ok, so once i again i must ask for the forum's help. i need to arm myself with info going into my cardio's office today. had a three month echo last week. valve is fine, but he said my aorta maybe widening and wants to do a ct aorta to make sure. now he says this before he even looks back at my previous TEE's. not to mention the fact that i had two CT aorta's pre and post op. the surgeon and the doctor never said anything was wrong with my aorta. can this happen in a period of three months?? i'm done taking tests and just want to move on. i can't see how after ALL the tests i've gone through, this is just now showing up
aorta problems?
- Thread starter ryen0
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Marguerite53
Premium Level User
Hello. Sorry that I didn't follow your history at all. I guess if you trust your cardio then you really ought to let him do his job in keeping you alive. That would be my first instinctive response. Of course one does wonder if it is just a ploy to help pay for the expensive machinery....but honestly.....that can't be so, can it really?
I'm sorry for your frustration. Many of us have complicated experiences and some occur before surgery, some after. I would think that you would want to be sure that all was well. Just check with your insurance that everything will be covered, take a huge sigh and exhale slowly, put your comfy clothes on and get on in for the CT.
Good luck. Let us know what you find out.
Best wishes.
Marguerite
I'm sorry for your frustration. Many of us have complicated experiences and some occur before surgery, some after. I would think that you would want to be sure that all was well. Just check with your insurance that everything will be covered, take a huge sigh and exhale slowly, put your comfy clothes on and get on in for the CT.
Good luck. Let us know what you find out.
Best wishes.
Marguerite
netmiff
Well-known member
I think I would be questioning your cardio about this. Why does he need to do another test now? why did it not show up before ? etc., etc., I can not help you with whether it is likely to show up now or not. Hope you et some satisfactory answers on that one!
Marguerite, I know here in Canada we do not get nearly as many tests as you guys to the south do, I have often thought it is to justify having the expensive equipment and to help pay for it. I had AVR replaced last year and an aortic aneurism "tucked in" at the same time, had an ultrasound about 4 weeks after, and am now scheduled for annual follow-up. Last time I was at my family doc( who has a good sense of humour) I was complaining I am in there about every other month right now for something or other (had two trips to ER in one week, turned out to be a bladder infection) and I was saying I've just gone downhill since turning 50 3 years ago, I used to go and see him once every two years for my annual physical, and he said "you're not sick" !!! - and I have to agree with him on that one.
Marguerite, I know here in Canada we do not get nearly as many tests as you guys to the south do, I have often thought it is to justify having the expensive equipment and to help pay for it. I had AVR replaced last year and an aortic aneurism "tucked in" at the same time, had an ultrasound about 4 weeks after, and am now scheduled for annual follow-up. Last time I was at my family doc( who has a good sense of humour) I was complaining I am in there about every other month right now for something or other (had two trips to ER in one week, turned out to be a bladder infection) and I was saying I've just gone downhill since turning 50 3 years ago, I used to go and see him once every two years for my annual physical, and he said "you're not sick" !!! - and I have to agree with him on that one.
briansmom
Well-known member
It is possible that this could be new, especially if you were a bicuspid. There are some on this forum that advocate prophylactic replacement of the ascending aorta when replacing a valve so that this kind of thing can't happen. Unfortunately, you are in for another round of tests, but better safe than sorry. I hope that it turns out that the doc was being overly aggressive.
Please keep us posted.
Please keep us posted.
Ok, just got back from the cardio. Basically what really pisses me off is their communication skills, but that's another topic. So anyway, my post op echo showed my aorta at 3.7 My one week post op CT Scan showed it at 3.0 Now my cardio's echo's showed about 3.9 before surgery, and 4.0 at this most recent echo. My aortic valve doesn't leak one bit. So basically my cardio gave me a lecture on all the different ways they measure things and how different people can have different readings. He doesn't think there is an issue, but he still wants to do another CT and compare it to the surgeon's CT to make sure. So i guess i'm going ahead with the test. This is my thing. How can you have batteries of tests and someone in your heart, and not say anything is wrong with your aorta. Then just a few months later they suspect something???? But he seems to think they are just making double sure that everything is ok. The good news is that my mitral valve isn't leaking and my left ventricle is returning to normal size. Thanks for the input everyone.
Great news about your valve not leaking and your heart muscle size! About your possible aortic problem, let me tell you, I had a mitral valve repair in 2004 and my cardio checked for aortic enlargement just before the surgery. No sign of enlargement. But then, in 2007, out of the blue, during a routine yearly CT scan, they found my ascending aorta had dialated to 4.7 cm. So I guess it can happen anytime to anyone. I'm glad they found it because now that we know it's there, we can, hopefully, repair it in time.
Get the test is my experienced opinion.
Get the test is my experienced opinion.
abbanabba
Well-known member
Hi Ryen0... sometimes it really does come down to different techs doing different tests being interpreted by different people. Given the sizes you've listed, I wouldn't think they'd be overly concerned by it at this time anyway, as they seem to wait until it gets up near 5.0 before they consider intervention. "Normal" (according to my echos) is in the 1.5-4.0 range. Still, it's good to know they're keeping an eye on it.
My own aortic root went from 2.5 to 3.7 in a matter of months, but then stabilised and over the last couple of years has gradually increased to 4.1. Don't know how it will go after the valve surgery, but at this stage they're happy to keep an eye on it.
Glad to hear the rest of your heart is recovering well though.
A : )
My own aortic root went from 2.5 to 3.7 in a matter of months, but then stabilised and over the last couple of years has gradually increased to 4.1. Don't know how it will go after the valve surgery, but at this stage they're happy to keep an eye on it.
Glad to hear the rest of your heart is recovering well though.
A : )
Hey Ryen, I can understand your frustration my friend. I guess I can offer my own experience with ct scans and aorta measurements...
I presented to my cardiologist with chest pain 3/08. Cardiologist ordered a CT scan. CT scan showed an aneurysm of 4.5 cm, with a strange bulge on the front when viewed from a 3d reconstruction. The strange shape and the sudden increase in size prompted me to be very aggressive in seeking more than just one or two or even three opinions.
After several consultations with several surgeons and two CT scans and one 1.5 hour MRI later, everyone is pretty certain that the bulge was a motion artifact of the CT scan. My aorta is really 4.1 to 4.2 cm, and the growth is much less aggressive than I originally thought.
My thoughts on my experience: In hindsight, I wish I hadn't felt compelled to waste so much time worrying about my aorta. I spent quite a bit of time and money on the issue and I'll never get the time back. I went beyond just a trusting patient's casual pursuit of knowledge, diagnosis and treatment plan for the ailment and I regret it, but I don't regret pushing and learning and testing until I felt comfortable with my decision to wait. If I hadn't pushed, I would always feel more uneasy about it than if I had just settled for "trust me, I'm a doctor."
I say let them test until you're comfortable with their diagnosis/interpretations. It sounds like there's a huge question mark hanging over your head right now, like a dark cloud. Personally, I wouldn't allow a question mark to linger.
To me, it sounds like your doctors are just practicing due diligence, making sure you're alright. It seems like they're trying to get a solid measurement for your aorta to be on the safe side.
I presented to my cardiologist with chest pain 3/08. Cardiologist ordered a CT scan. CT scan showed an aneurysm of 4.5 cm, with a strange bulge on the front when viewed from a 3d reconstruction. The strange shape and the sudden increase in size prompted me to be very aggressive in seeking more than just one or two or even three opinions.
After several consultations with several surgeons and two CT scans and one 1.5 hour MRI later, everyone is pretty certain that the bulge was a motion artifact of the CT scan. My aorta is really 4.1 to 4.2 cm, and the growth is much less aggressive than I originally thought.
My thoughts on my experience: In hindsight, I wish I hadn't felt compelled to waste so much time worrying about my aorta. I spent quite a bit of time and money on the issue and I'll never get the time back. I went beyond just a trusting patient's casual pursuit of knowledge, diagnosis and treatment plan for the ailment and I regret it, but I don't regret pushing and learning and testing until I felt comfortable with my decision to wait. If I hadn't pushed, I would always feel more uneasy about it than if I had just settled for "trust me, I'm a doctor."
I say let them test until you're comfortable with their diagnosis/interpretations. It sounds like there's a huge question mark hanging over your head right now, like a dark cloud. Personally, I wouldn't allow a question mark to linger.
To me, it sounds like your doctors are just practicing due diligence, making sure you're alright. It seems like they're trying to get a solid measurement for your aorta to be on the safe side.
aussigal
Well-known member
One thing my Surgeon and Cardio do to try minimise the chances of false-positives from different reading methods etc is to always get the same person to do the scan and make the report.
Roger Frank
Well-known member
csutherland
Well-known member
Jerry has had two odd situations like this. He had a Prostatectomy in Dec, 2000. That's major surgery that takes a while to get over & you know how many times a day nurses come in, do vitals, listen to the chest & back, etc & nobody ever mentioned any abnormalities. When he was recovered from that, about 2 mo later, he was in pre-admission for hernia surgery when the anesthesiologist said, "how long have you had this heart murmur?" Jerry said he didn't have a heart murmur, but they begged to differ, putting off the hernia surgery till his AVR about a year later. The heart surgeon said nothing about his aorta at that time.
Three years later his aortic aneurysm was seen for the first time in a routine echo. It was measured at 5.3 by echo, TEE & later CT. Now they're saying it's 5.0-5.1. We didn't think they were supposed to shrink but we'll take that measurement!
Three years later his aortic aneurysm was seen for the first time in a routine echo. It was measured at 5.3 by echo, TEE & later CT. Now they're saying it's 5.0-5.1. We didn't think they were supposed to shrink but we'll take that measurement!
just wanted to share the results. looks like my aorta hasn't changed at all. so it's not widening according to them. it is somewhat dialated at the root. according to the nurse there is no sign of aneurysm or dissection "per say" so here are my beefs. why didn't they say it was dialated when they did the first echo? and why did she say "per say" ? i'm sure it's just in the case i drop dead my family won't sue 
i guess i want a doctor to say either point blank, everythings fine, or something is wrong. i always get vague answers. well anyway it's still good news
i guess i want a doctor to say either point blank, everythings fine, or something is wrong. i always get vague answers. well anyway it's still good news
just wanted to share the results. looks like my aorta hasn't changed at all. so it's not widening according to them. it is somewhat dialated at the root. according to the nurse there is no sign of aneurysm or dissection "per say" so here are my beefs. why didn't they say it was dialated when they did the first echo? and why did she say "per say" ? i'm sure it's just in the case i drop dead my family won't sue
HAH! They're slippery man. I think per se in latin means "by itself", but in your case I think she's saying nothing appears overtly wrong from the scan. There's a lot of factors that you have to account for when looking at dilitation - so I'm told. They say that a bigger guy should naturally have a larger aorta than, say for example, a small woman. So if your aorta is a bit on the large side and you're a big guy, that might be normal for someone like you. You have to remember that only a fraction of the general population gets a ct scan of the aorta, so it's hard to say for 100% certain what's normal or safe. Some people make it to 7.0 cm and never knew they had a problem, others don't make it to 4.5.
I think it's pretty hard to see dilation of the aorta with an echo. Dissection not at all. According to the person that does my echo's, they can see different things in different people depending on body size, fat in the chest and stomach area and other limiting factors. They probably didn't see anything alarming in the echo and just wanted to be sure, therefore, the ct. Insurance, insurance.
MrP
Well-known member
The margin of error is greater in an echo measurement, as your experience shows. A 64-slice CT scan will be much more precise and establish a good baseline for monitoring potential growth in the future.
