A 3.5 cm ascending aortic aneurysm is something to take seriously, but the good news is that at this size, it’s usually manageable with monitoring and the right lifestyle adjustments.

Aneurysms like this typically grow slowly—about 0.1 to 0.2 cm per year on average. So, if everything stays stable, it could take 10–20 years to reach 5.5 cm, which is when surgery is usually considered. That said, some things can make it grow faster, like high blood pressure, smoking, or certain genetic conditions. If any of those apply, it’s worth addressing them right away.

The key is regular check-ups. Most doctors recommend imaging (like a CT scan or echocardiogram) every 6–12 months to keep an eye on it. If it’s growing faster than 0.5 cm in a year, they may talk to you about earlier intervention.

In the meantime, there are things you can do to keep it stable:

1. Keep your blood pressure under control—medications like beta-blockers or ARBs (like losartan) are often helpful.
2. Avoid heavy lifting or intense physical strain, as those can put extra pressure on your aorta.
3. If you smoke, quitting will make a big difference.
4. Stay on top of your overall heart health—diet, exercise, and managing cholesterol all play a role.
If you haven’t already, it might be worth seeing a specialist who focuses on thoracic aneurysms. They can give you a clearer picture and talk about any next steps based on your specific situation.

I previously had a sudden complete Type A-1 aortic dissection. Mine has been stable after two emergency open heart surgeries 9.5 years ago. I'm at 4.1cm. I hauled 600 lbs of black dirt this weekend and worked HARD around the yard and garage. I am 60 years old, 6ft and 248lbs. You're going to be fine. You know you have a problem and you're doing something about. Peace.