Short answer: YES. Avoid them. With chiropractic adjustments, it's wise to proceed with caution. With an ascending aortic aneurysm, particularly one that has grown, there’s potential risk with sudden or forceful movements, especially to the neck or upper back. Your chiropractor was right to express uncertainty. It might be best to avoid adjustments until you've had a conversation with your vascular surgeon to ensure it's safe based on your specific condition. Gentle therapies like soft tissue work or mobility exercises might be safer alternatives in the meantime. If you don't have a vascular surgeon yet, it's time to start shopping. A cardiologist is not going to save you and they're not the ones that have to open you up and fix your aorta. You wanna make friends with the best thoracic surgeon in your area who is done hundreds of these aortic grafts. Your life depends upon it. One of the things I learned was that cardiologist are super good at prescribing drugs to lower your blood pressure and or eliminate bad cholesterol. If you have an interventional cardiologist, they know how to put a stamp in. The condition that you have is not going to be treated with a stent and is not going to be treated with a pill. The only way to fix an ascending aortic aneurysm, is to open up your chest and stop your heart before fixing it. It is amongst the most complicated surgeries in the world. It is not the kind of thing that a cardiologist does and it is not the kind of thing that I would take advice from a cardiologist about. Thoracic surgeon is what you need.

I used to get adjusted all the time, and I honestly believe that the force of the adjustments were such that it's possible that my chiropractor inadvertently either exacerbated or caused my ultimate dissection. I saw a chiropractor between the ages of 38 and 45 fairly regularly and he was a big guy who delivered a heck of an adjustment. When I did decide, and I learned that one of the things that causes an aortic dissection or sudden increases in blood pressure and or from the chest, I thought back about the adjustments I've gotten from him. He was a great guy, but he was huge and he would come down on me super hard to the point where it would crack my back, but it would also knock all the air out of me. It felt great afterwards, but in retrospect, I think it was a mistake to have this chiropractor, who was actually honest to God a former Mr. Teenage Universe, cracking my back. He also did a neck snap adjustment once that I specifically told him not to do and he did it anyway. That made me very uncomfortable and made me very untrusting of him and so I stopped seeing him after that because I had pretty serious neck pain for several months after that.

As for exercise, it’s wonderful that you love cycling and want to stay active. Balancing your activity with your condition is key. While your cardiologist has encouraged you to push through, it’s important to listen to your body and not overdo it. An e-bike could be a great option to take some strain off while still letting you enjoy the activity. Unless you've got a trained and heavily experienced thoracic surgeon, giving you that advice, I'd be very cautious about any Doctor Who told me to push through if I had an aortic aneurysm. Having dissected myself, I can assure you that the last thing in the world you wanna be doing is spiking your blood pressure with wind, sprints, deadlifts or planking. There's a lot of ignorance even in the medical community about what this condition is and what can happen, so educate yourself and don't just assume that because the doctor tells you to do it that it's a smart thing to do. After I dissected and had a median sternotomy, my general practitioner suggested that I join him for a kickboxing class. As much as I love my GP, his suggestion was tone deaf at best. Again, the last thing in the world you wanna have is to get kicked in the chest after you've been cracked open and then wired shut. 10 years out from my surgery I still feel very vulnerable and will until I leave this earth.

For heart rate, the general recommendation is to aim for a moderate intensity level—often around 50–70% of your maximum heart rate—but this is something you should customize with your doctor. Since you’ve been diagnosed with A-fib, your "safe zone" might be different. Using a heart rate monitor could help you stay in a range that feels manageable and doesn’t exacerbate your symptoms. You’re doing the right thing by staying informed and advocating for yourself. I wish this listserv was around when I detected in 2015. Would help me answer some questions. Peace.