Exercise, Lifestyle and Life Experience with Dilated Aorta?

@houston13 That’s a really informative video.

My husband had a similar diagnosis back in 2007, i.e., an aneurysm was 4.3 cm. He was told it was okay for his height and weight. He did nothing to change his lifestyle, listing heavy stuff, etc. It was unfortunate but we had "no clue" - I am not even sure that we knew the significance of the ascending aortic aneurysm. I sure don't remember it. We seriously woke up when his first cousin, who is one month older and a "fitness nut" was found dead on the bedroom floor with a ruptured aortic aneurysm in the same place as my husband's. His daughter, an EMT saved his life. He was airlifted to a large hospital (Abbott Northwestern) in Mpls where they did a fabulous job of repairing him. He is alive now with some deficits but he is alive.
Fast forward to 2021 and my husband was assigned to a new cardiologist cause the old one accepted a different type of job elsewhere. This new cardiologist ran an echo and then an angiogram with contrast. By now, his aneurysm had grown to 4.8-4.9. It has remained stable (last measured May 2024). He will have yearly tests although his potential cardiac surgeon said he could skip a few years. We have decided not to do that and will do it yearly.
A lot depends on whether you have vasculitis or any other risk factors. Find a cardiologist that specializes in ascending aortic aneurysms and also a surgeon. Community hospitals don't have the experience with this type of medical condition. Go to an academic center or a private center that does a whole lot of them. (For example: I don't know if the Cleveland Clinic is an academic center or a private entity.)
Good luck,.

@hsminc Mine is diagnosed 4.3cm of the root. I was told immediately to stop lifting heavyweights and doing things with heavy exertion. I still lift and run, bike, hike, at moderate levels. I hope I can get 17+ years with no problems. Even though his cousin had a dissection it doesn’t sound as though he has a genetic or familial component. Has he had genetic testing? It gives me hope. Thanks for posting.

@c130herkengineer Yes, he went through genetic testing but they tested him for genes related to Marfans. He also had a thorough physical exam and the only indication was his "flat feet." This was done through the company that does a whole lot of genetic testing. The bloods were drawn at Mayo and we received the results through Mayo.
Is this a genetic predisposition? I, honestly, don't know but I am suspicious there is some genetic component. This first cousin's father died of a ruptured aorta but we are clueless about whether it was an abdominal aortic aneurysm or an ascending aortic aneurysm. No exam was ever done; he was in his eighties at the time and this was in 197x. His doctor (rural Minnesota) and family just said it was "old age."
The first cousin also has a descending aortic aneurysm and an abdominal aortic aneurysm. (My husband has neither.)
This cousin was a weight lifter, runner, and coached his kids' and grand kids' baseball and other games. The VA where he received care "forever" thought the cousin was in fantastic shape. Of course, they had no reason to do CT or other scans looking for "trouble."
My husband's mother (sister of the above) had giant cell arteritis and the ensuing strokes/ruptures in her brain are what killed her - they called them massive strokes. She had vasculitis and died at age 85. Thankfully, the PET scan that my husband had done did not show vasculitis. If my husband had vasculitis then we would opt for surgery as this would be an important risk factor for rupture.
My husband is 81, soon to be 82. He is very active and in reasonably good health otherwise. We do not smoke nor drink. We walk 3-4 miles every day, including up some pretty steep hills.
Since my husband was diagnosed with this aneurysm almost 5 years ago, he has not lifted anything heavier than 30 lbs and is basically careful. He has never been a weight lifter but did lift heavy stuff around our home. No more.
Hope this is helpful.

Hsminc: I have exactly what you have. ATAA: 4.2, Root 4.5. That was a year & 1/2 ago. Same reactions: depressed. Have weights & downhill skiing. Go to gym 3-4 times/week. 200 lb male and just turned 89. I know, everyone thinks I'm 70's. But this disease does not care about your age, just doctors do. I think they are vague due to our litigious society. Yesterday I was curling with a 40 lb cable and took blood pressure right after. 170/79 pulse 78. No clue that would go that high. Researched & found 180/95 = an immediate medical attention if it does not drop. New target = 160/75. Don't want to depress you further, but knowledge is power. Researched in medical library disclosed that doctor's have relied on aortic diameter to determine disease severity & risk of rupture & acute dissection. Blood pressure control is done with medications. However, AWS (Aortic wall stress) has generally not been measured. This could account for younger patients with controlled blood pressure still experiencing acute Aortic Aneurysm problems.
AWS = systolic B.P. X Aorta Radius divided by Aorta Wall thickness.
So, why don't they measure stress on aorta's walls? It's difficult, no way to do that yet except on cadavers. So, like the song says, "don't worry; be happy" because even with aneurysm's open heart surgery, the success rate is 98%. You will be there for your daughter and by then, the success rate should be 100%. Good Luck!

@dew88 just a comment, it is known that while exerting your BP spikes significantly especially if your holding your breath, and starts coming down immediately after the exercise/rep from its peak so if you measured 170/79 right after, the peak was actually higher.

I asked Dr Prakash once about ways to measure BP while exercising, and he told me there is absolutely no way for someone to do that, the current methods are just too sensitive to movement.

@hsminc

Cleveland Clinic is a non-profit multispeciality academic center. The invented the Bentall procedure. I ended up having an emergent Bentall procedure during my open heart surgery Sep 10, 2024. I was having three major procedures done. We planned to not do it that day since surgery was already going to be about 8 hours. It was 4.7 at the mid ascending aorta and 4.8 at the root. However, the root ruptured and aorta tore so the Bentall was done. We had discussed 3 scenarios and options depending which is good because the surgeon had the materials ready just in case. I was in surgery between 10 and 11 hours and lost 3.5 liters of blood. I wouldn't blow of monitoring a 4.8 to 4.9 ascending aorta or root for "a couple of years" and would fire that surgeon. I still have a 4.6 cm ascending aneurysm on the native aorta on the distal end that we are monitoring with CT contrast and echos no more than a year apart. I have been getting care through Mayo Clinic in Jacksonville. Something we take for granted is that the aneurysm may not be the only issue going on. I was 60 when that went down. The aneurysm was found 2 years ago and 9 months later I was in open heart surgery and that wasn't really on the radar 2 years ago.

@rlhix Wow! What an amazing story. You had superb care and being in excellent physical condition too did not hurt! You were and are young.
We have both gotten all our care at the Mayo Clinic in Rochester. It is almost 1400 miles away but when you have been to a facility for 30 years there is a degree of comfort and feelings of “home.” We stay in the same hotel every time and try to reserve the same suite of rooms.
We have been to Mayo JAX and that would be a good alternative but it is not as familiar nor as easy. We like having our shepherds with us and being able to walk to the clinic and hospitals.
You have had an incredible journey. Best wishes for many more miles of “good road.”
Get

@beebo That is a great video. Is really learned a lot from it.

Here’s a related question: Is there a difference between an aortic aneurysm and a dilated aorta? Thanks!

@beebo It has to do with the ratio of the size it is supposed to be to what it actually is at the time. For me a 4.2 or 4.3 would be considered mildly dilated where as 4.4 is moderately dilated and some would say aneurysmal at that point. It is semantics at that point.