What do I do to treat an ascending enlarged aorta?

Herb asked...

I had a heart scan that showed ascending aorta is enlarged to 4.4 cm. Is this bad and what should I do next?

Expert Answer

Carolyn Strimike, N.P. and Margie Latrella, N.P. are cardiac nurse practitioners specializing in the prevention of heart disease and stroke. They have over 40 years of nursing experience in Cardiology between them. The main goal of their work is to counsel, motivate and empower women to adopt healthy lifestyle choices.

It is a good thing that you had a heart scan and that you are now aware that you have an enlarged ascending aorta. I am not sure what type of "heart scan" you had, but generally a CT scan or MRI would be in order to best evaluate the enlargement of the ascending aorta.

The main concern with this condition is that the area can possibly continue to enlarge and lead to an aortic dissection or rupture. A dissection is where there is a tear in the inner lining of the blood vessel wall and blood leaks into that area (picture a double barrel gun). There is then a possibility that this process can weaken the blood vessel wall and actually lead to the blood vessel rupturing.

The good news is that you know about this condition so you can do your best to try and prevent this from occurring, plus you can routinely monitor the size of it with regular follow up scans. The best thing to do is keep your blood pressure very well controlled. Ideally the top number of your blood pressure should be less than 110mmHg, stop smoking if you are a smoker, and do some mild exercise like walking 30 minutes a day (but check with your healthcare provider before you begin any exercise). You should avoid very heavy lifting or weight training. Finally, get your cholesterol checked and keep it well controlled also.

Generally, surgical repair is the only "treatment" for this condition. It will be up to your physicians as to when and if this will be necessary. There are a few items that your physician will consider such as your age, weight, and actual location and size of the enlargement. Usually surgery doesn't occur on an enlargement under 5 cm, but again each individual is different and other factors must be looked at.

We wish you the best.