What makes ascending thoracic aortic aneurysms increase in size?

Surgery depends on more than the size of the aneurysm. I am 5’2”, 103 lbs. I had surgery when mine was at 4.7. So don’t just go on the size of the aneurysm , other factors go into play.

I am right there with you moonboy. God does not always reach down with his almighy arms and heal us. He shares that blessing by working through highy trained medical providers, ie: Cardiothoracic Aorta Specialist. I have seen that personally, Years ago I prayed and prayed for Gods hand to tough my body and heal it. I could not understand why he did not hear and heed my deepest most earnest prayers. Through a series of events, I was referreed to a surgeon who gave me a whole new lease on life. It was only afterwards, that I realized God was blessing my surgeon by enabling him to successfully remove my ailment. We were both blessed by God.

A CT scan in May 2024 showed my AAA at 4.6cm. Another scan a few weeks ago, has shown it still at 4.6cm. My surgeon doesn't want to see me for another 2 years. He said he wouldn't do anything until it reached 5.5cm anyway. I am 80 years old, & I was told that I was more likely to die with it, than from it. In a way I guess that's encouraging, as i'm still reasonably active. I walk up to 3kms, 2 or 3 times per week. I go to the gym for an hour, 3 times per week. I'm also an active fly fisher and wildlife photographer. So I am regularly out and about doing something.
What has disturbed me, is that when I asked the surgeon what my limitations should be, re strenuous exercise, weight lifting etc. He said there are no restrictions. I can lift weights & do cardio sessions without any limitations. It won't affect the aneurysm in any way.
This advice seems to be contradictory to anything i've read here. So, i've decided to throw caution to the wind, & keep up with the cardio, but restrict any weight lifting or pulling to a minimum, as I have been doing.
I do need to lose some weight, & the 16/8 diet i'm on, is helping with that. Since beginning, 2 months ago, i've lost 5 kgs. I want to lose another 5kgs, but the weight loss seems to have plateaued, but i'll keep at it.
I live in regional area of Victoria in Australia. The surgeon has to travel over 300kms once a month to see patients here. So it's not like I can make an appointment with another surgeon for a 2nd opinion.

My aneurism as-sending arortic
I have my yearly CT tomorrow. The last one was 4.1. It had grown .1 in one year. My cardiologist is not worried. I am 69 and he said I will probably die from something other than the aneurism .
So I don’t understand the worry about a 4.3. My dr said he doesn’t even call it an aneurism. He calls it a dilation . I hope we all will be okay.

Not certain you are asking about HIIT increasing the size of the aneurysm, but here goes anyway. My impression is that growth and dissection are closely linked to blood pressure. Blood pressure rises the more intensely you work out. If you've had a stress test, you can see that on the test results. Another factor seems to be how quickly you go from low to high intensity. If you raise the intensity more slowly, your BP does not spike as high as with an abrupt change. In your place, I'd discuss this with whomever is managing your aneurysm. 4.9 is in the range when I would get a bit more cautious. But everyone has their own take on this situation. Good luck!

I’m curious why the doctor you saw did not suggest surgery for a 6.3 aneurysm? I would think with symptoms surgery would be warranted.

I really think some Doctors (depending on their specialty) who are not board certified in matters of the heart and major, serious medical issues like aneurysms, just do not want to seem like they are not the experts we have come to expect. My doctor found my aneurysm with a stethoscope, sent me for an ultrasound, changed his mind, did not inform me. Got to hospital & had to adjust to a CT scan with contrast for an unknown abdominal problem. When asked for my aneurysm size in cm's, the doctor could not find them but thought via memory that they were Ascending aortic Aneurysms: a Root @ 4.5cm and a regular @ 4.1cm. He just could not see why I was so interested in knowing my numbers. Yet, everyone on this cite knows theirs. Go figure. Been a year & still do not know my numbers for sure.

You need to find a doctor who's experienced and shares information with you. This is not acceptable IMHO.

"Watch and wait" is easy for doctors to say, isn't it? It isn't their aneurysm.

If it is any consolation: at least you are not far from when they can go in and put a sleeve on it, or repair it, whichever the case may be.

Have a firm and frank discussion with your provider, in person; let him/her know that because you are so very concerned, your blood pressure is likely spiking.

Some things you can do now are:
1) check your BP 2-3 times a day and keep it under control;
2) not lift heavy things over 5-10 lbs;
3) not strain when difficult bowel movements occur;
4) don't do valsalva maneuvers;
5) strain toward reaching orgasm;
6) exercise to the point of maximum heart rate; exercise is still important as an aorta is a muscular vessel, so it does need exercise and walking is the best for now; but check with your doc about what exercise to do and not do....

High BP and pressure of lifting on the aneurysm can cause it to increase in size, depending on MANY factors, and not knowing all the details about this aneurysm, I cannot say which factors - only your doctor knows those details).

Arteries are like a rubber band, stretched an average of 70 times an hour. Your rubber band (aorta, which is the largest rubber band in your body) has developed a bit of a thin spot or beginning of a tear (rather like a hang nail). You don't want to over stress it, but you also don't want to stop all exercise, because exercise keeps arteries strong and healthy.

Aortic aneurysms are very common. You are doing well, they are monitoring you closely. See if the doctor can get approval to go ahead and fix it if you want to just stop worrying.

OR just be calm, matter of fact and live with it until they say it is time.

Entirely agree. The only reason a doctor has MD behind his or her name is that they managed a good GPA for a bachelor's degree and got mostly "Pass" in all their medical school Pass/Fail courses.

MD does not equal "a good doctor".
They put their pants on just like the rest of us.

"Board Certified" is mandatory in my assessment of physicians. I've worked among all sorts of them for over 40 years both clinically and administratively - managing them and their practices - and they are just like all humans and have all the failings of humans.

Cavet emptor.