am I exercising too much with a 4.3 ascending aortic aneurysm?

Posted by kmailloux @kmailloux, Mar 15, 2023

I am a 60 year old female, who has been very active her whole life. I was a very competitive gymnast, then moved to triathlons, then to cycling and running, strength training has always supported these activities. I am a certified personal trainer, and the aneurysm is a new diagnosis as of Dec of 2022. it was shocking - I now have a heart condition. I ran a marathon 2 weeks after I turned 60. My Cradic surgeon has stated that I can train for a 50k (31 miles) race, as well as a 150 mile bike ride. I have a 50 lb lifting weight limit. My BP is low and I am on no medications. My questions are .. is the activity too much? I run 5-6 days a week plus strength training and biking. I have mild chest pain - all of this has been told to my doc. they keep telling me everything is ok - I am just so nervous about all of this - but want to keep doing what I love. Any input will be appreciated.

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Profile picture for dew88 @dew88

@gladifoundthissite Same thing, diagnosed with a mitral valve prolapse 12 years now and no problem,. Also 1 year diagnosed with a ATAA 4.2 and so far no follow up recommended by my primary care doc. But will start looking for a cardiologist to determine what the status is on that currently. I am beginning to think that a lot of diagnosis'' are sounding a little like common medical cliche' For example; "due to your size, that is big" or keep up the exercise", etc. rather than ask what type of exercise do you do, then discuss his recommendations based on your answers. Why do they do that? Maybe its because they cannot be sued for issuing medical cliche' type answers.

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@dew88 unfortunately not all Drs are familiar with the latest in aortic research, you need a cardiologist who is an expert in aortic diseases and communicates with other researchers who study the effects of multiple factors on aneurysms ((like exercising) , hope you find one near you, it makes a difference

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Profile picture for dew88 @dew88

@gladifoundthissite Same thing, diagnosed with a mitral valve prolapse 12 years now and no problem,. Also 1 year diagnosed with a ATAA 4.2 and so far no follow up recommended by my primary care doc. But will start looking for a cardiologist to determine what the status is on that currently. I am beginning to think that a lot of diagnosis'' are sounding a little like common medical cliche' For example; "due to your size, that is big" or keep up the exercise", etc. rather than ask what type of exercise do you do, then discuss his recommendations based on your answers. Why do they do that? Maybe its because they cannot be sued for issuing medical cliche' type answers.

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@dew88 see the below interview with Dr Prakash he talks about the issue and some of his efforts to share that knowledge

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Profile picture for kmailloux @kmailloux

Oh my goodness! I would be getting a second and third opinion as soon as possible. Number one that cardiac surgeon would have been fired! At least from my patient care. Mine had to go into an emergency surgery while I was there, which was totally understandable, I was not as high risk as you. And the PA had spent 45 minutes with me. I felt very confident that this was an emergency situation and I would be considering getting a new primary care physician as well. This is a serious condition. They should be calling you back they should be giving you guidance not walking out of the room!

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@kmailloux With my Ca score of 2814 and a 4.2cm aortic aneurism I was pleased to hear my cardiologist schedule me for a CT angiogram with dye to pinpoint the plaque on my first visit. We will go from there and I'm worried but satisfied for now.

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Profile picture for gamecock77 @gamecock77

@kmailloux With my Ca score of 2814 and a 4.2cm aortic aneurism I was pleased to hear my cardiologist schedule me for a CT angiogram with dye to pinpoint the plaque on my first visit. We will go from there and I'm worried but satisfied for now.

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@gamecock77 That is exactly what my Ca score is and my aneurism is. I am waiting for a CT angiogram to really pinpoint my plaque situation. LAD score was 2200 alone.

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Profile picture for lfaison @lfaison

Recently diagnosed with < 2.5 abdominal aneurysm, was a shock, third medical strike in 9 months

Been active for my 65 yrs, 6’ tall, 165lbs, gym rat, runner, skier - water & snow, but the medical issues are piling up, e.g. mild stenosis, weakening heart valve… Docs haven’t dictated changes in my athletic activities, I have started Rapatha, aspirin, weekday abstinence;

Docs say I Inherited bad genes, from maternal parent/grandparent…

Continue living life to the fullest

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@lfaison definitely “Live life purposefully…to the “Very Fullest”
I was diagnosed about 2016 with an aortic aneurysm. My doctors have watched it closely for its growth. Happy to say things have been behaving. I have to be mindful when seeing other Drs for other reasons, to mention the aneurysm so that they too are made knowledgeable of my condition.

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Profile picture for andytheman @andytheman

I have a torn aortic aneurysm in my abdomen. It only measures 3 cm but it is torn. I went to a hospital emergency department for an unrelated issue and the doctor walks into my exam room and said “we are going to transfer you to a trauma hospital for emergency surgery”

I asked why and he said that a CT scan showed that I had a torn aortic aneurysm. I said ok then was transferred to a trauma hospital. While in the trauma hospital a cardiovascular surgeon said that I would have to come back into the hospital but right now it isn’t bleeding so we feel that you are stable enough to be discharged. I felt uncomfortable with that but I accepted it.

The cardiovascular doctor said for me to see my cardiovascular surgeon ASAP. I made the appointment with him for the next day and he laughed and said “I don’t see anything through a sonogram.”

He was obviously Annoyed that I dare visit him and he was quick to attend to the patients that had appointments that day.
He poo pood the whole appointment and he walked out saying “all hospitals say ASAP and we have ways to take care of these things!”

What if I’m briskly taking a walk and I collapse? Most people would think I had a heart attack and push on my chest. That would do nothing and I could die as burst aneurysms are usually fatal. As he was walking out of the exam room I asked him if could burst and he said “it could!” Then said “see you next year!” I made an appointment for a year from now.

I happen to have a replacement aortic mechanical heart valve and am on blood thinners which could cause me to bleed out. Should I seek a second opinion.
I messaged my PCP last week and he has failed to respond. I feel like a walk-in time bomb!

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@andytheman absolutely get a second opinion. November 9, 2025 I was getting ready for church, my family had gone a head of me because I was running late. Shortly after they left I felt a stabbing pain that went in through my chest and came out my back. The pain was indescribable. I can’t imagine pain being any worse than losing a limb or a burn. Something kept telling me it was not a heart attack, we went to the ER and after a 3 hour wait I was finally taken back, asked a few questions I was taken to have a CT scan. The tech immediately told me I had an aortic tear. They rushed me back to the exam room and told me I was about to have emergency surgery. An hour and half later I was under the knife. They told my husband that patients with this type of tear don’t make it to the hospital but those that do have less than a 1% chance of survival. But guess what I made it. I am healing well physically but struggling emotionally. I am a firm believer that ever doctor cannot know everything and apparently this doctor did not. I am an advocate for Aortic Dissections because they are over looked more times than they are diagnosed. Find yourself a thoracic surgeon, get a CT San and there be no more guess work. Go with the working signs you body is giving you. Cardiologist don’t know what they need to know about Aortic Dissections.
Do not wait!

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I can’t believe that they made you wait so long and also the fact that you made it after all that waiting. That intense tearing type pain is a burst aneurysm. I have no pain so I guess they are waiting for it to burst and possibly kill me! I have a feeling that due to the fact that it isn’t bleeding they figured they were waiting for the last minute before they repaired it . I’m not comfortable with that. The first hospital last year found it by a cat scan for something else and panicked and sent me directly to a bigger hospital better suited to repair the torn aneurysm but that hospital cardiologist said “ well it isn’t bleeding but you will need to come back but you don’t need surgery today !”
Why not fix it now? Why wait? I couldn’t understand it. Here we are almost 2 years later and I just had an echo and even though it was at 3.9 2 years ago instead of the 5cm criteria they are doing nothing!! It could have grown. I’m so upset. It’s not burst and it’s not bleeding but it’s a good time to repair the torn aneurysm before a major event occurs. May be because I’m on blood thinners they fear going in. I don’t know. They act like it’s their little secret ! I am getting what feels like “heavy arms” which is one of the symptoms of a torn aneurysm but it doesn’t seem to be a big deal to my cardiovascular surgeon. By the way, he does have a specialty as an aortic artery specialist so I’m assuming he knows what he’s doing but it’s the constant exams I’m having and they don’t call me back to the office until “ see you in 3 months “ for a follow up. It’s killing me to wait.

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I hear how frightened and worn down you are, and I want you to know your reaction makes sense. Waiting while your body carries something this serious is brutal on the mind. I survived a Type A aortic dissection in 2015. Mine announced itself with sudden, tearing chest pain, and I was rushed into emergency open-heart surgery. My ascending aorta and arch were repaired with a Dacron graft. I’m here because the right team acted decisively, but I also learned something important afterward: when it comes to the aorta, you are allowed to question, push, and get more eyes on the problem.

I cannot believe they made you wait that long initially, and the fact that you made it through that period says a lot about how lucky you’ve been so far. That tearing pain you describe is not nothing. Even now, the emotional toll of being told to come back in three months, over and over, can be as damaging as the physical risk. Living in constant surveillance mode is exhausting.

Here’s my strongest advice, as a patient who’s been there. Get a second opinion at a major medical center that sees aortas all day, every day. Not just a good cardiologist or surgeon, but a high-volume thoracic aortic program. Make friends with the most experienced thoracic aortic surgeon you can find and put your case directly in their hands. Places like UCLA, UCSD, Cleveland Clinic, Mayo Clinic, and the University of Minnesota have teams whose entire focus is complex aortic disease. Those surgeons are used to gray-area cases, chronic dissections, borderline measurements, anticoagulation issues, and the question you’re asking: why wait.

Size thresholds are guidelines, not commandments. Symptoms matter. Growth rate matters. Anatomy matters. Your peace of mind matters. If something feels off to you, that deserves respect, not a calendar reminder. I was told after my surgery to avoid heavy straining, breath-holding, and anything that spikes pressure. Even now, years later, I’m careful. I’m not saying this to scare you, but to underline that you’re right to want clarity and a plan you can live with.

You’re not wrong for being uncomfortable. You’re not being difficult. You’re being alive and paying attention. Advocate for yourself hard, and do it at a place that has seen thousands of aortas like yours. I’m glad you’re still here. Don’t let anyone make you feel like your questions are an inconvenience. Peace.

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Exercising hard causes your blood pressure/heart rate to rise and pulsate faster and harder through your blood vessel with a weakened wall that can rupture even at normal heart rate/blood pressure and your aneurysm increases faster! When an aneurysm ruptures, we get a brain hemorrhage and need to go to the emergency room quickly to survive and reduce brain damage!

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Profile picture for andytheman @andytheman

I can’t believe that they made you wait so long and also the fact that you made it after all that waiting. That intense tearing type pain is a burst aneurysm. I have no pain so I guess they are waiting for it to burst and possibly kill me! I have a feeling that due to the fact that it isn’t bleeding they figured they were waiting for the last minute before they repaired it . I’m not comfortable with that. The first hospital last year found it by a cat scan for something else and panicked and sent me directly to a bigger hospital better suited to repair the torn aneurysm but that hospital cardiologist said “ well it isn’t bleeding but you will need to come back but you don’t need surgery today !”
Why not fix it now? Why wait? I couldn’t understand it. Here we are almost 2 years later and I just had an echo and even though it was at 3.9 2 years ago instead of the 5cm criteria they are doing nothing!! It could have grown. I’m so upset. It’s not burst and it’s not bleeding but it’s a good time to repair the torn aneurysm before a major event occurs. May be because I’m on blood thinners they fear going in. I don’t know. They act like it’s their little secret ! I am getting what feels like “heavy arms” which is one of the symptoms of a torn aneurysm but it doesn’t seem to be a big deal to my cardiovascular surgeon. By the way, he does have a specialty as an aortic artery specialist so I’m assuming he knows what he’s doing but it’s the constant exams I’m having and they don’t call me back to the office until “ see you in 3 months “ for a follow up. It’s killing me to wait.

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@andytheman
I have an aneurysm in the ascending aorta that measures 4.4 cm. I am monitored yearly by CT scan with dye to check for changes, am also told that 5 cm is the time they would operate as the repair surgery is also pretty serious. I am 75 and told by my thoracic cardiologisr that it’s possible to live with this issue for years without it ever getting large enough to require surgery.

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