Wednesday, March 30, 2011

Ascending Aortic Aneurysm and Pregnancy.

On March 22nd, I went to the cardiologist set up by my primary doctor related to a heart condition that was detected on a recent echocardiogram.  I was born with a Bicuspid Aortic Valve (BAV), which means I have two leaflets or cusps instead of the normal three.  It is the most common congenital heart anomaly, although more common in men. I was told this should not be a problem until I was much older if ever a problem.  I found out about this 5 years ago.  And this BAV is the cause of my recently diagnosed Ascending Aortic Aneursym (ballooning of the aorta).  


Well, before the cardiologist visit I was having chest pains and palpitations.  It hurt so it alarmed me but at the same time I related it to my crazy lack of sleep schedule (working part time nights while being a full time stay-at-home mom doesn't exactly give you beautiful rest). Which I really think sleep is necessary for all around health!  So I put it off not thinking much of it but then it came everyday and more than once a day so I went to the doctor.  Blood work was perfect; chest x-ray was perfect; echocardiogram not so perfect.  


Gifford Medical Center sent my echo to be reviewed by Fletcher Allen in VT.  My Ascending Aortic Aneurysm measured 3.9cm.  Surgery is recommended at 5.0cm but less than that if you have a BAV (I have) or Marfan Syndrome (I don't have).  When your aorta is 1.5 times it's normal size it is considered an aneurysm.   


So when you are pregnant, it's a whole new ballgame.  Termination of pregnancy is recommended.  The cardiologist said if I measured at 4.0cm she would highly recommend it.  She also said I can in no way become pregnant again until after heart surgery.  She felt better knowing that at Darmouth, where I will be going for my visits, they measured at 3.6cm.  Still, doesn't seem so far off 4.0cm to me, and what if it grows?  I can have a dissection (a slit in the aorta) and that is what they fear and what I pray does not happen to me.  It is extremely painful, and by extremely, I mean like someone is sawing open your chest painful (as it has been described) and death can follow quickly even with treatment.  Scary.  Third trimester and early postpartum, from my research, is when it would be most likely to occur (at the same time it's not "highly" likely to happen at all).  During pregnancy your heart is pumping harder.  And since my body is getting ready to deliver life, all my muscles and connective tissues are relaxing and stretching, not good for my already weakened, stretched out aorta.  But that is the WORST outcome for all of this.  I can very well have a perfectly normal pregnancy (under the care of specialists). 


A part of me wanted to end this pregnancy, for reasons I'm sure you can all figure out.  I have my son and husband who need me.  Thank you to all my family who have supported the difficult decision to terminate if we had decided to or need to do so.  If it grows by next appointment, we will have to reconsider again.   I wish I was given a percentage of this happening to me, but she couldn't do that.  I realize I am at risk but I also realize my aneurysm isn't considered huge.   There is not much out there, from what I can read up on, when someone has this while pregnant.  Or the stuff I do read doesn't sound so promising.  I did find one girls blog and she went ahead with the pregnancy and her heart did well, but she lost the baby 2 weeks before her c-section due to a very unlucky circumstance.  Though, she lost her father (age 28) and aunt (age 24) to this heart condition and their aneurysms were relatively small too.  So yeah it's pretty serious.  She did have open heart surgery soon after and seems to be doing well.   Other articles I read were of young women having surgery while pregnant.   The cardiologist also mentioned that if it does grow, they would probably need to do a CT scan to get a more accurate measurement and that means baby would get radiation.  It's a heavy load we have been given.  But I believe EVERYTHING happens for a reason.   






I wanted to start this blog, not as a way to only talk about my aneurysm but to keep family and friends updated once in a while with photos of my family and what we are up to through the seasons.  Also, it's much easier to write out all the details of what is going on with my pregnancy rather than explain it over the phone to my family 10 times! :)  So when my appointments happen I will update.  Next one: April 27th.  But I'm sure my concerned, precious family will not leave my phone alone ;).  


Thank you to my supportive, loving, and caring family and friends who have offered support and kind words. :)  My name has been given to many prayer groups and I LOVE you all for that.  One of my co-workers prayer group here in Randolph,  a prayer group back in my hometown (Syracuse, NY), and a group from my Aunt in Florida and I think my grandma mentioned Connecticut too.  Wow, how amazing.  I truly believe in power of prayer.    And Thank you to my husband, I love you more than you will ever know!!!

2 comments:

  1. I found your blog as I was searching for information on ascending aortic aneurysms and there really isn't much out there for reference if you don't have marfans (which I don't and have ascending aortic root aneurysm of 4.2). Wondering about your pregnancy, as we are thinking of the same.

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