Whoops : 4.1 cm dilatation of the ascending thoracic aorta


(Hugh Walter Jennings) #41

I’ve been using the treadmill at a local gym. Been watching my heart rate. I’m had it up to 120 and no discomfort in my chest whatsoever.

My blood pressure is averaging 111/72 the past week. If I check it when I wake up in the morning before I get out of bed it’s around 105/65.

So I’m lot less stressed over my dialated aorta.

I have an appointment with a cardiologist in early to mid January. Hopefully he will be patient while I explain what I’m doing in my own as far as food choices and suppliments.

I’m focusing on anti-inflammatory foods and supplements for now.


(Hugh Walter Jennings) #42

Update, saw the cardiologist last week and she ordered an echocardiogram, a stress test, and two CT scans (I assume they’re CT scans) of my abdominal aorta and the one that’s dilated.

Echocardiogram is tomorrow. I remembered I had an echocardiogram a few years ago and looked at my chart and it was 2017. That’s about 4 years ago before I started eating right and exercising to lose weight.

The reason my primary care doctor sent me to a cardiologist back then was because I was having some chest tightness. I self-diagnosed that myself. I got to looking around on the internet to see what could cause it besides heart issues and it turns out acid reflux can do it. Sometimes it would get so bad I couldn’t lay down.

Anyhow after reading a couple of articles I raised the head of my bed and stopped using spearmint tobacco pouches. I was using them to avoid smoking. That night I took a maximum dose of Pepto bismol about a half hour before bed and everything was fine. The chest tightness was gone for good lol. So I postponed the stress test that was also ordered.

My primary care doctor kept bugging me about the stress test so I went ahead and did it but it was during covid. They wouldn’t let me do the treadmill did the chemically induced method. I’ll never do that again. Anyhow it came back okay per the results.

One thing I noticed reviewing that 2017 echocardiogram test result was that they mentioned “mild dilation of ascending aorta at 3.9 cm”. So I’m feeling a lot better about it now. If it only increased in size by .3 cm since 2017 I’ll take it.

Stress test and the rest of it are the second week of February. I looked into stress tests and it appears for my age around 2.8 mph will be the speed of the treadmill to get my heart rate up to around 135. I’m already used to going on the treadmill at 3 to 3.2 mph for up to 45 minutes with no discomfort whatsoever. Just got home from 40 minutes on the treadmill. So I’ll figure the stress test will be a breeze as far as the treadmill part.

My blood pressure is fine with my PCP reducing my amlodipine from 10 mg per day to 5 mg. It was getting too low and I think it was because of the nattokinase combined with the amlodipine.

Cardiologist skilled scheduled me for a July appointment. She said that’ll be fine unless the tests indicate I should see her sooner.

Anyhow feeling a lot less concerned about it at this point.

One thing I’m not supposed to do is shovel snow anymore. So I just paid a couple of neighborhood teens to take care of it. Sidewalks and my driveway. I spread a bunch of gravel and made a gravel driveway in the front yard up by my porch.

Did that because of kids breaking into cars when they’re parked on the street in this neighborhood. As well as stealing them. I don’t leave anything in my vehicles and leave them unlocked so they don’t bust the windows up for nothing lol. I have clubs on the steering wheels.

As far as keto, I’m still showing ketones on my urine strips most everyday. No need to check blood ketones if they’re showing up on the urine strips. My weight has leveled out. Up a bit and down a bit day to day. I’m going to stop fasting until after the stress test. Seems to be conflicting studies on whether or not fasting is good for cardiovascular issues. I don’t think my fasting has done any harm. No symptoms and I feel pretty good.

One other thing, I read a couple of articles about how to prep before an echocardiogram. The search results also showed a couple of articles on what not to do after an echocardiogram.

A couple of things was don’t eat a big meal and don’t do any moderate to heavy cardio. The article said it could skew the results of the echocardiogram. Scratching my head on that. How could what I do when I get home after the echocardiogram affect the results of the echocardiogram ?

I’ll ask them what’s up with that tomorrow.


(Hugh Walter Jennings) #43

Update

The post cardiogram stuff turned out to be for invasive cardiograms, not the basic one.

Results in and the doc sees nothing to be concerned about. Heart is slightly enlarged but no indication of heart failure at all. Blood pumping rate is great for my age. Says proceed with the stress test and aorta scans next week.

Can’t wait to tame the treadmill into submission lol. Going to call the office tomorrow and ask if they can add a CIMT while they’re at it.


#44

Hugh. Thanks for the updates. The stress test may not be the best diagnostic tool. But it will be interesting to see if you get the chest tightness when you are working at maximum heart rate.

The stress test that my cardiologist ordered was a run on the treadmill until I was at maximum effort (and a bit more), and then when I was at passing out stage, it was quickly off the treadmill to an exam bench next to the treadmill for a stress echocardiography to visualise how my heart was beating while my heart was still working hard from the running test. So that protocol gets an ECG/EKG plus a stress echo.

There is a paper somewhere that shows an increased risk of heart attack in the weeks following a stress test. So, take it easy.

Have you had a Coronary Artery Calcium (CAC) score done? That would be good information to have alongside the aorta measurements and heart enlargement measurements as any increased plaques clogging the arteries may be an area for action to fix local blood pressure problems that cause heart and aorta anatomy changes. The CT scan for a CAC score, if you can get the pictures, will also get you a qualitative look at any inflammatory excess (ectopic) fat inside your chest and around your heart - that stuff is good to get rid of.


(Hugh Walter Jennings) #45

Thanks, I feel pretty confident I’ll be ok with the stress test, seeing as though I’m used to daily use if the treadmill.

Only part I’m not used to is the grade increase during the test. I’ll start increasing the grade at the gym starting today to get used to it before the test next Wednesday.

I’ll ask about the calcium score thing when I call about the CIMT.

In 2019 the results if my lung CT scan indicated a mild dialation of my ascending thoracic aorta at 3.9 cm. I’m sure I saw that on the results but didn’t pay any attention to it. Just noticed that a couple days ago when I was reviewing past results. The recent one says 4.1x4.2 cm, so that’s only a .3cm increase in 5 1/2 years.


(Jane) #46

Love me some John Prime!


(Hugh Walter Jennings) #47

Well that was an adventure ! Went in for my stress test and my two CT scans for my ascending and abdominal aorta yesterday.

Talk about a train wreck. Stress test on the treadmill went ok. It was over with before I got to the point I wished it was over with. Breathing semi- hard but not enough to stop me from having a conversation with the nurse conducting the test.

She kept fiddling with the electrodes during the test. I suppose that’s what they’re called. The little patches they put on you and hook wires to for the EKG. After it was over she said “I don’t know, I hope it’s good enough for your doctor to review”

Scanned me for a second time and sent me to the waiting room for the imaging of my aortas. Waited an hour and a half watching people who came into the waiting room and after a few minutes being taken into imaging rooms across the hall. So I finally go to the window and ask why they keep taking people before me. The girl at the window asked me what my name was and I wasn’t on the list. Told her I had an 11:00 a.m. appointment and the gal at the desk where they did the stress test took my paperwork and came back and told me I was registered. She went over there and did that because they didn’t know if I would be on time for the 11:00 a.m. appointment.

So the gal at the radiology window got on the computer and said “sir you have to register before we do these tests”. I told her that I registered at 7:40 a.m. and told the person that registered me I was here for a stress test and also two imaging tests. Anyhow she told me to take a seat and she would take care of it before she did anything else. About 20 minutes later I was finally called to go back for the tests.

Wait, it gets better. The gal that brought me back took me to a waiting area to discuss what the procedure was and started to ask me a few questions. One of them was “when did you have your abdominal aorta repair ?” I told her I’ve never had an abdominal aorta repair but a few years ago they did an ultrasound of it and didn’t find anything wrong. I told her the only thing in my body that I wasn’t born with was mesh from an umbilical hernia repair about 20 years ago.

I’m already fairly irritated at this point and she asked “are you sure you don’t have a stent in your abdomen?” I replied " that requires surgery I didn’t have but if it’ll help me get the hell out of here mark me down as having one !" I also
explained to her the screw up with registration and the nearly 2 hours I waited for her to call me back. I did tell her it wasn’t her fault. She apologized for having me wait and said she would have to call the cardiologist and see what’s going on.

She came back in to the room I was in and said my cardiologist didn’t explain but her guess was she mistaken my hernia repair for aortic surgery lol

Then I proceed to pull my sleeve up on my right arm and showed her the IV they left in my arm at the stress test. They had told me that I’ll need it at imaging. The gal looks at me and said " I don’t know why they did that. That’s the wrong size for our needs. " Being the joker I am I said “strike three I’m out of here”. The look on her face was priceless lol. I’ve then told her it was no big deal.

She smiles and tells me to hang on a minute and comes back in and says she checked and the one in my arm was within specs of the juice they was going to stick in me.

So I get on the table and she tells me over the speaker from her safe little booth to protect her from the radiation they were pounding me with, “it’s going to get real hot very quick…just relax it won’t last long” She was talking about the contrast solution. I did feel it but it wasn’t nearly as bad as she described it and it only lasted 4 or 5 minutes.

So right as they were letting me leave she told me to keep an eye on myself. Some people have a reaction to the contrast juice. She said the overwhelming majority of the time if someone has a reaction it’s immediate. But I’m not in the clear for 48 hours. I think I’ll be all right on that.

So I finally get home 3 hours later than I should have. I kept telling myself to forget about it. Somebody just made a mistake.

But it wasn’t over yet. I fell asleep on the bed last night reading and when I woke up I pulled my shirt off to get in the shower. Looked in the mirror to make sure I didn’t have a rash that I was told to look for in case I had a reaction. No rash but I found these…

The nurse doing the stress test didn’t remove all of them lol

Results not posted yet but seeing as though I had no discomfort on the treadmill part, I’m feeling pretty good about it all. I did ask her a few questions so I could go home and do an armchair diagnosis. The part that raised my eyebrows is my systolic blood pressure got up to 180. From what I read looking into it, it turns out it’s not an issue.

We’ll see.


#48

Fingers crossed for a good result after such a stressful day!


(Hugh Walter Jennings) #49

All good. Cardiologist office called and said my stress test was normal and I have no aneurysms of either aorta.


(B Creighton) #50

That is awesome Hugh… You might recall on your “My LDL lowering plan is working” thread I said:

So here’s your party!!! :shopping: :balloon: :icecream: That ice cream is keto of course :blush:


(Hugh Walter Jennings) #51

Ha, thanks !

I’m still waiting for the results to post on my chart so I can see them. Cardiologist office told me they were already posted but I can’t see them. Called the tech support line and was told they switched systems and they were having to send a note to all their doctors advising them how to post results so patients could see them. I was told I should see mine a little after 9:00 a.m. tomorrow.

So far I feel fine and I’m past the 48 hrs mark the imaging tech told me to watch for any rash/reaction from the contrast they put in my IV.

A CIMT is what I really want to have done for an idea where I stand with atherosclerosis. If my doctor won’t do it I’ll just have it done myself.

There’s a pop up clinic that includes the CIMT in a cardiovascular screening package. They’ll be at a nearby location in early March.

We’ll see.


(B Creighton) #52

I go Monday to get my annual blood testing done. I felt last year was illuminating. I was able to keep my oxLDL within optimal range even though my total cholesterol was 175. My VLDL was in the high range which is where most of my triglycerides and cholesterol were obviously being circulated so not a worry as far as atherosclerosis, and sure enough when I got my sono this last fall they didn’t find any atherosclerosis. It helps to understand what is going on behind the numbers, and now I’m not worried about getting CVD. I am glad to see you getting such awesome results from your efforts, and would even like to use you as a poster child for objective reversal of atherosclerosis if you are willing. I believe I achieved it, but unfortunately don’t have any objective test results from back when I believe I was getting CVD. I know I can see improvements in my veins, and my BP is way down telling me my arteries are essentially working as they should and are not plugged up. If you do get a CIMT, the results would be super interesting I’m sure. Even if you aren’t 100% clear, we will be able to objectively observe future improvement!


(Hugh Walter Jennings) #53

If the CMIT indicates the amount or level of soft plaque, that’s what I want to know. And yes, a future CIMT can track any progress.

Good to hear your cardio system is great !

I spent many decades eating fast food, so it’s no wonder I have plaque in my arteries.


(Hugh Walter Jennings) #54

Ok, had to go to the hospital medical records office to get my imaging results. They need to have the imaging dept email them to me. Supposed to have that no later than tomorrow.

What finally showed up on my chart that I can see now is just a review/summary from my cardiologist. Most all looks ok but she noted severe calcification of the coronary arteries.

The type of plaque is supposedly indicated by the specific CT angiogram my doctor ordered. Soft plaque and calcified. It’s also supposed to show blockages and how much percent etc.

What the medical records department gave me was basically what I can see on my chart, a summary with no specifics other than the size of my ascending thoracic aorta. The previous CT scan of my lungs listed it as 4.1x4.2cm.

The CT angiogram from last Wednesday showed 3.5 cm. That type of angiogram is supposed to be more accurate. So that’s great news. 3.5cm is consider the upper end of normal or dilated depending on what medical outfit I look at.

Either way, it’s better than 4.1x4.2cm.

The cardiologist summary noted my pacreas, airways, lymph nodes, bladder, liver, spleen, gallbladder, and bowels are all fine.

I do have bilateral non-obstructive renal stones. Looked that up and doesn’t seem anything to worry about as long as I stay hydrated. May have to watch oxalates intake but haven’t looked into that yet.

Anyhow, at this point I want to know how much soft plaque I have and what percentage of blockage the calcification is causing. I’m still feeling pretty good about everything. My stress test notes noted my breath rate was fine while on the treadmill and I didn’t feel any discomfort in my chest.

Will know more, hopefully, when imaging sends me the results. I told medical records that what I want to see is the same thing the doctor who reviewed the imaging stats and my cardiologist reviewed. We’ll see if they will send that to me.


#55

Hello Hugh, I was thinking of you and your aorta dilatation. That coronary artery calcification would be worth pursuing. They can visibly see it and it was a CT scan, so there should be a Coronary Artery Calcium (CAC) score in your results somewhere. That CAC test is a good guide as to how to reduce plaques in arteries with things like Natto Kinase and Vitamin D & Vitamin K2 monitored supplementation.

Anyway, my feeling is that you are being brave, and getting things done, but maybe not taking the results that are indicating problems with enough concern. That’s a tough call, as you have done so much to learn and look after your health at this point.

Here is another consideration to add to the mix and it is visceral fat that accumulates on and around the hear and around the aorta. You have had the CT tests done but there are no reports on the amount of visceral fat that is present, and that fat is metabolicly toxic, and it can be reduced. The link is to Dr. Sean O’Mara talking in Oct 2025 about aortic ectoptic visceral fat.

https://www.youtube.com/live/5xpYi1tfBOY?si=4j4n73faQw55n_Lq&t=2944


#56

@VirginiaEdie

I take L-citrulline (as does Hugh) for aging blood vessels as it may work better than L-arginine.

It was covered in a recent STEM Talk podcast episode that provided references.

[00:31:56] For our final question this AMA, a listener asks Ken about the arginine paradox, which regards L-arginine, which is used by the body to make nitric oxide, which is necessary to relax and maintain flexibility of blood vessels. However, several papers have reported that supplementation of arginine does not reliably improve aging blood vessels. In contrast, recent research suggests that L-citrulline might be more effective. The listeners sent questions asking about the possible effects of citrulline in vascular health and aging.

In his answer, Ken cites the following papers:

Administration of L-arginine plus L-citrulline or L-citrulline alone successfully retarded endothelial senescence .

Effects of L-Citrulline Supplementation on Endothelial Function, Arterial Stiffness, and Blood Glucose Level in the Fasted and Acute Hyperglycemic States in Middle-Aged and Older Adults with Type 2 Diabetes.

Citrulline Supplementation Improves Microvascular Function and Muscle Strength in Middle-Aged and Older Adults with Type 2 Diabetes.

Effects of L-citrulline supplementation and watermelon intake on arterial stiffness and endothelial function in middle-aged and older adults: a systematic review and meta-analysis of randomized controlled trials .

Citrulline regulates macrophage metabolism and inflammation to counter aging in mice .

First time that I have heard the term “Inflamm-aging”.