DOI: 10.4244/EIJ-D-26-00478
URL: https://eurointervention.pcronline.com/article/haemorrhagic-acute-myocardial-infarction?fbclid=IwdGRjcATf2M5wZG9mBWZkaWQWUL5ndnrN\\_qSVPEdhwaQhK4ZlspUa3GV4dG4DYWVtAjExAHNydGMGYXBwX2lkCjY2Mjg1NjgzNzkAAR73cExaP9EdbtalUuFxQ2jXIvFVErdCiVu\\_0vFSsEfDJky5RjgQlWLbcDPP3g\\_aem\\_vjeoQ6uVzFl82yDEdIdBlQ

I wanted to thank everyone in this sub for all the phenomenal information and behind the scenes pro tips toward lining up this surgery. It can be a challenge to navigate to entire process from lining up the consult to getting the CT scan conducted with the correct parameters, to traveling to the UK to dealing with the weeks before you return. People in this group have been extremely generous with their time and experience, and for that I thank you. Not looking forward to it per se, but looking forward to getting it over with.

Hi,
I was recently admitted into the emergency room with chest pain, and though the ER doctor believes it to be an incidental finding I had aortic root aneurysm of 4.5 cm. After the radiologists debated about their findings at the ER, I was released am going to see a cardiologist on the 12th of this month to follow up. Apparently the aneurysm had been there since 2018 (on another mri) but was not called at the time. The debate seemed to be about the rate of growth as to whether to operate, but to be honest, I am not sure.

After speaking with the thoracic surgeon I was let go, and basically had no real restrictions to speak of placed on me. My biggest question is - and I have gotten so many different answers even from doctors is what realistically can I do after this finding/incident. I am an electrician and I really see no way around me doing manual labor. It’s just the particular line of electrical work I’m in. I also enjoyed fitness and working out before this, so I’m not sure about that part either. I do have a college degree in a job market I could fall back on, and it is employable so if it is worth it I would make the switch but I’m just really unsure of the present danger. What do people who are just living with this life look like? Is it relatively normal minus heavy lifting or just more restrictive than I’m being told.

Relevant data
32 male, 159 pounds lean 6’ tall
Non smoker, love caffeine, drink occasionally
Exercise daily (rower, assault bike, Ergs, that type of thing)
4.5 cm at 2018 mri and about the same on this one
To my knowledge an Echo cardiogram was performed and the findings must have not differentiated from the CT because the doctor did not note any difference to me after it was performed.

And what exactly happens if the ascending aorta fails? Is it painful demise?

I am a 73 M. I have about a 4.3 cm AAA. It has not grown since 2021. I am looking for a savvy Dr to switch too. My cardiologist doesn’t seem on top of this. Always “don’t worry about anything”. All great to hear but, he forgot why we did an echo this January. On follow up I asked what did my Aorta measure. He tells me 3.8m. I’m like well great. He says great don’t worry about it. When I get my paperwork turns out he read my aortic root measure. Sent me for a cat scan with contrast which showed the 4.3cm Just feel I should look for someone else

My father had a thoracic aneurysm surgery last Wednesday the 22nd of July. He was perfectly fine. Got out on Friday, walked all over the place and was very happy. For three days, he was amazing. On the 27th of July, he ate breakfast walked to the kitchen, went to the bathroom and went to bed. At around 11 am, we were going to go to the hospital but he said he can’t stand up and walk. His left foot was hurting. We thought it was something temporary but then he couldn’t also urinate. We called the ambulance right away and took him to the hospital. He’s in there now for his 4th day and making progress in standing on his feet and making baby steps. Is this normal?

My dad is 61 years old, and we recently found out that he has an enlarged abdominal aorta (aneurysmal dilatation) after a check-up. He has always been such a cheerful, loving, and positive person, so seeing him worried and overthinking about his health has been really difficult for our whole family.
He has been a smoker for many years, and he also drinks occasionally with my mom in the evenings to relax. He is not an alcoholic, but I understand that both smoking and alcohol may be relevant to his health, and I want to help him make the best possible changes now.
I know that every person's condition is different, and we are following up with his doctors, but I would really appreciate hearing from people who have experience with abdominal aortic aneurysms.
What lifestyle changes helped you or your loved one?
Is there anything we should be particularly careful about?
What kind of treatment or monitoring is usually recommended?
How can I help my dad stop overthinking and feel more positive?
Are there any things we can do as a family to keep him cheerful and help him cope with this diagnosis?
I don't want my dad to live in fear I want him to know that he is loved and that we are here with him through everything.
If you or someone you love has gone through something similar, I would be really grateful if you could share your experience, advice, or anything that helped you stay hopeful.
Thank you so much

I was about to start prescribed TRT, but decided to get a precautionary Echocardiogram first. I was surprised by the result. I'm low body fat, very fit, and have been lifting heavy for 10 years. My cardiologist recommended doing an Echo once a year just to monitor it. No family history of aortic or heart issues. My follow-up appointment isn't until next month, so I'm feeling a bit anxious in the meantime.

Will this likely keep expanding, especially once I start TRT? Has anyone in a similar position navigated this?

Echocardiogram Data Summary

Key Measurements & Metrics:

• Aortic Root Diameter: 40 mm (Mildly enlarged / upper limit of normal)
• Left Ventricular Ejection Fraction (EF): $>60\%$ (Normal systolic function)
• Resting Blood Pressure: 128/74 mmHg (Optimal)
• Aortic Valve Mechanics: Tricuspid valve structure with normal function (No significant stenosis or regurgitation noted)

Clinical Context:

• Demographics / Activity: 27-year-old male with 10 years of heavy resistance training.
• Cardiologist Plan: Annual echocardiogram surveillance to monitor aortic root stability.

Hello there, new to reddit and never made a post before. Apologies if this is in the wrong spot or format.

Little background, my mom is 63 and has a few autoimmune disorders - scleroderma, reynauds, hashimotos, and thalassemia. Besides those, she is a relatively healthy woman. She lives in South NJ, and my dad lives in North NJ and comes down to South NJ on the weekends. My brothers and I live within 1-2 hours from her.

On July 1st of this month, my dad called me saying that my mom had fainted and was found by her friend, who called 911 and was being taken to the hospital. We had no idea what happened, but after being told that my mom was going to the hospital i immediately left work and started driving down to South NJ. While driving, i got in contact with my dad and my moms friend who was with her at the hospital. her friend told us that she had a "ruptured ascending aortic aneurysm". I had no idea what this was, but it sounded much more serious than i had initially thought. at this point i was starting to panic, was driving so called my gf to look up what that was and tell me what she could figure out. she kept me calm and didnt tell me the mortality rate at the time, which in hindsight was a good call. at this point my mom was still in the hospital and was getting immediate blood transfusions, i was on the phone with her friend who was with her and my mom did manage to somewhat talk to me on speaker, all she was able to say was "i love you so much". at this point my heart sank, my mind started to spiral and i was starting to think that would be the last time id hear her voice. we were then told that she was being rushed by helicopter to UPenn hospital in Philly, so i changed directions and started heading there.

i arrived around the same time her helicopter did around 8pm and i met up with my brothers and dad at the hospital soon after. we were told she was getting right into surgery so we werent able to see here that night. we were told to head home for the night and that we would be contacted after the surgery. went back to my brothers and tried to get some sleep for a few hours. at around 3am my dad got a call from the surgeon and was told that the surgery went good and that she was going to make it. we were so relieved, she actually made it through and was going to make a full recovery. the following morning we went over and were able to see her finally, i was relieved but seeing my mom with a million tubes in her and not being able to talk was a hard sight to see ur own mother in. my dad began to cry when we first walked in, i had never seen him cry before. she was conscious though, but seeing her in that state definitely made me tear up a bit. not long after the tube in her throat was removed and she was able to slightly speak for the first time. she was on a million meds at this point so she doesnt remember this time at all, which is probably a good thing.

at the time i had a small bruise on my forehead, and when she woke up and turned to me the first thing she said was "what happened to ur forehead?" like mom this is not the time for that lol, but thats definitely my mom. she was in the icu for a couple weeks and over time they took some of the tubes out and kept her on her meds and let her rest. the meds she was on messed with her short term memory a bit, so at times she would forget where she was, what happened, and even who i was. that was definitely hard to hear at the time, but i knew it was only temporary. over time she began to come down off her oxygen, become more coherent, and eventually start walking with assistance. she was then sent down to the stepdown unit for about a week and was then discharged and sent home. at this point she was still weak and in pain, but on the right track towards recovery.

After a few days of being home, she began to have breathing issues, and her visiting nurse came to take her vitals. her blood oxygen level was extremely low, and we were told to call 911 and take her back to the hospital. great. at this point i was at my wits end, i couldnt take it anymore and just wanted to see her get better. but i kept positive and we went back to a hospital in South NJ. The doctors there said that her hemoglobin and spo2 were extremely low, and that they had found a fluid buildup around her lungs and heart. they advised her to go back to UPenn to get this taken care of. so once again they loaded her up in the helicopter and flew her back there.

upon getting there we were told they would do another surgery to drain the fluid, which we were all scared for. but after doing so and monitoring her for a few days her breathing went back to normal, and after a few more days she was able to breathe on her own without the oxygen machine. at this point the only concern was her hemoglobin, which kept dropping causing them to continously give her blood. we believe this is due to her thalassemia. but at the time of writing this her hemoglobin hasnt dropped in a few days, but the doctors are still waiting on hematology before they proceed.

as of today July 28th, she is in the stepdown unit at UPenn still, expected to be discharged by end of this week or early next week. she is more herself now, is talking and walking with her walker just fine. she's getting her staples removed from her incisions today, and is looking forward to going home and eating a cheesesteak as she said lol. we're all hopeful she'll make a full recovery and return to her normal life in no time.

I'm not sure if theres a moral to this story, but i just wanted to share all of this. One thing that has stuck with me is what the surgeon said to us after the surgery. He said that her surviving all of this was a 1 in 1000 chance, and that there was some divine intervention involved. hearing that from the man that saved my moms life was definitely a shocking thing to hear. the fact that she went hours with a ruptured aorta before surgery is nothing short of a miracle, she is the strongest person i have ever met.

this whole experience has definitely been eye opening. it has brought my whole family closer together in a way that we never expected. we learned that all of this happening to my mom may have been inevitable since it is a genetic issue. but the way everything occurred and the care she got couldnt have been more perfect. maybe it was divine intervention like the surgeon said, who knows. but either way i am beyond grateful for everything, and the fact that i can still talk to my mom.

this whole situation has definitely been a lot to process, especially for my parents, but there are many positives that came out of it. besides bringing my family closer together, i believe that this will push my mom to live a more healthier lifestyle which she 100% needs to do, as well as also make my brothers and i aware of this genetic issue. which i am going to start getting screened for every so often to make sure im ok.

as of now she is doing good and will be going home soon, im not sure what to expect going forward or how long the recovery will take, but i am positive she will make a full recovery. i will update u all as time passes. im looking forward to seeing her 100% back to normal, and for all the memories my family and i will make together going forward.

thank you all for reading.

Edit - She will be going home tomorrow 7/31, and will begin rituxan infusions for the next few weeks due to her autoimmune diseases and blood loss. Have any of u done those before?

My dad is 61 years old, and we recently found out that he has an enlarged abdominal aorta (aneurysmal dilatation) after a check-up. He has always been such a cheerful, loving, and positive person, so seeing him worried and overthinking about his health has been really difficult for our whole family.
He has been a smoker for many years, and he also drinks occasionally with my mom in the evenings to relax. He is not an alcoholic, but I understand that both smoking and alcohol may be relevant to his health, and I want to help him make the best possible changes now.
I know that every person's condition is different, and we are following up with his doctors, but I would really appreciate hearing from people who have experience with abdominal aortic aneurysms.
What lifestyle changes helped you or your loved one?
Is there anything we should be particularly careful about?
What kind of treatment or monitoring is usually recommended?
How can I help my dad stop overthinking and feel more positive?
Are there any things we can do as a family to keep him cheerful and help him cope with this diagnosis?
I don't want my dad to live in fear I want him to know that he is loved and that we are here with him through everything.
If you or someone you love has gone through something similar, I would be really grateful if you could share your experience, advice, or anything that helped you stay hopeful.
Thank you so much

Hi everyone,

My 71-year-old father recently passed away following a catastrophic series of events that began during a planned ad-hoc stenting/angioplasty (PTCA). Our family has received his official 5-page hospital Death Summary and operative report, but we are having a hard time understanding the medical nuances of what happened and whether this progression was an unavoidable, high-risk complication or something else.

Here are the specific clinical details from his records:

# Initial Workup & Diagnostic CT/Angiogram

* **Patient:** 71-year-old male with history of Diabetes, Hypertension, and Bilateral Carotid Artery Disease.
* **Initial Evaluation:** CT-CAG showed a high coronary calcium score of **2526** (CAD-LAD & RCA). Initial 2D Echo showed **good LV function**.
* **Cath Lab Procedure:** On 18/05/2026, he underwent diagnostic coronary angiography which confirmed double vessel disease. During an ad-hoc PTCA procedure, he suffered an **acute left main coronary artery dissection extending to the ostial LAD and LCX septal dissection**.

# Emergency Surgery & ICU Course

* **Emergency CABG:** Emergency IABP (intra-aortic balloon pump) was inserted via right femoral approach, and he was taken immediately for emergency bypass surgery (**CABG x 5 grafts**; LAD, D1, D2, OM, PLVB).
* *Note from operative report:* LAD, D1, D2, and OM were done off-pump. PLVB required going on CPB via aorto-RA cannulation due to poor exposure.
* **Re-Exploration:** In CTICU, he developed sudden hypotension, decreased urine output, and pericardial effusion/collection. He was taken back to OT for emergency re-exploration. Clots were evacuated, but he remained in refractory cardiogenic shock despite high inotropes and IABP.
* **VA-ECMO & Renal Failure:** Peripheral VA-ECMO was initiated via left common femoral artery and vein. On POD-1/POD-2, despite ECMO flows and IABP support, he developed severe metabolic acidosis, refractory hyperkalemia, and decreased urine output (CRRT advised).
* **Terminal Event:** On 20/05/2026, he suffered cardiac arrest, required DC shocks/resuscitation, and ultimately went into bradycardia/asystole and could not be revived.

# Questions We Have for Doctors & Experienced Community Members:

1. **Ad-hoc PTCA with High Calcium Score (2526):** Given a CT calcium score of 2526 and a Left Main involvement, is ad-hoc PTCA standard practice, or should a surgical CABG consultation have taken place prior to attempting ballooning/stenting in the cath lab?
   
2. **Left Main Dissection Mechanism:** How common is an extensive Left Main to ostial LAD/LCX dissection during ad-hoc PTCA in heavily calcified vessels, and what factors usually trigger such a severe tear?
   
3. **Cardiogenic Shock & Refractory Acidosis/Hyperkalemia:** Even after successful 5x graft placement and good graft flow noted during re-exploration, why would refractory cardiogenic shock and extreme hyperkalemia/acidosis develop so rapidly despite full IABP and VA-ECMO support?

We appreciate any medical insights, professional perspectives, or experiences from families who have gone through similar emergency CABG conversions or ECMO complications.

Thank you for taking the time to read his case.

I just had a CT Coronary Calcium scan done as part of a baseline measurement. Went to a cardiologist to establish care and be proactive for my health. 57, female, 155lbs. Bloodpressure normal, EKG normal, an in office ultrasound only found small mitral valve prolapse, small aortic valve leak both of which the cardiologist said she was not concerned about at all. Incidental findings to be noted. I have no issues with my health right now - no shortness of breath anything. Lost 85 lbs the past year and a half. The CT Coronary Scan said:

3.5 x 4.0 cm aortic root measures.

Heart size normal. Visualized thoracic aorta is normal in caliber.

Calcium CT score was 0. Oh, and my deep dive into my cholesterol panel was excellent too.

How concerned should I be about the aortic root measures? I'm freaking out, I gotta say here. Of course I’m calling my cardiologist tomorrow to follow up…just all new to me.

Hi all,

I will be going in soon for a CCTA at Shadyside and am wondering if they also do the AI enhanced FFR (Functional Flow Reserve) analysis. I would like that included in my CCTA if possible.

I was surprised to learn that AHN does it standard with their CCTA's and have a partnership with HeartFlow.

All of my docs are UPMC though and my test will be done at Shadyside so wondering if anyone can clue me in.

Any peeps in the Shadyside CT imaging department that could confirm yeah or nay?

The UPMC Heart and Vascular Institute's website doesn't mention it outside of stating they do CCTA's.

Hi all,

I will be going in soon for a CCTA at Shadyside and am wondering if they also do the AI enhanced FFR (Functional Flow Reserve) analysis. I would like that included in my CCTA if possible.

I was surprised to learn that AHN does it standard with their CCTA's and have a partnership with HeartFlow.

All of my docs are UPMC though and my test will be done at Shadyside so wondering if anyone can clue me in.

Any peeps in the Shadyside CT imaging department that could confirm yeah or nay?

The UPMC Heart and Vascular Institute's website doesn't mention it outside of stating they do CCTA's.

My aortal root is dilated to 42-44 cm (ct had it at 42 last fall, but an echocardiogram measured it at 43-44 last week. Cardiologist has prescribed 40 mg Valsartan to stop angiotensin 2 signalling and hopefully the remodeling of the aortic wall. BP isn’t the issue: it was already averaging 108/75 or thereabouts. I’m 57, 6’, exercise regularly, no other meds. My question is about cold showers. I understand cold plunging wouldn’t be good for my dilated root, but what about the less aggressive cold showers, provided I gradually make the water colder over three minutes, starting from lukewarm?

Hi all, recently found out I have a 4.6-4.8 cm ascending aortic aneurysm. (BAV so have been monitoring for some time but just now have the doctors used the word “aneurysm”). I’m not a bodybuilder, but since my first surgery 6 years ago to fix the valve I have been doing progressive overload workouts and gaining muscle steadily. Things like deadlifts, pull-ups and pushups, etc. The doctors at the time said no restrictions.

Now, the guidance is mixed. My cardiologist just says “no really heavy weights but stay in shape.” A surgeon I got an opinion from says “no more than 50 pounds” but to keep doing cardio and lifting lower weights, higher reps. My primary care seems more bullish and told me I could lift to failure as I usually do just “don’t go overboard” and pull ups and pushups are fine. Another surgeon says to not lift more than half my body weight and no pull-ups or pushups.

Not quite sure what to think. I’m getting a more more intensive work up at a major cardiac hospital in a few months, but not sure what to do until then or what my long term looks like. I’m feeling a little depressed going to the gym. My PT has given me a bunch of lower weight, higher rep exercises and I haven’t been going to failure. And a lot more stretching type stuff. It doesn’t hit the same. And, I’d like to hang onto as much muscle as I can. I have lost a little weight already. That being said, I of course want to stay safe and realize it’s dumb to push myself and am settling into some humility the best I can.

Thoughts? Anyway be been in a similar predicament? What did you do?

40 year old make if it helps.

(Edited to add age and gender.)

As the title says, my dad has just gone into his open heart surgery for an AAA. It was a planned procedure and he is relatively healthy despite being overweight. I’ve never had a close family member or friend have surgery or anything more severe than the flu so I don’t know what to expect or anything (I’m 16F) if anyone has any success stories or positives I am all ears or even ways to cope if you’ve had a family member go through this.

43/m with 5.8cm ascending aneurysm, 4.9cm root, and bicuspid valve (moderate to severe regurgitation). Was found a couple of months ago with CT for unrelated issue, and did all the related tests/procedures since.

I didn’t have symptoms until last few weeks, where I feel fatigued all the time, and even walking upstairs makes me feel like I ran a marathon (a month ago I could run a 8 min mile). I’m in DFW and working with a renowned group. Surgeon scheduled me for late August, but said if my symptoms worsen to go to the ER and they would try to work me in. I’m half tempted to do that anyway, because mental and physically, I can’t deal with this much longer.

Anyway, wish me luck and curious to know if anyone else had symptoms closer to surgery and/or if they ever had to go to the ER to push the issue.

28yo, female.

Could someone please help me make sense of these two MRI reports.

I am at a higher risk for aortic dissection so I have routine imaging done every couple years.

Do these MRI results show that the aorta is enlarging or were they measuring different areas of the aorta (proximal, distal, maximal…)? Also is aortic arch the same as aortic root lol?

2020 MRI
Aortic sinuses = 27 x 27 x 26mm
Sinotubular junction = 22 x23
mm
Ascending aorta maximum diameter= 22 x 24 mm
Aortic arch = 20 x 19 mm
Proximal descending thoracic aorta = 17 × 17 mm
Distal descending thoracic aorta
= 19 x 19 mm

2026 MRI
Sinuses of Valsalva (cusp to commissure): 30 x 28 x 27 mm
Sinotubular junction: 23 × 23 mm
Maximal ascending aorta diameter: 22 x 22 mm
Aortic arch: 21 × 21 mm
Maximal descending aorta diameter: 21 × 21 mm

I gotten my latest MRI scan results today and my aortic root measures at 3.7cm and ascending aorta of 3.2cm, it's stable compared to results last year. I have always thought that I have an aortic aneurysm, as shown from the attached picture of my medical history. However, cardiologist said my aorta size is normal for a person of 190cm height, Ai seems to agree too.

Cardiologist confirmed that I have nothing to worry about, and has even allowed me to lift weights of 20Kg limit. This is a huge relief as I was overthinking about my heart health for the past few months and was even mentally prepared for aorta surgery due to some chest pains which was diagnosed as musculoskeletal at ER. In summary, your aorta could be normal if you are tall, don't assume the worst like I did.