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Old 08-16-2022, 07:00 AM
 
Location: Midwest
7,110 posts, read 9,141,062 times
Reputation: 13475

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I've had this done by ultrasound twice now. First was a standard screening a few years back. Neither was problematic.

The more recent one was my rheumy's puzzlement at a diagnosis of heart failure by a cardiologist at his university medical center. Both ultrasounds were normal with nominal irregularities of no significance.

I believe the "heart failure" dx was made by a doctor who practices medicine by billables. He and his ace team had my wife and me wired for sound by the time he was done with his spiel, wanted me to stay late on a Friday for some invasive cardiac camera procedure, it was pretty mind blowing.

We passed on that horrorshow, got another opinion which said everything is normal. I guess my rheumy isn't cynical enough to understand that not all docs live by The Code. Some just like To Do Stuff. $tuff.
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Old 08-16-2022, 07:07 AM
 
Location: Elsewhere
78,870 posts, read 72,894,507 times
Reputation: 100267
Quote:
Originally Posted by jacqueg View Post
All I can say is that of the two people I personally know who died of aneurysms - one had just turned 40, the other in his 60s - neither had ANY symptoms at all.

Why did your doc recommend that you be screened?
Same here. Good friend died a little more than two years ago, just short of 56. No symptoms that I know of. Left work, texted her teenage son that she was on her way home, got in her car...and her coworkers leaving the building saw her car slowly moving and banging into other cars in the parking lot. She was dead behind the wheel of a brain aneurysm.
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Old 08-16-2022, 07:45 AM
 
7,590 posts, read 5,623,786 times
Reputation: 17039
Quote:
Originally Posted by BobTex View Post
A few thoughts.

If it were me and I need a surgery to mediate concerns and worry I will do them even if risky.

Aneurisms are familial maladys.

If you have high blood pressure manage it and drop it as it is an issue if you have an acute aneurism (one determined to be high risk to leak or rupture).

Get a second opinion from a highly regarded vascular surgeon but do some preliminary screening (ultrasounds) and then get a 2nd opinion if anything is found. I'm a huge believer in that tact. If 2 independents say the same thing your trust level should go up exponentially.

If this is based on a light history of smoking I think this is a bunch of hoo ha . . . JMPO. You're a healthy and asymptomatic man!
30 year retired Neuro ICU nurse with 30 years experience in the field. This is more of a cardio vascular issue but we would frequently recover and care for these patients due to risk of stroke post procedure.I'll try to give my thoughts on this and a few other posts above.
My dad had an abdominal aneurysm that they would check periodically and then when it started growing he had a successful surgery and recovery. Weeks later he died in his sleep, supposedly his heart just stopped.
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Old 08-16-2022, 08:17 AM
 
Location: USA
6,363 posts, read 3,171,848 times
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Quote:
Originally Posted by marcopolo View Post
Friends, I'm wondering if I should be screened for aortic aneurysm, and I am trying to assess the benefits and risks of such a procedure. A doctor has made a tepid recommendation for it. Can you help?

I have no symptoms, wonderful lab test results, healthy diet and exercise and sleep habits. I fear frailty and incapacity more than death.

What are the odds of a false positive from the screening?
What is the mortality rate for elective abdominal aneurysm repair?
What is the rate of significant non-fatal complications for elective abdominal aneurysm repair?
What is the rate of hospital-acquired infections for surgery patients?
What is the rate of incidence of abdominal aneurysm crises in unscreened healthy people?

Male, into retirement years. Thanks in advance.


I interpret your doctor's "tepid" recommendation as (1) she doesn't believe it is necessary and (2) she's covering himself for malpractice if you don't get the scan and you have an aneurysm.


Doctor's Comments to Patient: "I said it might be beneficial to get, but you aren't high risk, so why not save some money and not have this done."

Doctor's Testimony at Mortality and Morbidity Review: "I said it might be beneficial to get, but my recommendation was ignored so no scan was performed. Too bad the patient died."
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Old 08-16-2022, 08:35 AM
 
Location: The Driftless Area, WI
5,967 posts, read 3,192,732 times
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A screening test is one that can be done cheaply and safely and has a reasonably high chance of finding an abnormality.

Screening for AAA is certainly safe (just an ultrasound) and not very expensive....The incidence if AAA is about 3 in every 10,000 men over 65-- not rare, but certainly not common, so the chances are not good that a screening test will uncover an unsuspected case. (Compare that to a screening colonoscopy that finds polyps in 1 of every 10 pts).

OTOH- you don't actually do surgery on an asymptomatic AAA until it gets bigger than an arbitrary size-- a size that usually can allow it to be detected by a competent doc on physical examination-- which is perfectly safe and costs nothing at all.

Another case of "We have a test or treatment. Let's find something it's good for to make some money."
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Old 08-16-2022, 11:26 AM
 
Location: Midwest
7,110 posts, read 9,141,062 times
Reputation: 13475
Quote:
Originally Posted by Dwatted Wabbit View Post
I've had this done by ultrasound twice now. First was a standard screening a few years back. Neither was problematic.

The more recent one was my rheumy's puzzlement at a diagnosis of heart failure by a cardiologist at his university medical center. Both ultrasounds were normal with nominal irregularities of no significance.

I believe the "heart failure" dx was made by a doctor who practices medicine by billables. He and his ace team had my wife and me wired for sound by the time he was done with his spiel, wanted me to stay late on a Friday for some invasive cardiac camera procedure, it was pretty mind blowing.

We passed on that horrorshow, got another opinion which said everything is normal. I guess my rheumy isn't cynical enough to understand that not all docs live by The Code. Some just like To Do Stuff. $tuff.
Let me clear this up. I had 3 ultras. Oops, forgot one.

First one came back normal several years back.

Second one at the cardiologist who misdiagnosed me, that flawed/fake one was bracketed by the earlier one several years back and then the later one to confirm/deny the dx from the Doctor Dollar$$$ supposed cardiologist.

My bad, it just slipped my mind that I'd had the second one. And my rheumy was quite puzzled because my third one came up clean, he couldn't put that all together.
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Old 08-16-2022, 11:57 AM
 
691 posts, read 217,507 times
Reputation: 1290
There's really no danger to having the screening done... I'd just do it.
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Old 08-16-2022, 04:08 PM
 
Location: Washington state
5,976 posts, read 3,876,149 times
Reputation: 18315
I had an aneurysm in 2014 when I was 57. Had no prior warning or problems. Just boom, there it was. I was very, very lucky. It was an aneurysm on the basilar tip (artery in the center of the head) and so many people who have those end up needing therapy of some sort. I was just fine and spent only a week in ICU, driving the nurses crazy because I was probably the only healthy sick person there.

But OP, if you have an option to get checked, I'd really do it if I were you.
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Old 08-16-2022, 08:16 PM
 
Location: East Texas, with the Clan of the Cave Bear
2,882 posts, read 5,109,819 times
Reputation: 3948
Quote:
Originally Posted by rodentraiser View Post
I had an aneurysm in 2014 when I was 57. Had no prior warning or problems. Just boom, there it was. I was very, very lucky. It was an aneurysm on the basilar tip (artery in the center of the head) and so many people who have those end up needing therapy of some sort. I was just fine and spent only a week in ICU, driving the nurses crazy because I was probably the only healthy sick person there.

But OP, if you have an option to get checked, I'd really do it if I were you.
Basilar tip . . . impressive! You are a blessed man !

I'd like to clarify some things. The abdominal, carotid, and intracerebral aneurysms are 3 different critters with intracranial being the hardest to treat but is much easier in the last 15 years or so with interventional neuroradiology techniques such as coiling and stent placement. This is minimally invasive compared to the open craniotomies and aneurysm clippings when I first started.

Aneurysms can be on ANY artery in the body. Some places are just more sensitive than others.

Modern medicine is a wonderful and even mysterious thing where the skill of the practitioner is on display. I marveled at some of the skills of the surgeons I worked with over the years.
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Old 08-17-2022, 03:55 AM
 
13,584 posts, read 11,711,313 times
Reputation: 25516
I've got a friend with an inherited thoracic aorta aneurysm that he's quasi monitored over several decades. He's fast approaching 60 and is putting off repair.
His brother had the surgery and is fine.
Nothing to mess with. You can look at all the statistics you want but if it ruptures, the chances for survival are slim.
But I'd be as selective as possible on my surgeon.
Take the test. Nothing to lose, everything to gain.
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