Exercise Guidance with Ascending aorta dilation

@houston13
My cardiologist's nurse practitioner has me wearing a Holter monitor yesterday when I was scheduled for a training session at the gym with my trainer. We are doing stretches and flexibility exercises (no planking, stomach crunches, or squatting). It will be interesting to see what the Holter monitor shows during that hour of training.

I am in much the same situation. I hated to give up heavy weigh lifting and rowing, but decided I would rather live to a ripe old age. In addition to walking, I discovered reformer Pilates, which is as much about breath control as it is about core stabilization. If you find a good studio with nationally certified experienced instructors you will learn how to breathe through planks and squats and avoid the valsava maneuver that spikes your blood pressure. The reformer springs provide some resistance, not as much as heavy weight lifting, but it is effective. I've been doing this for 4 years and had no change in the size of my AAA. I don't know of any research that looks at Pilates, but my cardiologist was fine with it.

@ewei6911 all those exercises lead you to hold your breath to maintain core stability, it takes a lot of practice and discipline to learn how to breath through every second of each rep, that big strain causes your BP to spike by more than 100mmHg in certain cases, it drops immediately after the exercise but those huge spikes can of course be very dangerous for an aneurysm. So listen to your cardiologist!!!

@houston13
My cardiologist's nurse practitioner has me wearing a Holter monitor yesterday when I was scheduled for a training session at the gym with my trainer. We are doing stretches and flexibility exercises (no planking, stomach crunches, or squatting). It will be interesting to see what the Holter monitor shows during that hour of training.

@ewei6911 your cardiologist is checking your heart function to make sure there is no arrhythmia, etc, things that an EKG in the office may not show. It is great when Drs go beyond just routine examination, hope everything goes well!!!

@mermaid1 I was told by my cardiologist that doctors that exercise should be done within moderation. Don't over do it and beware of symptoms. Dizziness, shortness of breath and any discomfort.

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.

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.