Aortic Conditions, Diagnostics & Treatments

Maintaining an active lifestyle, including cardiovascular exercise, is strongly recommended. Strenuous activities, including heavy weightlifting, should be avoided. Specific exercise recommendations should be discussed with the treating physician.

Changing nutritional habits to a diet low in fat and carbohydrates and high in fiber and protein is recommended.

Smoking is a risk factor for aortic disease and should be stopped immediately.

Passive smoking is also harmful. It is important not to breathe any secondhand smoke.

Systolic blood pressure can go as high as 300 from crack cocaine usage.

Using crack cocaine, even once, puts you at risk of life-threatening aortic dissection (tearing) or rupture.

Appropriate blood sugar levels are very important for the health of the cardiovascular system. Healing is quicker and the risk of infection is reduced after surgery when the blood sugar level is kept between 90 and 110.

If you are a recently diagnosed diabetic (defined as having a blood sugar greater than 120 and an abnormal level of hemoglobin A1C), it is important to consult an endocrinologist. Purchasing a glucose monitoring device for home use will be necessary. By following an appropriate drug regimen along with balanced nutrition and daily exercise, the goal should be living a normal lifespan while maintaining an appropriate blood glucose level in the range of 90 to 110.

The ratio of muscle to fat in the body is very important to overall health. The issue is not so much the weight of an individual as what makes up that weight. A heavy but muscular person is much healthier than a very thin individual who has lost their muscle as a result of unbalanced nutrition and inactivity.

It is most desirable to have very little body fat. Both blood pressure and blood sugar levels are more easily controlled when the muscle-to-fat ratio is optimal. This will also strengthen the immune system and boost postsurgical healing, while at the same time decreasing the blood sugar level.

A desirable muscle-to-fat ratio is best achieved by a balanced diet and a physically active lifestyle.

Aortic patients are at higher risk of endocarditis and graft infection if they develop a dental or gum infection.

Conscientious daily dental and gum care is important to avoid infection.

Regular dental checkups are very important, as is taking antibiotics prior to teeth cleaning and other dental work.

Prior to surgery, echocardiography, MRI or CT with contrast are used to monitor the aorta. Generally, for enlargement less than 4 cm, testing will be done at 12-month intervals. Once the aorta reaches 4 cm, it is checked more frequently - every 6 months and in some cases every 3 months.

Echocardiography is also used to evaluate the valves and chambers of the heart.

A thallium test with adenosine may be used to evaluate the coronary arteries prior to surgery.

Shortly after surgery, a baseline MRI or CT is taken. Followup tests are done on an annual basis and compared with this baseline.

Expert, proactive treatment of aortic disease makes possible the continuation of happy, productive lives. Focusing on personal goals and enjoying hobbies and leisure activities with friends and family, as well as meeting the challenges of every day living, are all important aspects of normal life. When medical care, appropriate diet and exercise, and diagnostic monitoring are all in place, those with aortic disease may live active, fulfilling lives.

Aortic disease in itself is no reason to become an invalid or "couch potato." Doing so is neither physically nor psychologically healthy. Assuming no other conditions are present that might restrict your activity, long periods of boredom, gloomy thoughts and inactivity should be avoided. Fully participating in your treatment plan, including the medical, dietary and exercise recommendations previously described, positively affirms that you, not the disease, are in control. You need not feel victimized by this condition. There is a great deal that you, in partnership with your healthcare professionals, can do to confidently live your life.

When it is time for elective surgery, the most recent technical advances in aortic surgery are all available, aimed at achieving the best possible outcome. Following surgery, ongoing medical care, diet, lifestyle choices and a positive attitude are key factors in the pursuit of a normal, active life.

All first-degree relatives (i.e., parents, siblings and children) of those with bicuspid aortic disease, Ehlers-Danlos syndrome, Marfan syndrome and other connective tissue disorders should have a complete aortic checkup. Since these conditions may skip generations, nephews and nieces, grandchildren, etc. should also be notified and have a complete aortic checkup.

A family history of sudden heart-related death should be investigated. If autopsy reports are available, it will be possible to determine if the death occurred due to aortic disease (aortic rupture or aortic dissection). If no further information is available, all sudden heart deaths should be regarded with suspicion since aortic rupture or dissection may have occurred.