When that happens, the aortic valve, one of the structures of the heart that prevents blood from going in the wrong direction, can malfunction. And when blood starts flowing backward instead of forward, that can cause problems such as the chest pain and difficulty breathing M.E. was experiencing. And one of the major risk factors for a thoracic aortic aneurysm is high blood pressure, which M.E. had had for more than 20 years.
But there was something different about M.E. About the same time she began experiencing chest pain and difficulty breathing, she also began forgetting things. It started with small things, like where she left her keys or parked her car. For a 63-year-old woman, it didn't seem too unusual. But slowly, the forgetfulness progressed. She began forgetting people's names and what had happened a week ago, a day ago, an hour ago. She feared she was experiencing what her mother had gone through years ago: Alzheimer's disease. With no desire to be given that diagnosis, M.E. never sought medical attention for her memory loss.
At first, M.E. did not want surgery, the typical treatment for ascending aortic aneurysms. She is a Jehovah's Witness, and few surgeons are comfortable operating on the aorta of a patient who refuses blood products. But as M.E.'s doctor tried to manage her aneurysm with medications and watchful waiting, the chest pain and difficulty breathing got worse and she elected to have the operation.
The surgery itself went smoothly - there was minimal blood loss, no blood products were required - and only five days after surgery, M.E. was able to get out of bed and walk with assistance.
But the plot thickened when pathology reviewed the routine surgical specimen.
With most aneurysm repairs, a piece of the aorta is examined to try to determine what caused the aneurysm. When the pathologist looked at M.E.'s tissue, she saw something unusual, something not seen when high blood pressure is the cause of an aneurysm: "extensive lympho-plasmacytic chronic inflammation" - a lot of white blood cells that shouldn't be there. So if high blood pressure wasn't to blame, what caused M.E.'s aneurysm?
The solution is on G7.