Question: I am hoping to have a cardio-thoracic surgeon answer my question, if not, then a cardiologist.

Over the last 6or 7 months I have experienced nagging and sometimes painful mid to upper back pain on the left. I have seen my primary care physician 4 times for this, and he took lung y-rays twice due to the area of my complaint. These were unremarkable.

In November, my doctor did a cardiogram and it showed arryhrthmia. I was passed along to a cardiologist, who did an ultrasound, a stress test, and a CT scan of the heart. The cardiogram apparently showed no occlusions, but the CT scan revealed dilitation of the ascending aorta, plus a left ventricle valve problem.

I have seen a cardio-thoracic surgeon and she did an excellent job of reviewing the CT scan with me and explaining the upcoming procedure (ascending aortic aneurysm repair). However, she was very explicit in stating that my ongoing back pain has no relationship to the aorta, and that the surgery might even cause me more back complaints.

This came as a big XXXXXXX to me since multiple online medical sources include back pain as a symptom of aortic dilitation. The prospects that the constant symptom I have sought help for these past 7 months (back pain) has not been addressed is very disappointing.

My back pain is there 75% of the time, and occasionally awakens me. I have much lesser pain in the sternum and it occurs less often. I also have no fatigue, shortness of breath, or other usual symptoms, and until last week was able to walk over 30 miles a week.

I am also concerned because surgery is a month away to allow me to get dental work done, but my back discomfort is growing worse. It was at a 2 or over 10, but in recent weeks has climbed to 6.

I am not sure how I would explain myself if the pain worsens and I go to the emergency room. I don't want them to miss an escalating heart condition because my pain in primarily on the dorsal side.

Please advise whether back pain is a possible symptom of a dlitated aorta. In the alternative, is it possilbe that I am misimterpreting the origin or focal point of my pain; instead could I be feeling pain from deep within me, i.e., region of the heart/aorta?

Thank you doctor for your response. I do have 2 follow-up questions. But first, thank you also for your answer to my previous question about sedation during my angiogram. Turned out the doctor's staff thought I was asking for general anesthesia, but they did supply conscious sedation and I was fine.

The surgeon showed me in detail the aneurysm, but made no mention of aortic dissection. Would my recent CT scan have revealed aortic dissection or a tear if present? Although the cardiologist mentioned earlier aortic dissection, the surgeon did not specially discuss this in conjunction with the CT scan. As I understand it, an aneurysm can develop a tear, but again the surgeon did NOT state that.

Question 1) Should I assume there is no evidence of aortic dissection at this time?

Question 2) What symptoms are associated with aortic dissection? You mentioned that aortic dissection can cause pain. Can you state where that pain would be and at what pain level. I do no wish to confuse my back symptoms with any actually related to the heart.

Actually the surgeon was sympathetic to my plight regarding back complaints and urged me to seek out an osteopath for evalutlon. And, as you advised, an MRI of the spine is probably indicated after 7 months plus of back complaints.

Thanks for all your expertise in sorting through this with me. May I reserve the right to contact you again as things progress.