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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why Am I Asymptomatic For Premature Ventricular Contractions?

I am a 52 year old man. 6-2, 175lbs,... active runner (and walker) 35-40 miles/week. BP 110/70. (pectus escavatum but no other symptoms of Marfans). And no symptoms at all and no medications or vitamins. Routine physical (new doctor) they perform an EKG (first time in decades) . Abnormal EKG - possible LVH. Echo results were normal for LVH, milf mitral valve regurg (but apparently normal for my age), 50-55% ejection rate, but aortic root dilation of 4.0. So now I am referred for a CTA. I feel fine...although now that I know I have PVCs, I feel them all the time. The CTA will probably tell the rest of the story. The question - why is 4.0 the cut off for aneurysm? And why I am completely asymptomatic for something that could be so serious? (Or could it also be nothing?)
Mon, 6 Aug 2018
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Internal Medicine Specialist 's  Response
Hello welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advise.

Aortic root aneurysms do not usually cause an individual to have any specific symptom. Like other thoracic aortic aneurysms, root aneurysms are commonly found in asymptomatic (no symptoms) patients when undergoing a radiologic or cardiac study like a CT scan or echocardiogram. In some cases the aortic root aneurysm will lead to certain symptoms such as dull chest pain, angina (chest pain on exercise) or shortness of breath. As an aortic root aneurysm expands, the fine balance between these three structures is distorted. The expansion leads to outwards pull on the aortic valve leading to the inability of the aortic valve to close properly. This may lead to blood may reenter into heart lead to angina and aortic regurgitation. Aortic root aneurysms are associated with acute aortic dissections. Therefore, elective repair can prevent this catastrophic event especially in patients with Marfan syndrome, Loey-Dietz syndrome and other genetically related aneurysm. If you're suffering from PVC then you have to be examined for ectopic contractions of heart through ECG. You may need anti arrhythmia drugs.

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Why Am I Asymptomatic For Premature Ventricular Contractions?

Hello welcome to Ask A Doctor service. I have reviewed your query and here is my advise. Aortic root aneurysms do not usually cause an individual to have any specific symptom. Like other thoracic aortic aneurysms, root aneurysms are commonly found in asymptomatic (no symptoms) patients when undergoing a radiologic or cardiac study like a CT scan or echocardiogram. In some cases the aortic root aneurysm will lead to certain symptoms such as dull chest pain, angina (chest pain on exercise) or shortness of breath. As an aortic root aneurysm expands, the fine balance between these three structures is distorted. The expansion leads to outwards pull on the aortic valve leading to the inability of the aortic valve to close properly. This may lead to blood may reenter into heart lead to angina and aortic regurgitation. Aortic root aneurysms are associated with acute aortic dissections. Therefore, elective repair can prevent this catastrophic event especially in patients with Marfan syndrome, Loey-Dietz syndrome and other genetically related aneurysm. If you re suffering from PVC then you have to be examined for ectopic contractions of heart through ECG. You may need anti arrhythmia drugs. Hope I have answered your question. Let me know if I can assist you further.