New diagnosis of ascending aortic aneurysm and I’m terrified

@booklover71
Thank you! I wish you continued good health and blessings.

@hercules
To your questions, I was 65 when I had my ascending aortic aneurysm surgery. They found one at about 5.4cm a second aneurysm while fixing the first one. It all turned out fine for me. I had some post-op issues but they mostly disapated a few months post surgery. It has been 1.5 years now and I am back to doing all my pre-op activities... hiking 8-10 miles in the Rockies, biking 50+ miles weekly, walking regularly, etc.
If you have a 4.2cm aneurysm, I'd not worry too much... just keep an eye on it like you are doing to track it's growth rate. They probably won't operate until it has grown to >5cm so don't fret it. When I was your age, my aneurysm was probably at your current levels and I was blissfully ignorant and nothing untoward happend...

I think everyone is different. I was told when I was 53 I had an ascending aortic aneurysm at 4.1 cm. Last year at 70 , it reached 5.3 cms and I had the full ascending aorta replacement and my BAV repaired. It was a big surgery and took a while to bounce back- but definitely worth doing. At 4.1 it’s pretty small and I was getting an echo every 6 months. When ( If) you have the surgery you need to go to a center that does these regularly , as there are a lot of things to consider with a full heart- lung machine surgery and the team that is in place to facilitate this type of surgery. Good luck- and you probably have many years of low growth time to see what happens.

Cuando me diagnosticaron por hallazgo buscaban litiasosen los riñones, como comentan se me vino el mundo encima sali con 4.3 cm en el año de 2021, en julio me hice un TAC con contraste y subio a 4.7 cm, dice mi angiologo que aun continue en vigilancia, soy de mexico y cuando me lo detectaron no ECONTRE NADA DE INFORMACION EN ESPAÑOL, actualmente ya ya existe mas informacion, pero pienso que hay muy pocas recomendacion en relacion a lo que si pudes hacer, inclusive yo he ido con varios medicos y algunos nomas me asustaron exageradamente.

I think every case is different but being concerned and cautious is normal and getting into a support group is helpful. Know what to do and do it and then try to let go of worry.

@drobledo no se si hay muchos que entiendan/hablen español en este foro. Por lo pronto, yo tuve un aneurisma aórtico ascendente de 5.2 cm, reparado en el 2020. Con 4.7 cm el suyo está llegando al tamaño crítico ~5.0 cm, el cirujano decidirá cuando es momento de repararla depeniendo de varios factores, el tamaño del aneurisma, el tamaño de su cuerpo, los riesgos de la operación, la historia familiar, etc.
Es muy importante que continue la vigilancia periódica con su especialista, un cardiólogo que se especialice en enfermedades de la aorta y empiece a buscar al mejor cirujano cardiotorácico que tenga disponible, alguien que tenga mucha experiencia en este tipo de operaciones. Lo mas crítico cuando se tiene un aneurisma es controlar la tensión, tensión alta es el peor enemigo de un aneurisma, debe asegurar que tiene la combinación de medicamentos que le ayude a controlarla. Mantenga su cuerpo sano, si fuma deje de fumar, manténgase activo pero sin hacer esfuerzo que lo lleve a aguantar la respiración (como levantar pesas muy pesadas, algunos abdominales, etc) , se sabe que durante esos momentos la tensión arterial sube significativamente. El objetivo es estar lo más fuerte y sano posible cuando y si en algún momento necesita la operación, que a la velocidad con la cual la suya ha crecido es probable.

Lo importante es que usted sabe que la tiene y puede monitorearla y planificar tratarla, muchas personas no tienen esa oportunidad.

Espero todo salga bien

Your fear is understandable and uncomfortable , but I , like you , am more concerned than I have been about my heart surgery and side effects of that over the past ten years . The aneurism issue can be a slow grow , slow kill, at times not even painful event . You might die from something else , a bit like a long prostate issue .
Re the fear - it sounds scary - I said I wanted numbers . Percentages , likely progression etc .- the lady surgeon gave it to me - could be a few months , maybe as much as two years , possible paralysis , choking, smothering , loss of speech …… scared me senseless!!!
BUT the human body is like a fancy car - lots of bits and pieces . Wires. Microchips, sensors, valves, different pressure levels, liquids, filters . Stuff flowing , coming and going . Moving, twisting , waking . Sleeping , getting hit , cold , wet and dry . Amazing that any of us are even alive last 70! Make the most of every minute, hour and day . Be careful crossing roads , talking when eating , and watch for pieces of chicken bones in pies .
Lots of stuff just waiting to kill you ,
Stay away from desserts and sexual physical stuff , well at least desserts! Smile and take what comes - seems like you have no choice !!!! Be happy !!!

@moonboy
I am glad I decided to read comments, because like some others have stated no doctor told me not to lift anything more than 40lbs. I am overweight and I have high blood pressure, so I have been working with a trainer doing weights and circuit machines lifting over 40lbs. No one said anything to about the other things i.e. Marfan's syndrome or some identified genetic markers. The cardiologist didn't say anything close to comments I am reading and just made me feel like I was concerned for nothing. I was hospitalized for a few days 2 weeks ago because they thought I was having a stroke. My aortic aneurysm increased a little more than the average .01 in a year. It went from 4.1 in May of 2024 to 4.3 a year. I am wondering should I be concerned?

I know exactly how you feel reading those comments and realizing how little guidance you were given. After my own Type A dissection and open-heart surgery with a Dacron graft in 2015, I learned that the absence of warnings doesn’t mean the risks aren’t real. Many cardiologists still underemphasize the mechanical stress that heavy lifting and straining can place on the aortic wall, especially in people with hypertension or borderline aortic dilation. The general goal is to minimize sudden spikes in blood pressure—the kind caused by lifting weights, bearing down, or holding your breath during exertion. Even though your aneurysm is currently 4.3 cm, that increase from 4.1 cm in a year is worth paying attention to. It’s not catastrophic, but it’s faster than the typical 0.1 cm per year average growth rate. That suggests your aorta might be under more hemodynamic stress than ideal.

Given your weight training and high blood pressure, it would be wise to revisit your exercise plan. Emphasize aerobic conditioning—walking, light cycling, or swimming—while avoiding any lifting or resistance that causes you to strain or hold your breath. Stay under that 40 lb limit until a specialist familiar with thoracic aortic disease (not just a general cardiologist) reviews your case. Also, make sure your blood pressure is tightly controlled, ideally under 120/80 mmHg with medication if needed. If you haven’t already, ask your doctor whether you should be evaluated for connective tissue disorders or genetic aortopathies like Marfan’s or Loeys-Dietz, especially if you’re younger or tall with long limbs, or have a family history of aneurysms or dissections. Those conditions can affect surgical thresholds and follow-up plans. You were right to be concerned—your instincts are spot-on. Keep monitoring your aorta with imaging at least once a year, possibly every six months given the recent change. You’re not overreacting; you’re being proactive. Peace.

@monica6287 I just want you to know that my aneurysm also grew 2 mm in one year. It’s not abnormal, it is just at the high end of normal. I don’t believe my cardiologist was the least bit concerned. The growth did make him change his mind about changing my imaging to every other year.
I agree with Moonboy that there are risks. But, in the lower numbers risks are rare, so do not worry about things that could happen! Relax! Take care of yourself, but, enjoy your life!!!