly gotten benefit out of reading about
everyone's travails and appreciate this place. I am in a holding pattern having been diagnosed with a 4.3 ascending aortic aneurysm a year ago, and measuring the same approximately six months later. I am perhaps overly watchful about my BP, which is way lower than yours on my meds, yet I still worry lots about it!
Truly you should check further on that BP and research it online as I believe the link between BP and aneuryzm rupture is great.
One article by Dr John Elefteriades of Yale
strongly suggests a correlation between spikes of BP and dissection/rupture.
THey did a study where those who ruptured or their families (all didn't survive, etc.) were questioned on life events just prior to rupture. Emotional excitement and physical exertion figured largely in the cases of about 170 or so patients who had come through his hospital with ruptures over a certain time period...and so it goes...
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