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Forum Name: Diseases of the Aorta

Question: Mild Aortic Enlargement


 wizbanger - Thu Jan 22, 2004 1:23 pm

Would you offer an opinion? A friend of mine has told me that their Mother (age approx 77) has a recent diagnosis of “mild aortic enlargement". I am not sure how the testing was performed (ultrasound CT/MRI etc) nor the exact location other then abdominal and size 2.8cm. I believe this diagnosis is via the family General Practitioner. The issue is he wants to re-exam her in a year. Is this too long of a time period for a re-examination. The only reason I was given when asked about this time period was the Doctors concern for insurance issues. My concern I suppose with the little information I have is how stable is this condition. I have read that the average enlargement of this size aneurysm is approx .4 to .5cm a year but I don’t know if this person will be considered average? At 3cm only .2cm away I believe a the diagnosis would change to an aneurysm. Would a follow-up visit before a year passes be called for? The overall history of this person I don’t know but I do believe she has controlled high blood pressure via meds, no connective tissue disorders, non-diabetic, no other family history and a reasonable lipid profile. What do you think in general would be a reasonable time period for follow-up, based on information thus provided or if more is needed perhaps I can aquire it. Thank you for your thoughts.
 Dr. Yasser Mokhtar - Mon Jan 26, 2004 11:29 am

User avatar Dear sir,

Thank you very much for using our website.

Aortic enlargement should be followed carefully. The usual interval of follow-up is a year between each exam and the reason being is the rate of enlargement of the aorta itself.

Vascular surgeons have divided patients with aortic aneurysms into 2 categories:

1. Patients with aortic aneurysms that enlarge < 0.5 cm/year. These patients need only to be followed-up (unless the aneurysm is very big).
2. Patients with aortic aneurysms that enlarge > 0.5 cm/year. These patients are considered to have rapidly enlarging abdominal aortic aneurysms with a higher chance of rupture and need to be operated upon.

So, a yearly exam is considered the standard of care unless any symptoms arise and the main symptom is abdominal pain or a new mass appearing in the abdomen.

Once more, thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.
 wizbanger - Mon Jan 26, 2004 10:49 pm

Thank You yes it seems a bit reassuring and I understood your reasoning. Although I did ask her older daughter for and was told she is diabetic, overweight, her Lipid profile is bad (her daughter didn't know the numbers for me just indicated bad) and when I asked about her blood pressure was told 170/80 while on meds. I asked about other markers CRP/homocysteine/LP(a) etc. but she didn't know the results. Sorry I didn’t have that information to begin with. I hope she is seeing her Doctor more frequently for these other factors but would this change your thoughts any for follow-up testing concern the mild aortic enlargement or would it still stay once a year. I wanted to correct my previous information and yet not take too much of your time (sorry).

Thanks once again for sharing you knowledge and for being so helpful.
 Dr. Yasser Mokhtar - Tue Jan 27, 2004 9:11 am

User avatar Dear Wizbanger,

From the info that you told me regarding the blood pressure in a diabetic patient, her blood pressure should be controlled way better than that down to 125/80 or even lower as this will help in the delay of renal failure in patients with diabetes, about the lipid profile, the ldl should be < 100, otherwise her chances of having a heart attack or a stroke become higher.

And for follow-up of the aorta, i do not think it is necessary to be done except once a year unless the patient develops any alarming symptoms as discussed before.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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