I'm in a very similar situation as you. I have a 4.5 aortic root aneurysm. My blood pressure got up to 197/124 pulse at 53 in April of 2024. I went the emergency room. Dr ran a whole bunch of test. The minute I told him about my aneurysm. He completely changed. He said that their hospital was not equipped to handle my situation. Told me to go home an call my cardiologist in the morning. Most of the blood work he had ordered had came back abnormal. But he didn't want to talk about any of it. I was disheartened about the whole situation. I'm from a small community that I really enjoy. I don't want to move to a urban community just have a hospital ready to help. I guess if anything does happen I'll have to rely on life flite.