This is good clear information and I was happy to see the indexing equation as my diameter is 43mm (to be confirmed by CT) but I'm 188cm so in a low risk category. I feel like a lot of cardiologists are giving excessively cautious advice on exercising to people in my category as the data really isn't there. There is currently a long-term study being carried out on Masters athletes who have enlarged aortic diameters as the hypothesis is that it may be a harmless adaptation in some endurance athletes and will not raise the risk of dissection.
Thank you very informative! 62 yo female 5.2 ascending aorta with AVR mech valve 2005. Was super difficult to find info on surgical risk (re-surgery) vs dissection risk when I was diagnosed in 2019. Your presentation totally supports my conclusion made with my doctors at Cleveland Clinic, where I went to get expert advice. Am being monitored, no change in size since 2019 😊
When considering risk and size, how important is the familial history (example: a father that had an abdominal with surgery and a thoracic (death before intervention from Parkinsons)
57 yr old woman in Canada. 4.6cm Ascending Aortic Aneurysm. They have left me awaiting to see someone at The Aortic Clinic at our Major Hospital. In Canada nothing moves quickly. My GP actually wrote me an email that said, “If you get a nose-bleed let my office know” Um, that’s not a thing from ANY research I’ve done. I have chest pain for a year now and weak and nauseated, they told me 8 mos til a CT scan (we are supposed to be covered in Can as you may know) SO I paid $1300 to get one myself. That is how they saw the aneurysm. I just had an echocardiogram, waited 2 mos. For that. Cardiac surgical nurse told me get a graft sooner than later. So here I sit at home, no idea what to do. A decent % of thoracic ascending ruptures in women happen prior to 5cm. Also experienced surgeons say “make sure they have successfully done these surgeries MANY times before”. In Canada you don’t get to shop for the best. Man, I feel like my hands are tied, no meds nothing. Oh my GP did prescribe me Clonazepam for my sleepless nights. Thanks! I sound frantic, I’m not, just wondering wtf is GOOD Canada?!! I would like some care and to get on with it. My sense of humour can only take me so far.
I am living proof that the LVAD is helpful. Dr Legare inserted my LVAD (HN II) in Halifax in 2016, ten years post an Ischemic MI. This helped reduce my pulmonary hypertension to the point I could be placed on the transplant list. Fast-forward about a year and a half and (after one false start) I received a transplant. I have done well with it so far and am very pleased to have have been able to have the medical treatment I've received. Cheers Dr. Legare...Halifax's loss was indeed our gain here in New Brunswick...in my opinion.
I am 78, PVCs noticeable since 20's, increased in early 2023 to cause extreme fatigue, mental fog, lethargy. History of taking atenolol but stopped in 2021 due to bradychardia and pulse lower than 50 at rest. June 2023 fitted with Zio recorder, but cardiology PA said rate 10.3%, not serious but should see electrophysiologist. First appointment available late September, had gone through terrible summer. Cardiologist in September at Heart Hospital looked at same data, recognized problem, scheduled me for cardiac MRI to determine heart damage. Heart was found to be healthy (had stent in 2000 likely result of Vioxx for arthritis) but no sign of ever having heart attack (blockage determined from stress echo and angiogram). Results of cardiac MRI, electrophysiologist said I had serious problem he could resolve by ablation. Ablation was 3 weeks ago and as of now, feeling great. 10.3% rate insignificant to first cardiologist but 4 months later cardiologist looking at same data recognized daytime periods of 33% was not recognized by computer analysis. Happy my electrophysiologist recognized.
I am a 53yo male, 5'7", 175 pounds, and I walk about 28 miles a week. My blood pressure is good. However, I do have a bicuspid valve, a maternal grandfather that died at 62 of a heart attack, a father who had heart problems. I was also injured when I was younger in an auto accident and I have portal vein thrombosis and espophageal varices due to a loss of my spleen, and I almost bled to death this year due to the varices bleeding. As a result of various tests, I was diagnosed with a 4.8 cm ascending aortic aneurysm. My doctor is willing to do surgery now. My thinking is I don't want this hanging over me, a growth rate of 14mm/year means I'll be at the 5.0 threshold in a couple of years, and I am very fit and healthy otherwise now and never going to be healthier or younger. I really don't want open heart surgery. But I also think it is time to have the surgery. Anyone have any thoughts?
Did you have the surgery? I am 55 and in great shape but have a 4.7mm ascending aneurism with oderate to severe aortic stenosis from bicuspid valve. Doctor want to operate in 4 weeks. I am scared, but I feel like you, the best shape of my life, so now is the time.
@@robertlee7232 I had open heart surgery 12/19/23. It went well, but I had a ton of post op inflammation and pericardial tampanade and a pericardial effusion, which was probably worse than the actual surgery. They fixed the aneurysm but left the valve be. I won't lie, I was in good shape going in and it was still a lot of work and a long time getting back to normal. I had a lot of pain for about the first 6 months, especially when I coughed or sneezed. Lifting weights made me very sore, so I backed off those a couple of months ago to focus on walking. I'm holding a nice 185, and only get sore if I sneeze or cough, or if I bump into something and take like an elbow to my breastbone, which I think is all pretty normal. I can swing golf clubs full bore, though I'm a little stiff. I would absolutely do the surgery if I had it to do all over again. The peace of mind is massive, and their is no impact on my lifespan. So I effectively took this aneurysm out of the equation. One thing I was not prepared for is how down you can feel at times. You feel fragile and old at times, which messes with your male ego frankly. I had to rely on others while recovering, and I will never see myself as a young man again. But you get past that too. All it takes is a nice blue sky to remind me of how fortunate I am. It is great to get so many bonus years to help my family! Best of luck if and when you do it. Get a good doc, and you will be fine!
@@kiya4fun My AA is 4.9. It was 4.6 two years ago. According to doctor's notes it is bicuspid. I am 64 and I walk at least 1 hour per day. My weight is normal, blood pressure is good. I guess my day on the table will be coming soon. I am in no hurry. Good luck to all dealing with this.
seems like age should be a significant factor in decisions. Putting off surgery for a 60 year old places potential surgery into later years when surgery is higher risk. And there is a compounding effect, with a certain percent mortality that compounds each year, vs surgery which is a discrete event, once and done.
My brother’s (73 )new doctor sent him to cardio because he thought he had a fib. Turned out to be ascending aortic aneurysm (4.8cm). They’re watching it. Family history , both mother and father) father had an abdominal AA , had surgery at 66 years and lived to 87. Cousin on dads side dropped with no warning, mothers side: her sister had abdominal AA; her brother had one that “blew out” in 1965 and died in 2002 at 82; another of her brothers refused surgery and he died from burst aneurysm. My brother and I are 11 1/2 mos apart and because of our family history my cardiologist is recommending complete testing and I concur.
62 year old male at 5.1 AAA and have good bp and descent cholesterol. Surgeon wants to wait till next summer and monitor it. Also have a leaking valve .This has been monitored for 20 years and has just increased this year.
Absoultely outstanding. Thank you very much indeed for posting this disucssion. Help a great deal with the worry about such a finding on Echo. 4.2 dialtion of aortic root. BP well controlled as is weight. Question about profession - semi-professional athelets. I did find a couple of studies mostly focused on cardiac hypertrophy and LV diastolic dysfucntion..grade 1. Low normal EJ 50 -55%. So looking at the mechanics. This dysfucntionand dilation seems a little more complicated with a low EJ? Best wishes to all on this. Once again thank to Dr. Pozeg.
In April 2023 I went into the hospital with chest pain, shortness of breath, heart pounding, lightheadedness, slight nausea and slow heart rate. They verified several PVCs, did echo's, tried several drugs. They released me after 3 days with PVCs continuing. With a 24hr Holter monitor on the 4th day after hospitalization, it showed, heart rate of 45 to 135 multifocal atrial tachycardia, 1-6 beat runs of Super Ventricular Tachycardia, Bigeminy and Trigeminy, occasional PACs and frequent isolated PVCs at a rate of 26,827 in that 24 hr. period. Scheduled an ablation, and on the day of the ablation while on the table, the PVCs stopped and they couldn't do the ablation. Now waiting for an appointment at UCLA for a more in-depth heart mapping system. Currently running zero to a max of 30 PVCs per minute (Aug 13th). Frequency has been slowing down over the months, but hoping to have PVCs next time I am in the lab.
Not feeling well. Some part of the day I experience 0 pvcs, while a few minutes later I will have 4 pvcs/min. On the 26th of Dec I started having pounding and measured 16 pvcs/min for about 1/2 hr with chest pain. UCLA is sending me a Holter monitor on the 9th Jan to put on for 5-7 days. Today the heart pounding woke me up at 3:30am and I'm still awake. Today 9:44am I measure 6 pvcs/min Bigeminy.
Hi. You should not interpret this. You should ask your cardiologist directly. I had a major discrepancy between my first CTA (5.2) and second (4.5) - but these things do not shrink. The cardiologist should follow up with whoever did the readings and get clarity for you.
Im 42 and need a aortic aneurysm repair my number is 6.2 cm. And i need a valve replacement. Severe aortic stenosis with regurgitation. I literally getting a review now and find out what the gameplan is. Im was born with aortic valve disease. But im optimistic and just want to getbit done and over with fairly healthy besides this issue. Thanks for video nice to know whats gonna happen. Nov 14th my surgery 🎉🎉🎉
Yea it’s definitely a detail if family has had the same previously , it was discovered a 7.7 in my aorta ( wich burst on my father at same age of 62 , followed by death 3 days later ) in wich they immediately operated on 5 weeks ago, my brother also has had the same one
PLS! PLS! Help, I'll promote you, pay you, get fundraising and donations to U...I'm terminally ill with PVE but despite having no cardiac implications, feeling normal...why won't they operate...it's not that bad, I have Staphylococcus on antibiotics...I want surgery ..
My mom is 56 years old just diagnosed with dilated ascending aorta of 4.95 mm she is 5.3 inches tall and 122 lbs, my world is collapsing I don’t know what to think or do, leaving in another country didn’t see her since 5 years 😢
Thank you for your talk and video. It is refreshing to hear someone recognise that the data on this problem are not robust. I was monitored for 20 years up to 2017 for an enlarged aorta but dissected at an ascending diameter of 4.6 (@CT 1 year before dissection), and was almost certainly assessed against 5.5 cm. I really want no-one else to have to go through what I have. I certainly hope the TITAN:SvS trial produces some clearer figures. Please don't forget that diameter is only one of four variables in the Laplace equation, and variability in the other three (BP, wall thickness and allowable stress value) will be the resaon for the different diameters at dissection. CTDs considerably affect the allowable stress, body size and type affect the wall thickness, BP is modifiable. Agree on getting BP down immediately and effectively.
Thank you for sharing. Just had a patient 30%PVC burden completely asymptomatic and no structural abnormalities and stress test was negative and I was scared by the high burden but I kinda came up with the plan to just do an echo and holter in 6mons and sounds like that is an appropriate plan. Thank you!
Fantastic overview of the post cardiac surgery arrest protocol. We started to implement all your points in the CSICU, except turning off the drugs being infused prior/during arrest. Any additional suggestions why turning drugs off will benefit arrest outcome will be appreciated.
From the very first I day came across Dr Igudia RU-vid channel, I knew that was going to be the end of my type 2 diabetes. And to my surprise his herbs actually cured my Diabetes
I am ONLY 22 years old, I have over 20,000 PVCs a day and feel every single one 247, all day long. I recently got a cardiac ablation a month ago, and it was unsuccessful. I have no idea why this is happening. I am miserable. Metaprolol does not help. Nothing helps.
Have they evaluated you for cardiac sarcoidosis? Especially if you have any autoimmune issues in you or your family. It's one of those Zebra diagnoses that most practitioners don't think of.
Grateful for all the RU-vid promotions on this topic though I hardly research myself. I was diagnosed with a 4.0 ascending aortic aneurysm in June 2021. And I have been jerked around with getting help from doctors who tell me I was referred to the wrong doctor after I see a doctor. I was denied insurance through Keurig Dr Pepper in 2022 and assaulted out of that job position. Now I can only get hired on by temp agencies. My twin has had heart issues due to HBP after a leg injury he had surgery on and he deals with pain while working and his HBP rises. He had an artery rupture and he was told his heart is rubbing against something in his chest. He has to take HBP for an untreated injury and so far the solution is just to focus on his heart and not the pain or what causes his HBP. I have gotten more information from RU-vid algorithms than I have from doctors. I am also 40 and I was diagnosed at 38 years old. I'd have heart problems over ten years and I was rushed to ER multiple times and ignored. Once they gave me an MRI or chest scan years before 2021 and they saw nothing. So I am shocked they found a 4.0 cm aneurysm only a little more than a few years later.
I am shocked that even though T2 Diabetes is now quite well understood and easily reversible by weight loss, medics are still only talking about what drugs to use to treat the symptoms! These people are living in the past.
71 y.o. Male with 4.3 aorta. Being monitored biannually bp normally 120/70 low cholesterol and good blood chemistry. Are there lifestyle changes I should consider to minimize risk? Very active physically, good diet, medium alcohol consumption
jayyarnell4710, I am 70, 4.3 cm. High cholesterol in my instance but otherwise I am just like you. Did you have to take medicine or you have gotten away with just adjustment of the lifestyle?
This doctor isn't a good communicator. I sent his office a question about this video, and he can't bother to respond, or recommend that I schedule a visit for a consult. Very poor communication style.
Rounds are for other doctors, not for potential patient questions on youtube. Go through your own doctor. He is busy doing heart surgeries, you know, those things that nobody wants to wait very long for. I do not cardiac experts spending time responding to youtube audience questions. That is ridiculous.
@marshhen Excessively negative and dogmatic on your part. Getting opinions and going in for consults with more than one doctor prior to major heart surgery is perfectly reasonable. A doctor could certainly say to come in for a consult - a reasonable response which most doctors would do - and this doctor could not bother to do that.
Times used to be very Challenging, I had the worst days of my life living with Type 2 diabetes, I appreciate you so much Dr Igudia, You have restored me my life that was lost already . Thank you so much for curing me of my diabetes with your natural Herbs 😊
My wife is 75 years old, weighs 45 kgm and is 5'2" (158cm) tall. She had a CT scan and she was found to have an Upper Ascending Aortic Aneurysm of 5.2 cm and I have calculated her Index Ratio based on the formula given at 13.4, which is significantly beyond the index of 10 - 12 stated. She is nimble, agile and her general health is very good other than this asymptomatic aneurysm. The question is should she have the surgery to prolong her life with all the associated risks taken into account (potential strokes, depression, etc) or should she just carry on with medication to reduce her blood pressure?
Wish I knew... I trust my doctor... My aaa is still just under 5... I know that my hypertension is the biggest concern - so beta-blockers seem to keep me well. She needs to eat very well - no smoking - no booze... good diet... and keep blood pressure in the healthy range. I have to say, Christianity is the greatest medicine.
@@matthewstokes1608 thanks for the advice. I totally agree with you that faith in God and clean living with a healthy diet are best medicines for a happy and healthy life, supported by medical intervention as and when necessary. She had the Upper Ascending Aorta Aneurysm open surgery and Aortic valve repair last month and it's still relatively early days as to the ultimate success of the surgery. She has some complications following the surgery however; low sodium, Atrial Fibrillation, rapid heart rate and fluid build up in the lungs. These are being addressed and we realise it's a long slow road to as full a recovery as possible. With prayer and God's guiding hand we hopefully will achieve it.
