Physical uncovers potentially deadly aortic aneurysm in Indiana teen

On the last day of school, an Indiana teen found out he had an aortic aneurysm — and was whisked to Louisville for lifesaving emergency surgery.

Dominick Smith spent the first week of summer break at Norton Children’s Hospital. While it wasn’t the ideal way to wrap up the school year, the junior from Petersburg, Indiana, was grateful. On the last day of school, a doctor discovered Dominick had an aortic aneurysm with aortic dissection — a potentially fatal time bomb that could have gone off at any moment.

Dominick was at wrestling practice at Pike Central High School. That day, there happened to be a retired doctor with a machine to do an echocardiogram, which uses ultrasound to take pictures of the heart.

“Since it was the last day of school, I wanted to skip, but a retired doctor was doing free physicals, and mom wanted me to get that,” Dominick said.

According to Dominick, his echocardiogram took a bit longer than the rest of his teammates’, and that’s when the doctor called in the wrestling coach and then set Dominick up with a hospital in Jasper, Indiana, the next day. A CT scan confirmed the suspicion.

“They basically said, “Your aorta — it’s very enlarged,’” Dominick said.

Dominick had a massive aortic aneurysm with evidence of aortic dissection. The main artery that carries blood from the heart to the rest of the body was triple the usual size. And the vessel already had begun to tear. One blow to the chest could’ve ended Dominick’s life in an instant.

“It’s like a balloon. You keep blowing it up, eventually, it’s going to rupture,” said Bahaaldin Alsoufi, M.D., chief of pediatric cardiothoracic surgery at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine.

There was no time to waste. The Norton Children’s Hospital “Just for Kids” Transport Team picked up Dominick and flew him to Louisville for open heart surgery that night. Dr. Alsoufi successfully performed the five-hour operation.

Kids are going back to school, so be sure to get in for your annual checkups and sports physicals soon.

“Considering the acuity of his condition and complexity of the needed surgery, Dominick did great and had excellent recovery from his surgery.” Dr. Alsoufi said.

‘You’ve got some guardian angel’

What makes Dominick’s story unique is aortic dissection and massive aneurysm isn’t a condition often seen in 16-year-olds, especially ones with no family history or known genetic issues. Additionally, the fact that it was discovered accidentally without him having any symptom makes it more unique.

“He was completely asymptomatic. No chest pain. No history of any trauma to the chest,” Dr. Alsoufi said.

Had Dominick skipped school and not had that test at wrestling practice, there’s a good chance the teen wouldn’t be here today, according to Dr. Alsoufi.

“I told him, ‘You’ve got some guardian angel,’” he said.

Getting back to life

Dominick is recovering from his surgery. Wrestling and other contact sports are out of the question, but he knows it’s a small price to pay for saving his life.

“Somehow, just everything aligned,” he said. “And for that I’m grateful.”

Importance of sports physicals

While echocardiograms are not typically part of an exam, doctors recommend all children receive yearly sports physicals with their pediatrician. At a sports physical — which can be done at the same time as the child’s annual wellness checkup — the medical team gathers background information such as any history of asthma and cardiac conditions, previous injuries, and hospitalizations.

During the physical examination, your provider will listen to your child’s lungs and heart, check their strength and flexibility, measure height and weight, feel their stomach, check their blood pressure and look in their ears, nose and throat.

Parents are encouraged to schedule a sports physical at least six weeks before school starts to ensure the child can participate in sports. If your provider raises a concern about your child’s ability to participate, this provides time to address the issue.