I fully dissected at age 50. I am now 61. It’s totally normal to feel thrown off after being told you have a 4.7 cm ascending dilation, especially when training has been part of your identity for decades. The hard part isn’t the exercise itself—it’s sorting through all the mixed messages. Here’s the reality most aortic docs agree on: the danger isn’t movement, it’s sudden blood-pressure spikes. Heavy straining, breath-holding, grinding reps, and long isometric holds can all send your pressure way up for a split second, and that’s what you’re trying to avoid.

Cardio is generally the easiest part. Swimming, biking, steady treadmill work—these are almost always safe if you keep the effort smooth. A heart rate under about 150 matches what a lot of people in your situation have been told, but honestly the more useful indicator is whether you can breathe normally and stay out of that “I’m pushing hard” zone. Strength work gets trickier, not because you can’t do it, but because you have to approach it differently. Think lighter weights, higher reps, smooth breathing the whole way, and absolutely no bracing or bearing down. If you feel yourself clenching or straining, dial it back. Pushups, rows, TRX work—these can still be fine as long as you keep them moving rather than holding long static positions. Planks are okay in shorter bursts if you keep breathing, but not those minute-long, grind-your-core versions.

The exact pound limit isn’t the point. Whether it’s 50 pounds, half your body weight, or some other number, what really matters is staying in a range where you never feel forced to strain. If you can do a set of 12–15 reps smoothly, with zero urge to hold your breath, you’re in the zone. You don’t have to give up being active. You just have to shift from “training hard” to “training smart,” and once you settle into that mindset, it gets a lot less confusing. Peace.