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ECHO Report Shows Dilated Aortic Root. Meaning? Concerned?

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Posted on Tue, 18 Jun 2013
Question: Is an echo finding of a dilated aortic root (4.4cm), trivial thickening of the tricuspid aortic valve, no AS, trace to mild AI, trial mitral valve thickening, trace MR, trace TR, PI, right ventricular systolic pressure less than 20 mm HG, no pulmonary hyper tension, left Ventriclar size normal and overall LV function normal limits, LVF 60%, right atrial size, right ventricle size and function normal limits, no clot or thrombus, no pericardial effusion, no shunt, no evidence of significant cardio myopathy... Cause for concern?

Summary of my echocardiogram: 36 yr old male, extremely active 5-11 200 lbs
Left atrium enlargement 4.5 cm
Dialated aortic root
Trivial thickening of the tricuspid aortic valve, no AS, trace to mild AI
Trial mitral valve thickening, trace MR
Trace TR, PI, right ventricular systolic pressure less than 20 mm HG, no pulmonary hypertension
Left ventricular size within normal limits. Overall LV function within normal limits LVF 60%
Right atrial size, right ventricular size and function within normal limits.
No clot or thrombus noted no pericardial infusion notice noted No shunt detected no evidence of significant cardiomyopathy at this time
doctor
Answered by Dr. Jorge Brenes-Salazar (1 hour later)
Hi,

Thanks for your health concerns. The only remarkable issue with your echocardiogram is an abnormal dilatation of the proximal aortic root, which should be less than 40 mm for most patients; it will be important for you to have regular follow up with echocardiogram at set intervals (every 1-3 years) to make sure that the dilatation does not progress. If it does, and reaches 50 mm we start worrying more and actually considering surgical repair.

Good blood pressure control is essential, it should not limit though your physical ability to exercise.

Hope this is helpful, wish you the best,

Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jorge Brenes-Salazar (21 minutes later)
So in other words is it possible that my echo results may not be as accurate as another method to measure the aortic root? And at 4.4 cm should I be careful with my exercise routine? I run the Harvard stadium steps 4 times a week! Should I not exercise so vigorously? Thank you so very much for your response btw.
doctor
Answered by Dr. Jorge Brenes-Salazar (7 hours later)
Hi again,

Thanks a lot for the reply.

That is a very good point, Echocardiography is a great method to estimate aortic root size but the most accurate is CT scan with IV contrast; Echo can overestimate. I think that aerobic exercise like you are doing is fine; the type of exercise that I would shy away from is heavy weightlifting because of the increased pressures during exercise.

Hope that hepls, wish you the best of health,

Dr Brenes-Salazar
Cardiology
Mayo Clinic MN


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Jorge Brenes-Salazar (1 hour later)
I greatly appreciate your thoughts and time. My last and most important question is based on the meaning of heavy lifting! I lift weights 4 days a week! I lift heavy weights only once a week ie bench press and squats... Most of my routine is high impact training, like cross fit! I am happy to cut out heavy lifting altogether in an effort to preserve health however my concern is if my dilated aorta requires this level of concern and or care should I refrain from hi impact training as well? My blood work is magnificent and I have a restingheart beat of 53 bpm. 120/70 etc...
Promise, last question!

All the very best!
doctor
Answered by Dr. Jorge Brenes-Salazar (3 hours later)
Glad to answer your queries. The high impact cross training and aerobic exercise should be fine; it is heavy weight lifting such as benchpressing more than 200 pounds or very heavy squats that might become problematic, particularly since we will need follow up to ensure that the aortic root dimensions remain stable. The main risk as you can imagine is aortic dissection, not too common, but the major risk factor is aortic root dilatation, coupled with persistent hypertension. your blood pressure and pulse look great, keep up the good work

yours truly

Dr Brenes-Salazar MD
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Jorge Brenes-Salazar

Cardiologist

Practicing since :2007

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ECHO Report Shows Dilated Aortic Root. Meaning? Concerned?

Hi,

Thanks for your health concerns. The only remarkable issue with your echocardiogram is an abnormal dilatation of the proximal aortic root, which should be less than 40 mm for most patients; it will be important for you to have regular follow up with echocardiogram at set intervals (every 1-3 years) to make sure that the dilatation does not progress. If it does, and reaches 50 mm we start worrying more and actually considering surgical repair.

Good blood pressure control is essential, it should not limit though your physical ability to exercise.

Hope this is helpful, wish you the best,

Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN