Random pulsing chest pain and AAA

Heart health and blood vessels
1

I was diagnosed 4 years ago with a 4.4cm ascending aortic aneurism. I have stopped smoking cigars and stopped lifting weights over a year ago and dropped 42 lbs. I have been feeling much better, more energetic and less lethargic, moving quicker and with ease. 

Sunday night was my wife’s birthday. To celebrate, we went to one of our favorite Peruvian restaurants and I decided to go off for a night. And I mean I went off. Appetizers, entree, dessert and a small pitcher of sangria (holds approx 4-5 glasses). 

I came out of the restaurant stuffed and tipsy (obviously wife drove home). Why did I do this? Without getting into much detail, I was venting several concerns and circumstances beyond my control that have been bothering me. 

I checked the scale the next morning and expectedly I gained approx 4 lbs of water weight. Being a former competitive bodybuilder in my 20’s I expected this would happen and I would slowly rid the excess water weight by the end of the week. 

The actual concern is I have been getting these really odd chest pains right under my solar plexus. It comes very random and it was strong enough to wake me up in the middle of the night Monday morning. It almost feels like heartburn, it’s random and what it feels like is several “thumps” of pain. It’s not severe, but it’s enough to make me wince a little, then it goes away. I have taken Tums, Gas-X and Omeprazole, which all barely helps. My wife thinks it’s gas but I am concerned it may be more and may be affecting my AAA. Since Monday morning, I am still getting this but with less frequency. 

What are your thoughts please? 

2

What is the current size of your aneurysm? Gas doesn’t last for days. I’d get in to see your cardiologist right away.  I was having twinges of pain from my aneurysm, but my doctors wanted me to wait on surgery. I chose not to, and of course my surgeon came out after and told my husband that the walls of my aorta were thinner than they thought. My body was talking to me. 

3

Hi Sandy, it was initially diagnosed 4 years ago and most recently (June) confirmed the size hasn’t changed from 4.4cm

It seems to be going away. I’ve noticed it comes up again after I have coffee and certain foods. It’s less frequent and less intense, however due to my condition it has made me concerned. 

I’m going to back off altogether on coffee starting now. If it doesn’t go away completely by tonight/tomorrow morning I am seeing my cardiologist. 

4

While it is probably nothing, I was told by my surgeon (I am still pre-op, at 4.8 root and 4.6 ascending) that while I am very low risk of rupture or dissection because of my size (not yet 5 cm, the point at which she wants to operate) that I should always err on the side of caution. 

I am now keenly aware of every little pain, tweak, and twinge, things I would have ignored completely before diagnosis a year ago. 

Are you being monitored? If so, has it grown at all since diagnosis? 

While it probably is gas, especially if it gets better,  I would go in or at least call your cardiologist. While most people I know who have dissected experienced horrendous pain and tell you you would KNOW you dissected if you did, I know of at least three who dissected with only minor, almost imperceptible discomfort, and one who had no pain whatsoever and would not have known they even dissected if they had not felt like passing out. 

Now, it should also be noted that none of those people knew they had an aneurysm, and they were all large aneurysms, and undiagnosed. Yours is not that big in the overall scheme of things, if that measurement is accurate, but still maybe worth checking out.

I have been to the ER twice in the last year, and there is zero shame in it. In fact, the ER doctor told me, when I said I felt silly for coming in for every unusual pain, he said he would be coming in too, and there is no shame in it at all and to NEVER take a chance. When you tell them you have an aortic aneurysm, your wait goes to the top of the queue in an ER too, by the way. They tend not to mess around. If they take it that seriously, we should too,

5

Sorry didn't see the reply with size info before I replied. 

6

I think you are feeling anxious over your night of over indulgence and you shouldn't be beating yourself up. I think there is a tendency in us if we have gained some will power over ourselves that if we let go it will be broken. I think you are over reacting and your wife is right. Its amazing what weird pains trapped wind can create. You'll be fine and you are doing very well. by keeping your blood pressure down - the only thing you have to worry about, and obviously no sudden lifting you will carry on and on and on. 4.4 is almost normal.

7

Hi James, yes I am seeing my cardiologist every 3 months. Every checkup I get an EKG and he runs through a panel of questions, checks my bp which has been very good and my bpm which is also good. June was 1 year since I’ve been going to him, had an echo done he is saying no growth since last year which is great news. 

As far as this issue is concerned, as the day passes it seems to be subsiding but I am still erring on the side of caution. Clean eating going forward and drinking a lot of water to flush out the sodium intake and all the sangria lol

Thanks for listening, everyone. I try to live my life not worrying too much about this but I have to remind myself every so often that I have it. I’m hoping this dissipates completely by tomorrow morning, now it’s just a rare occurrence throughout the day today. 

8

Glad it hasn't gotten larger! I took cardiac rehab after my surgery, and they told us that a big salty meal can actually kill you. Better to eat sweets than salt. Be careful with your diet. Please do consult with your cardiologist. Better safe than sorry.

9

Really?? Omg I had no idea about the salty meal! Good to know, thank you Sandy!! Yes I’ll be a lot more careful. 

10

Hi,  My aaa is 4.2 discovered 8 years ago but never reported to me.  Incidental finding was reported to me 2 years ago when i had an incident of shortness of breath.  The same thing happens to me i can feel pain in my chest and i get shortness of breath randomly.  Last episode was when i was in lake tahoe at 6000 ft elevation.  I followed up and had a cardiac stress test.  Its a good idea to get a stress test to see if you have ischemia.  My husband is very worried too.  It is very strange living with an aaa. I know i developed it sometime in my adult years, but there isnt a reason...im a nonsmoker, normal weight, active, respiratory therapist and i dont do drugs(kinda not fair),,,

Im in the YOLO phase...its kind of a blessing no one knows how it hangs over your left shoulder..but remember just take time to make yourself first and relax, if you feel bad take a day to relax,

I am measured yearly by an ECHO, and I have had 3 chest CT (not too good, lotsa radiation)

Remember in healthcare the squeaky wheel sometimes gets help so dont ignore your symptoms.  I have the chance to talk to people with aortic replacements...and all are happy they did it ...not so bad

Yolo

 

11

wrong 4.4 is not normal.  The cleveland clinic evaluation is based on your height and chest size.  so dont say that...are you a cardiac surgeon?

12

Suzanne, panic and anxiety do not help and there is some research that at a certain age and size of person up to 4.2 or 3 is in the normal range it is very individual and variable.

Mine is 4.9.

The best you can do is take all precautions (mainly take beta blockers for BP) and calm down.

Check out you dont have asthma as the latest tets show that an anti asthma drug can slow and even stop aortic aneurysms in mice. I am on it because of breathlessness after sudden exertion. Since taking it the attacks have stopped and I am so relieved. The cardiologist has never linked it to the anuerysm (which they call a dilation) reserving the term aneurysm for measurements over 5.0cms.

No you are right I am not cardiologist but am medically trained and no one is more interested in my body than me so I am up with as much new research as I can find without being obsessive.

I have MRI every 6 months as it avoids the radiation risks. The last time I saw my cardiologist (last month) he said that the Professor had looked at my MRI results and was very pleased as it hadn't grown since 2014 and in future they would be monitoring every year and not every 6 months. I pointed out that a measurement wasn't taken in 2014 but in 2013 when it was only 4.0. He checked it out and saw I was right. So I AM being tested again in six months. It hadn't changed from 2017 when it was first reported to me at 4.9. I asked him to tell the professor. They are human. Be vigilant. I think the only good thing about knowing is that if you do have an event the hospital will immediately know what it is which is not the case whena dissection or rupture occurs in a patient who has not had a diagnosis and emergency and relevant action is crucial.

Other than that it is a beast to live with and yet I have found the every day richer for feeling well and grateful for it, taking nothing for granted. I ask for help with lifting even though I know I am strong enough I dont dash upstairs carrying things. I look after my body the best I can knowing it has this weakness. I have had full genetic testing as I don't have any of the recognised causes - no identifiable genes though my father did die of a rupture, he was dead on arrival at hospital and no one knows it size. And it is possible it is what my brother died of in the air over Italy on the way to his daughters wedding...it was vascular that is all we know. The main point being they both died under emotional stress which is the biggest risk and danger. I advise anyone to practice meditation and join a good mindfulness class. It may well be a lifesaver. Emotional stress could kill you.

13

I’m finding it interesting to learn of breathlessness after sudden exertion could very well be caused by my AAA. I had 3 episodes where i was utterly out of breath....not the type you feel after swimming a few laps, running/jogging for a while etc....this was I can’t catch my breath fast enough and feel panic trying  to. 

First episode was during my friends’ wedding. I was the best man and was dancing it up. I was at my heaviest at the time, occasionally hitting the gym and lifting weights/cardio and smoking a cigar once every 5 or so weeks. I suddenly stopped and tried to not show panic although I felt it, as I was facing my wife and my friends’ wife. It took a minute or so to finally catch my breath. 

The 2nd episode happened while hiking with friends. My wife and i were lagging behind (at our heaviest) and I was carrying a walking stick. The path was flat, no inclines or declines. A large black mass what appeared to be the size of a ball started buzzing around my head. Me like an idiot started kiddingly swinging at it like a samurai and running away from it as i got it obviously angrier. Laughter turned to fright when I suddenly stopped (after it finally flew away) and felt like i was gasping for air as if I just ran a marathon. 

Third incident was walking up 8 flights of stairs at work and following 2 guys much younger than me. When we got to the department we needed to, I snuck into an empty room, ripped off my tie and opened my dress shirt as I was again gasping for air. It was at this third time that i started going to my 3rd and current cardiologist. 

I figured all this time it had to do with my being very overweight, but even so, those 3 times I didn’t feel like I overexerted myself as I was going to the gym and walking on the treadmill for a half hour at a brisk pace. 

Coupled with my being older and this AAA plus overweight (I’ve lost 42 lbs since last November and plan to lose more), I can see now why even the slightest exertion one can feel breathless. 

14

Hi Suzanne and thank you for your reply. 

I agree with YOLO mindframe. When it was confirmed I have this AAA and what could happen down the line and/or if I were to not take care of myself, I was very depressed as I felt I had a death sentence looming over me and I would not be able to be here to see my kids grow up and get married, establish their careers and start their families, etc. 

But I was never one to stay down too long. My attitude is, if I take care of myself ( stopped smoking cigars (I recently sold them all, including 7 premium Cuban cigars 😢 ), lost weight, keep stress down, exercise and eat clean), then the rest is up to God. I spend now more time with my wife and kids (I was recently working in healthcare IT in a good position making good money but high stress, endless emails and meetings and days that never ended), I play with my dogs, I’m more involved with my kids’ activities, enjoy pool time, water parks, and I also scuba dive and am considering rejoining Tae Kwon Do. I am currently doing temp work at a company literally 1 1/2 miles from my house, I get to dress down, come in at 9, get 1 hour mandatory lunch break, out by 6 and home by 6:10. It’s the polar opposite of my last job, here I am very relaxed and a lot of times bored, but the good thing is I’m not dealing with corporate cutthroats and stressed out. I am relaxed, the people here are very down to earth and pleasant to work with. I am slowly getting used to this more and more and while I am submitting resumes and applying for an IT manager position (with much smaller companies), I am almost beginning to hope this company offers me a perm spot one day soon. Hey, I don’t have to make what I made. As long as I can pay my bills and save for retirement, is a higher salary and title more important than your health and quality of life with your family? I don’t think so. 

15

its scary isn't it - the breathlessness. I don't think as a symptom it has been looked at enough but it is beyond a normal out of breath feeling - its as though you can't breathe. Very hard to describe. There is a theory it is because the vagus nerve which is connected to breathing wraps round the ascending aorta and maybe the swelling affects it? but more interestingly that there is an excess of leukotrienes which can cause a rare form of exercise induced asthma they have also found in an excess of leukotrienes in aortic anuerysms...I take a leokotriene antagonist drug and have found that the attacks of breathlessness have almost disappeared (you learn not to run for the bus) but I was getting mild attacks often after climbing a couple of flights of stairs and now I don't get them. Such a relief.   

16

Since I’ve lost this weight, I find it easier to walk faster, climb more, and not over exert myself. Of course I won’t be swinging walking sticks at a large black mass anymore, but the occasional flight of stairs (2-3, not 8) or an occasional fast paced dance at a wedding I feel more comfortable and confident I will be okay. 

Which brings me to my question: is doing taekwondo going to be too much? I want to go back as I miss it, I already told my former masters about my conditions and they completely understand. So it’s up to me now to push myself but not to the point of danger and really listen to my body. 

It’s forms and self defense yes, but it’s also a lot of fast paced kicking which I’m concerned about over exhaustion. 

17

Hi Eric, I guess it is a case of try it and see - if it doesn't give you breath attacks. As far as i know sustained exercise is good the problem with weights for example is the suddenness of it. that is what put a jolt on the blood pressure.

18

Studies have shown that exercise and stress are triggers for rupture. I’d proceed with caution. 

19

I’m so sorry because I know exactly what you are describing.  I say that because I always hate to know that I know what another feels when it’s such intense fear and or pain.  Have you had genetic testing done?

20

Hi Suzanne,

I wanted to find a reason for my aneurysm too, and my genetic testing was negative. However, I recently  read that menopause and lack of estrogen are linked to aneurysms. I knew that heart issues could crop up without hormone replacement, (but didn't know what they were).  I had a full hysterectomy during reconstruction after breast cancer. My doctors were very much against any hormone therapy, but I am now looking into bioidentical hormone pellet implantation, as I heard it can be life-changing. My cancer was 11 years ago, and quality of life is important too!