Aortic Dissection Questions???

[char2mar]

I know a few of you out there have survived to talk about your aortic dissection. I recently had and still have symptoms that leads me to believe I may have a chronic dissection of the ascending aorta however the ER doctors don't think so. This what happened. I was at work and started to get twinges of stabbing chest pain. My heart rate suddenly went up to 120 to 130 bpm. I was expericencing some SOB. As the day progressed I started to get pain shooting up the left side on my neck to my jaw and behind my ear. The pain became progressively worse through out the day. I stopped off at an Emergency walk in clinic on my way home. My paulse was still high and my blood pressure 128/88 which is rather high for me. The doctor told me to go to the ER if I felt my symptoms get worse. The next day I ended up going to the ER around 1 pm...I couldn't stand the pain anymore...it was worse when I walked around or sat up...If I layed flat on my back I could bare it, but not when I was upright. I also had pain shooting down the back of my left arm. They did the usual EKG, d-dimer test, TNT, and chest xray. All came back normal so they sent me home. I suffered through Saturday and half of Sunday and then went back to the ER. The pain in my neck felt like my neck was tearing in two. The chest pain was worse then labour...I could not take in a deep breath or walk a foot without gasping in pain. Again they did the usual coronary work up even though I told them that I did not have CAD. (Would they listen....no) After much ado about nothing they decided that I had either plurecy or pericarditis and put me on a regiment of moriphine, and IV cortisteroids. The next day the sent me home with a seven day supply of oxycet. Told me to see my PCP. Which I did today and it was decided that I see a thoraxic surgeon sooner than later. I still have the pain but is not as extent as it was the past 4 days. The meds are starting to wear off and the pain is becoming almost unbarable again. I guess it is time for another pain killer. What I want to know is...are xrays a reliable test for dissection? Would it show if the aortic sheath is tearing? or is there a more definitive test for this. I know that dissections can be acute or chornic....I am so freaked out and extremely fatigued and in pain.....if you were I, what would you do??????

Char.

 

[kia]

Don't wait

Don't wait

You need a CAT scan or TEE (TransEsophageal Echo) as soon as either can be done to rule out a dissection. My daughter's dissection was discovered via a CAT scan. Don't fool around with anything less informative if you think it's a dissection. Good luck to you.

 

[Ross]

You need a CAT scan or TEE (TransEsophageal Echo) as soon as either can be done to rule out a dissection. My daughter's dissection was discovered via a CAT scan. Don't fool around with anything less informative if you think it's a dissection. Good luck to you.

BINGO! 100% Correct. They missed mine on a catheterization, x-ray, and echo. It was seen clearly (Now that I was very close to death) on the cat scan and confirmed by TEE.

 

[RobThatsMe]

Hi,

Here is some useful info for detecting aneuryms and dissections.

How are AORTIC ANEURYSMS detected?
Patients sometimes detect an aneurysm by feeling a pulsating mass in the abdomen, or it may be found by their physician during a routine physical examination. The best way to detect unsuspected aortic aneurysms is by an ultrasound or CAT scan of the abdomen. Ultrasound is quick, inexpensive, non-invasive, and accurate; if the aorta can be seen, the presence of an aneurysm can be identified or excluded. CAT scans of the abdomen remain the most accurate tests for aortic aneurysm, both for initial detection and for determining aneurysm size. They provide information equal to MRI scans.


Regards,
Bob

 

[PJmomrunner]

Hi Char:

I can relate to your situation in that I am about the same age and sex and also have BAVD--my valve is moderately leaky with no significant stenosis. I also have an ascending aortic aneurysm. I am asymptomatic except for chest pressure that seems to come with physical or emotional stress and go with rest. I also was recently diagnosed and I alternate between being extremely concerned that I could dissect at any time and telling myself to trust my doctors.

I have looked at all of your other posts as well as this one. Your "Moderately severe" regurg is class III and you are symptomatic--from what I've read, my general impression is that operating in the near future would be the usual practice in such a case--perhaps especially in a woman. The SOB and the tachycardia make me concerned that your valve may have gotten suddenly worse. I would think the other CAD-like symptoms could result when your heart/body isn't getting the blood supply it needs because of the tachycardia.

I would want to see a surgeon right away. Not next month or even next week. Check out these articles and, if you think it will help, share them with your docs, you need one of them to push for immediate assessment.

Good luck. Post back. I'm worried.

P. J.

http://circ.ahajournals.org/cgi/content/abstract/94/10/2472
http://www.emedicine.com/med/topic156.htm

I know a few of you out there have survived to talk about your aortic dissection. I recently had and still have symptoms that leads me to believe I may have a chronic dissection of the ascending aorta however the ER doctors don't think so. This what happened. I was at work and started to get twinges of stabbing chest pain. My heart rate suddenly went up to 120 to 130 bpm. I was expericencing some SOB. As the day progressed I started to get pain shooting up the left side on my neck to my jaw and behind my ear. The pain became progressively worse through out the day. I stopped off at an Emergency walk in clinic on my way home. My paulse was still high and my blood pressure 128/88 which is rather high for me. The doctor told me to go to the ER if I felt my symptoms get worse. The next day I ended up going to the ER around 1 pm...I couldn't stand the pain anymore...it was worse when I walked around or sat up...If I layed flat on my back I could bare it, but not when I was upright. I also had pain shooting down the back of my left arm. They did the usual EKG, d-dimer test, TNT, and chest xray. All came back normal so they sent me home. I suffered through Saturday and half of Sunday and then went back to the ER. The pain in my neck felt like my neck was tearing in two. The chest pain was worse then labour...I could not take in a deep breath or walk a foot without gasping in pain. Again they did the usual coronary work up even though I told them that I did not have CAD. (Would they listen....no) After much ado about nothing they decided that I had either plurecy or pericarditis and put me on a regiment of moriphine, and IV cortisteroids. The next day the sent me home with a seven day supply of oxycet. Told me to see my PCP. Which I did today and it was decided that I see a thoraxic surgeon sooner than later. I still have the pain but is not as extent as it was the past 4 days. The meds are starting to wear off and the pain is becoming almost unbarable again. I guess it is time for another pain killer. What I want to know is...are xrays a reliable test for dissection? Would it show if the aortic sheath is tearing? or is there a more definitive test for this. I know that dissections can be acute or chornic....I am so freaked out and extremely fatigued and in pain.....if you were I, what would you do??????

Char.

 

[BionicRedneck]

I know a few of you out there have survived to talk about your aortic dissection. I recently had and still have symptoms that leads me to believe I may have a chronic dissection of the ascending aorta however the ER doctors don't think so. This what happened. I was at work and started to get twinges of stabbing chest pain. My heart rate suddenly went up to 120 to 130 bpm. I was expericencing some SOB. As the day progressed I started to get pain shooting up the left side on my neck to my jaw and behind my ear. The pain became progressively worse through out the day. I stopped off at an Emergency walk in clinic on my way home. My paulse was still high and my blood pressure 128/88 which is rather high for me. The doctor told me to go to the ER if I felt my symptoms get worse. The next day I ended up going to the ER around 1 pm...I couldn't stand the pain anymore...it was worse when I walked around or sat up...If I layed flat on my back I could bare it, but not when I was upright. I also had pain shooting down the back of my left arm. They did the usual EKG, d-dimer test, TNT, and chest xray. All came back normal so they sent me home. I suffered through Saturday and half of Sunday and then went back to the ER. The pain in my neck felt like my neck was tearing in two. The chest pain was worse then labour...I could not take in a deep breath or walk a foot without gasping in pain. Again they did the usual coronary work up even though I told them that I did not have CAD. (Would they listen....no) After much ado about nothing they decided that I had either plurecy or pericarditis and put me on a regiment of moriphine, and IV cortisteroids. The next day the sent me home with a seven day supply of oxycet. Told me to see my PCP. Which I did today and it was decided that I see a thoraxic surgeon sooner than later. I still have the pain but is not as extent as it was the past 4 days. The meds are starting to wear off and the pain is becoming almost unbarable again. I guess it is time for another pain killer. What I want to know is...are xrays a reliable test for dissection? Would it show if the aortic sheath is tearing? or is there a more definitive test for this. I know that dissections can be acute or chornic....I am so freaked out and extremely fatigued and in pain.....if you were I, what would you do??????

Char.

Bout 2.5 years ago I had the same symptoms that you described. At 22 I guess the ER Doctors just kind of blew it off as my birth defect of not having an epiglottis (it grew in by the time I was 3) and letting acid in my chest. Even though I had went 20 years without any flare ups. They did the normal stuff to diagnose my indigestion and sent me home with a suped up thing of tums (I never took) In Jan my Cardio found my 7cm aortic aneurysm and wore out aortic valve. The heart cath showed that my aorta was tearing and about to burst (critical hour kind of thing).

The initial echo guessed my aneurysm to be about 4.5 to 5 cm, but the CAT scan showed it at 6.8 - 7cm. I would say that xrays are a good starting point but not a sufficient judge or "lets wait and see" answer to problems. I would see a surgeon or cardio or the hobo on the corner, as long as one of them will do more indepth testing and get a realtime accurate reading and status of your pumper. I hope all goes well.

 

[perrybucsdad]

I never had pain with my AA, but the pain that you describe, I have had many times and it has always been plurisy. Very painful in deed and very hard to breath in. They always tested for this with X-Rays.

 

[char2mar]

Thanks for the posts. I am waiting to see a thoraxic surgeon, hopefully this won't take too long. I am also getting an abdominal ultrasound this week. At the moment I feel not too bad,,,,slept all day yesterday and today...tomorrow I go back to work. If the pain returns than I will insist more tests be done. Keep your fingers crossed that it is just plurecy or pericarditis.
What ever it is, it is scaring the crap out of me.

Char