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What does "ascending aorta at 4.0 cm" indicate?

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Practicing since : 2004
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My question relates to conflicting information I am getting relating to an ascending aorta at 4.0 cm. The condition was discovered recently during a calcium screening. My calcium score was zero, but the following was in the report: “Visualized lung fields are clear and no pleural fluid is identified. Ascending aorta is at the upper limits of normal in caliber at 4.0 cm. Descending thoracic aorta is well within normal limits in caliber measuring 2.6 cm. No abnormal masses or lymphadenopathy are identified. Visualized upper abdominal organs appear unremarkable.” The physician’s assistant from the hospital where the screening was performed who called me with the test results emphasized the “normal” in “upper limits of normal” and advised that there is nothing different I should be doing relative to lifestyle, no limits on exercise, and that it should be rechecked in a year. She said if it gets to 5.0 cm, surgery would be needed. My primary care physician treated it much more seriously saying it should be checked in 6 months, I should limit exercise to light/moderate aerobics, lift no more than 50lbs, and work to lower weight and cholesterol. I am 6’4”, 245 lbs, total cholesterol 230. (No argument on the weight and cholesterol part.) I have also over the last 6-9 months experienced some very mild pain on the left side of my chest which can persist for many days and then be gone for a period of time. It does not seem related to exertion level. When I first started experiencing the pain, I went to the ER and it was determined I was not having a heart attack. I have really not been able to get a clear answer as to whether this pain is a typical symptom of the aorta condition and if that changes the course of action. I am going to see a cardiologist, but can’t get in for a couple of weeks. In the meantime I am looking for other opinions. What if any should be my exercise restrictions and other lifestyle guidance? Is mild persistent chest pain a typical symptom associated with an enlarged aorta?
Posted Fri, 7 Mar 2014 in Hypertension and Heart Disease
Answered by Dr. Benard Shehu 1 hour later
Brief Answer: You aorta is within normal range Detailed Answer: Hi, I read your medical history and understood your concerns. Having an aorta of 4 km is within the normal range. If it will be increased by 1 mm each year, then your risk for cardiac events will be increased. Only then can think about restriction in having exercise. For the time being, I do not think you should limit exercise. I highly suggest to continue following healthy lifestyle and diet regimen. I suggest to keep monitoring your blood pressure and to avoid alcohol, coffee, energetic drinks. If you smoke I encourage you to stop smoking. Hope it was of help! Dr.Benard
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