Hi.
My aneurysm is 4.2. My understanding is that high blood pressure, smoking and genetic factors or conditions (like Ehler's Danloos) are risk factors.. I have none of these so my anerysm is considered an anomaly. 4.1 is "barely an aneurysm" according to my doctor as, for my size (5'5"), 3.8 is normal size for artery. Your aneurysm size should be considered vis-a-vis your size to see what the risks are. In my experience with a caring cardiologist, there is no "apathy" about this condition. I am monitored yearly (for 2 years now, with no changes). My potential surgeon and I spoke about the open heart surgery I will need if it grows bigger and the surgery was said to be almost routine (for someone in good general health). It's a tough recovery that takes a while - ("in 6 weeks, you'll feel no pain, and in 12, you won't remember it."). I'm 66, so my job is to keep myself in great health through great nutrition (very little sugar, lots of variety of fruits and veggies, enough protein as I age) and to exercise (walk and weights) to the extent I'm able without elevating BP above 180. I'm optimistic, but it does take much maintenance and lifestyle management. I don't drink (at all, except a sip of my boyfriend's wine now and then on rare occasions) and gave up caffeine, too. I work out with a trainer 2-3 times a week and walk routinely. Much of this quells my anxiety as I know I'm doing all I can do. I control what I can and that leads to less perseverative worry. I hope this helps.