Lifelong medical treatment and lifestyle changes are necessary for those with aortic disease, both prior to and after aortic surgery. The following is a summary of some key points regarding the treatment of thoracic aortic disease. Please be sure to discuss the details of your individual situation with your doctor.
Blood Pressure Optimization
- Non-exercise systolic blood pressure (top number) generally should be maintained in a range of 105 to 110.
- Blood pressure medications may include long-acting beta blockers, long-acting ACE inhibitors, ARBs and a calcium channel blocker if needed. The addition of a low-dose diuretic may also be needed for those who retain water. These medicines can only be used if the patient is not allergic to them and there are no other contraindications.
- A home blood pressure machine would be helpful to monitor your blood pressure on a daily basis. The digital type is simple and convenient to use. Please be sure the one you choose has an arm cuff. After purchasing it, check the accuracy of the machine by taking it to a doctor's office and having its readings compared with their equipment.
- Keep a daily record of your blood pressure to provide to your physician when asked for it. Generally, monitoring blood pressure twice daily for a period of seven to 14 days will help fine tune the medication dosages and optimize blood pressure control. Once that goal is reached, you may follow up with your primary care physician for future medication adjustments.
Exercise and Diet
- Maintaining an active lifestyle, including cardiovascular exercise, is strongly recommended. Strenuous activities, including heavy weightlifting, should be avoided. Specific exercise recommendations should be discussed with the treating physician.
- Changing nutritional habits to a diet low in fat and carbohydrates and high in fiber and protein is recommended.
- Smoking is a risk factor for aortic disease and should be stopped immediately.
- Passive smoking is also harmful. It is important not to breathe any second-or-third hand smoke.
- Systolic blood pressure can go as high as 300 from crack cocaine usage.
- Using crack cocaine, even once, puts you at risk of life-threatening aortic dissection (tearing) or rupture.
Blood Sugar Optimization
- Appropriate blood sugar levels are very important for the health of the cardiovascular system. Healing may be faster and the risk of infection is reduced after surgery, if the blood sugar level is kept between 90 and 110.
- If you are diabetic (defined as having a blood sugar greater than 120 and an abnormal level of hemoglobin A1C), it is important to consult an endocrinologist. Purchasing a glucose monitoring device for home use to monitor your glucose level, following an appropriate drug regimen that keeps your blood glucose level in the 90 to 110 range and maintaining balanced nutrition and daily exercise, you may be able to live a normal lifespan.
- The ratio of muscle to fat in the body is very important to overall health. The issue is not so much the weight of an individual as what makes up that weight. A heavy but muscular person is much healthier than a very thin individual who has lost their muscle as a result of unbalanced nutrition and inactivity.
- It may be desirable to have very little body fat. Both blood pressure and blood sugar levels are more easily controlled when the muscle-to-fat ratio is optimal. This may also strengthen the immune system and boost postsurgical healing, while at the same time decreasing the blood sugar level.
- A desirable muscle-to-fat ratio is best achieved by a balanced diet and a physically active lifestyle.
Dental and Oral Hygiene
- Aortic patients may be at higher risk of endocarditis and graft infection if they develop a dental or gum infection.
- Conscientious daily dental and gum care is important to avoid infection.
- Regular dental checkups are very important. Check with your physician or dentist about taking antibiotics prior to teeth cleaning and other dental work.
- Prior to surgery, echocardiography, MRI or CT with contrast may used to monitor the aorta.
- Echocardiography may also be used to evaluate the valves and chambers of the heart as well as the aortic root and the ascending aorta.
- A thallium test with adenosine may be used to evaluate the coronary arteries prior to surgery or other procedures.
- Shortly after surgery, a baseline MRI or CT will typically be taken. Follow-up tests are done on an annual basis - or more often if your physician recommends it - and compared with this baseline.
Maintaining a Positive Outlook
- Expert, proactive treatment of aortic disease makes possible the continuation of happy, productive lives. Focusing on personal goals and enjoying hobbies and leisure activities with friends and family, as well as meeting the challenges of every day living, are all important aspects of normal life. When medical care, appropriate diet and exercise, and diagnostic monitoring are all in place, those with aortic disease may live active, fulfilling lives.
- Aortic disease in itself is no reason to become an invalid or "couch potato." Doing so is neither physically nor psychologically healthy. Assuming no other conditions are present that might restrict your activity, long periods of boredom, gloomy thoughts and inactivity should be avoided. Fully participating in your treatment plan, including the medical, dietary and exercise recommendations previously described, positively affirms that you, not the disease, are in control. You need not feel victimized by this condition. There is a great deal that you, in partnership with your healthcare professionals, can do to confidently live your life
- When it is time for elective surgery, there are technical advances available aimed at achieving the best possible outcome. Following surgery, ongoing medical care, diet, lifestyle choices and a positive attitude are key factors in the pursuit of a normal, active life.