Aorta enlargement

[Caitlyn6]

Hi all. Looking for an info for my aunt. She is mid 60s, on Peridopril for long term hypertension. She fainted December two years year ago and the dr referred to a cardiologist who thought she had had a bleed on the brain or had afib but later said they couldn’t find any evidence for either. They increased her perindopril and put her on apixaban. Im not sure if she is still on the apixaban. She had an echo May 2019. Now they have told her the echo showed she has an enlargement of the aorta 4cm and they will repeat the echo in September and decide what to do then. She doesn’t know where the aneurism is in the aorta. Has anyone had anything similar or have any advice or questions she should ask after the next echo? Many thanks.

[Alisbabas]

Hi mine is mildly dilated due to have a bicuspid valve

They will watch it I’m sure, my echos are yearly

Sorry I can’t be any more help

Ali

[Cliff_G]

Hi Caitlyn6, apologies for not seeing this earlier. You should go to thinkaorta.org and download the Think Aorta Booklet "Caring for your Aorta". (The rest of the site is dedicated to rapid diagnosis of with people who have actually had a dissection).

Your Aunt should ensure her blood pressure is kept *well* under control and that means 120/80 not 140/90 as BP is a direct influence on aortic size and risk. If she is still having trouble with resistant hypertension she should be referred to a specialist hypertension clinic. One option which works in a remarkable number of these cases is Spironolactone, which works in a particular type of cause of high BP.

There is evidence that beta blockers or ARBs help to protect the aorta in those with Marfans, but it is thought that these may help in those without Marfan, too.

Genetics is also very important in aortic health. Has she any other family member with aortic disease? She (and her doctors) should carry out a genetic test, especially if she has family history. There are 37 genes currently known to be associated with aortic dissection, and if one of these is found, it affects what diameter is considered to be too small to operate.

Unfortunately, what I've said above is not known as widely as it could be in primary care, so she may need to be assertive.

Good luck

[Caitlyn6 in reply to Cliff_G]

Thank you so much. I will forward this info to my aunt. Really helpful and kind of you.

[Cliff_G in reply to Caitlyn6]

👍