Have I Developed A New Symptom???

Lately I have been having this swallowing problem. I've had several episodes where it seems like food gets stuck in my thorat on the way down. For years I've had throat tightness...at first it was only on exercise exertion, but now I get it just walking. I don't find references to these symptoms in the literature. Could it be the aneurysm compressing the esophagus?

I just found this:

Symptoms of an aortic arch aneurysm or a descending thoracic aneurysm may include, but are not limited to, the following:

wheezing, coughing, or shortness of breath as a result of pressure on the trachea (windpipe)
coughing up blood (hemoptysis)
hoarseness as a result of pressure on the vocal cords
difficulty swallowing (dysphagia) due to pressure on the esophagus
pain in the chest and/or back

and this:

What Are the Symptoms of an Aortic Aneurysm?
Aortic aneurysms often cause no symptoms at all. But if present, symptoms include:

Tearing pain in the chest, abdomen, and/or middle of the back between the shoulder blades.
Thoracic aneurysms may cause shortness of breath, hoarseness, brassy cough (due to pressure on the lungs and airways), and difficulty swallowing (pressure on the esophagus)
Rupture of an aneurysm can cause loss of consciousness, stroke, shock, or a heart attack
If you are experiencing sudden unexplained chest, abdominal, or back pain, or any of the other symptoms mentioned above, seek medical attention.


???

Jim

Flying The Friendly Skies Again

We'll be on holiday soon...overseas...on another cruise. I really like cruises. There is nothing like being pampered. I'm on schedule for my six month check up with my primary care physician and my cardiologist in October. It will mean another round of tests. If things are stable then six months later I'll do it all again. There is no way to know for sure, but my guess is that not much has changed since last winter. We'll see.

Valve Disease Symptoms

A heart valve patient writes in an online article:

One morning I woke up feeling really tired - I couldn't understand it because I'd had a good night's sleep. Then over the next few weeks I started to feel breathless - it was a struggle even walking upstairs, which was odd as I've always been so fit and healthy. After about two months of this, my feet suddenly swelled up overnight - I couldn't even get my shoes on - and my throat felt really tight.

This morning I woke up feeling really tired even though I slept well last night. I also have a dull feeling, not quite a pain, in my chest. It feels like my heart is just so tired. I keep watching my ankles but so far there is no swelling and I'm not breathless. I've had tightness in my throat for years on exertion. These are "pre-symptoms" of valve disease. They don't count and you have to wait until you faint, get dizzy, or otherwise keel over.

So, it's back to watch and wait.

Summertime Relaxation

I'm enjoying my twice daily beach walks with Bradley the dog. We try for three miles in the morning and one mile in the afternoon, but sometimes we just play ball and swim in the afternoon. Summertime has finally arrived!

Photo: the garden railroald at "Liberty Bell," our beach cottage on Fire Island

Feeling Good!

Here's a photo of me and Dan that was taken 25 years ago in top of the Eiffel Tower in Paris. It was our first overseas trip together. We started in Paris and then flew to Rome. Next month we'll be returning to Rome for the first time in 25 years. We'll see some sights then embark on a cruise to Egypt and the Greek Islands.

I'm feeling fine. I don't notice any increase in the intensity of any of my relatively minor symptoms. I walk three to four miles a day. My weight is not good but at age 60 at least I'm not obese and I'm still quite active.

My friend Jane had her surgery last week and she's doing well. That is good news!

Still Trying To Be As Active

Yesterday I walked five miles on the beach with Bradley, our dog. Last year I usually walked four or five miles a day on the beach and I'm hoping I can continue that pace this year. I've also been swimming in the ocean, although it's been a cool and rainy Spring with not much real beach weather.

As for symptoms, I continue to feel my heartbeats pulsing up into my throat. Five years ago I only felt this when I exercised. Now I can feel it when I'm resting. What is it? I think it is my enlarged aorta pressing against the esophagus or other throat structures that I'm feeling. When I have my next echo in six months I'll know if there has been any enlargement of the aneurysm.

PHOTO: a gargoyle in Lyon

Vacation And Status Update

Photo: The cloister at Moissac, France

Dan and I just returned from a great 2-1/2 week trip through Southern France. At the end of the trip we flew to Lisbon for a couple of days. I felt fine during the trip but a little more tired than I would have liked after we got back. It was probably just jet lag.

I'm now pretty much convinced that the pressure and tightness that I feel in my throat is due to the enlargement of the aorta pushing against the esophagus or other nearby structures. This started about a year after I first learned that I had a valve problem. At first I felt the pressure only when I really exerted myself like when I would jog for exercise. But now I feel this pressure even when I'm not doing anything strenuous. It feels like my heart is beating right up into my throat. That's about the best way I can describe it.

I've read some articles recently that help me to better understand the relationship between bicuspid aortic valve disease, aneurysms and aortic stenosis. Unfortunately, aortic stenosis combined with BAV and an aneurysm is sort of a triple whammy - not good! The stenosis (narrowing of the aortic valve) produces hemodynamic forces (a jet) that stress the aorta, according to one studay I read. There is a lot of debate about when to have surgery for an aortic aneurysm, i.e., at what size aneurysm. 5.0 is usually the trigger point for surgery except for Marfans patients. For those with Marfans, 4.5 seems to be the trigger size. Since bicuspid valve disease is in some ways similar to Marfans, there seems to be some who feel that 4.5 should be the trigger point for BAV patients. Then there is the whole body size calculation that figures in to the equation. Bigger people may have naturally larger aortas, so for them the surgery trigger size might be larger. However, there is a risk of rupture or dissection at just about any size. So the debate goes on. I'll find out if my aneurysm is growing and if so, at what rate, when I get tested in the Fall. If he aneurysm is stable (not enlarging,) that's one thing, but if it is growing at more tan .1 cm per year, that is of great concern.