hi hoping someone could help.
I went for an echocardiogram recently and have since heard from my doctors saying that my gp would like to discuss the results with me. So curiosity got them best of me and I tracked down my test results but I’m struggling to understand it. One thing I did notice was it said I had a ‘dilated aortic root at the level of sinuses’ Could someone please explain what this means and if it’s something I should be concerned about. Thanks so much
Glad you got your results, hopefully they just want to talk you through your results and nothing to worry about hun x. I havent heard of your condition before so I can't be of any help sorry hopefully somone will be along who can advise on what this means 😘.
thanks so much for your reply 😊 yeah hopefully it’s nothing to worry about x
Google is your friend (though one whose offerings need to be treated with caution): "Otherwise known as an aortic root aneurysm, a dilated aortic root is when the first section of the aorta, where the aortic valve resides, becomes enlarged. When this enlargement reaches a critical size, there is a risk of it rupturing or tearing, leading to a life-threatening situation."
This was the first suggestion that I came across that I could just about understand. I guess the level of your concern should depend on what stage your condition has reached.
I've spent a lot of time this year Googling medical terms, treatments, appropriate diets and so on, and one does need to exercise caution with the results. The las test result I had was for possible Celiac address, and one reading was very low indeed. My first reaction was that this was bad news, before more Googling reassured me that it was good.
I guess that health professionals are used to (perhaps expect) patients to Google. Two cardiology nurses have told me "oh you don't want to Google", but short sessions with the GP, staff whose English is difficult to understand, mask-wearing and my less-than-perfect hearing do not make it easy to understand what one is being told.
The aortic root is the part of your aorta around the aortic valve, where the blood comes out of the main pumping chamber of the heart, the left ventricle, heading for the rest of the body. The sinuses are the three pouches that make up the aortic root, so basically this report is saying your aortic root is larger than it should be.
The big questions that follow are: exactly how large? Was there a figure on the report?
If it is under 4.0 cm I personally wouldn't worry at all (my own aortic root is around 3.6 cm, which is upper end of normal ... it's the next bit of my aorta that is way over size, at 4.8 cm), if it is over 5.0 cm then I would want a referral to a surgical centre specialising in aortic disease and to avoid lifting heavy weights while waiting. If it is in between, then while it is not urgent I would want medical advice and to find out if there is anything else going on.
It is also relevant to consider your age and height and family history. If you are young (which for this means 'under 60') then genetic testing may be advised: there's an aortic panel of genes that can be sequenced to check for conditions that can make aortic root enlargement more risky, such as Marfan syndrome, Loeys Dietz syndromes, and a few more rare conditions. If you are very tall, then on the one hand your aorta might also be larger than average, so the genetic testing criteria take this into account. On the other hand, being tall can be a sign of a connective tissue disorder.
If you have a family history of aortic disease, connective tissue disorders, or unexplained early deaths, then this should also be taken into account when deciding what to do next.
The next step - if the enlarged aortic root is considered significant - should be a referral to a cardiologist with an interest in aneurysmal disease and to get either a CT scan or an MRI for accurate measurement of your whole aorta.
Even if you don't have Marfan syndrome (I don't ...) some of the best patient information in this area is from the Marfan charities, of which the largest is the Marfan Foundation in the USA, that also has divisions concerned with Loeys-Dietz, Vascular Ehlers-Danlos, and the whole spectrum of genetic aortic diseases. They are at marfan.org
There are professional medical guidelines on managing aortic diseases, of which the most extensive and detailed are published by the American College of Cardiology, last updated a year ago, at acc.org/Guidelines/Hubs/Aor...
If any doctor complains about anyone looking for information on foreign websites, please point out that there is nothing of any use on this subject on the NHS one.
Hope this is helpful - best of luck!
Thanks so much for your reply Julian.
Unfortunately my grandfather passed away some years back due to a ruptured aneurism and my dad was checked recently and got the all clear 😊
However I’ve never been checked until I went for an echocardiogram for something else and it looks like it’s been picked up during that.
I’ve got a copy of the report but I’m not sure where on the report it tells me the current size of it.
Do you know what it would come under?
Thanks again for your help.
Do you know if your grandfather's aneurysm was in his abdomen or closer to his heart? It does make a difference, in that abdominal aneurysms (which are more common) are more related to inflammation, cardiovascular disease and smoking, and have different genetics to the ones affecting the ascending aorta (including the root and the aortic arch).
If there is a measurement on the report, it will either be given in mm or cm and will be a figure that is in the sort of range I have given. The sinuses are also known as the 'Sinuses of Valsalva' which might be abbreviated to SV or SoV or something like that. You should also have a figure for the size of the ST junction (a narrowing between the root and the rest of the aorta) and for the lower part of the ascending aorta: these are all structures that can be seen with echocardiograms.
I’m not sure which kind my grandfather had to be honest.
In regards to the measurements I’ve found this if it help:
Aorta.
Sinus of Valsalva 41.6mm
Would that be it?
Hi Marcus - yes, that's exactly it. And 41.6 mm (which is actually +/- 2mm) means there is no immediate threat to your life, but there is something going on which should be checked out.
As Cliff says, get referred to a cardiologist, preferably one who is actually interested in aneurysmal disease (it's a niche specialism), and push for genetic testing (which any cardiologist can request), hopefully to rule out the most serious known conditions (which are rare; only a minority of these tests come back positive, even where there's strong evidence of some genetic factor).
If a further scan confirms the dilation and monitoring is recommended, it will probably involve annual scans: mine are a combination of echos and MRIs to limit radiation from X-rays, though I have had a couple of CTs along the way.
Checking your blood pressure and, if it's higher than normal, doing something about it, will also be a priority. With aneurysmal conditions, some blood pressure treatments are recommended as possibly slowing progression - but this is something to discuss with a specialist.
Thank you so much for all your help. I’ve got a telephone appointment with my gp on Tuesday so hopefully I’ll know what the next steps are then.
If the aneurism is at 41.6mm now am I correct in thinking that no surgical procedures would be needed until it reaches 50mm?
Yes, that's basically right - though in the very unlikely event that genetic tests came back positive for one of the Loeys-Dietz syndromes, that figure might drop to 45mm. But it's not something you would need to take any decision about for some time yet, and if you're lucky - and especially if you can benefit from medical treatments in coming years - surgery might never be needed.
Marcus, the sinus referred to is the very first part of the aorta as it exits the heart. It carries the aortic valve, and the coronary arteries which feed the heart muscle also branch out from there, then gives on to the ascending aorta itself.
How important this finding is for you is very much going to depend on what the detail is. A GP will know the basics, but in reality you need a proper work-up by, and Q&A session with, a cardiologist.
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