I was diagnosed with a 4.5 cm TAA in August '21. I decided to schedule a CT scan after loosing 2 of my neighbors suddenly, both around 50 years old. I am currently 56. I had no symptoms, plenty of energy, but I as concerned about my lifelong eating habits and stressful jobs over the years. Instead of reviewing my entire journey so far, let me just touch on 2 points. My impression of my medical team's response to my condition and how I'm coping with trying to control my hypertension.
From day #1, I was not impressed with the "sense of urgency" of my primary, nor my Cardiologist. I was looking for direction, expertise, and support in the form of an aggressive plan to prevent having to have open heart surgery within the next 2 years. My primary prescribed me 25mg of Losartan(lowest possible dose) and a cholesterol med. While it helped my BP a little, I wasn't satisfied. So, I did some reading and then requested an increase to 50mg about 3 months after my CT scan. My goal was an average reading of 115/75, but I couldn't get it down below 120/85. So, I requested an increase to 100mg. That did the trick! Generally though, early on, I was not impressed with this blase' attitude from everyone in handling what I deemed needed a major response. Ofcourse, I began eating better and tried to exercise more too. At that point, my primary hadn't even suggested meeting a cardiologist! But, I did it anyway because I needed to know someone was taking this seriously. 6 months in, I met a very good Cardiologist and he immediately scheduled an echocardiogram and an ultrasound. This gave us a better look at my entire chest cavity, something I'd learned from reading. Decisions on surgery take many things into account. But, ultimately, even he took a wait and see position on my TAA.
Fast forward to this past Sep, '22. My follow up CT scan. I was prepared for the worst, yet somehow my TAA was stable at 4.5cm, no growth. While thrilled, I knew from reading that these sometimes go a few years without growth, then get larger. The opposite happens too. In your case, you may go the next few years and it stays at 4.3cm.
Up until that follow up CT scan , I was only convinced of 1 thing. I felt the entire medical field was so confident in the abilities of Cardiac Surgeons, that the whole process just prepared us for entering a que for the procedure.
Secondly. My condition is probably due to hypertension. As you have indicated, I also was always able to handle stress. I was a problem solver, a program manager. Took pride in it! Little did I know that my "tough guy" attitude and willingness to carry all the burden to solve a problem, many which were out of my control, is what most likely caused the enlargement of my Thoratic Aorta. I sat thinking to myself, a day before Hurricane Ian hit us head on in Cape Coral Florida, "how can I let go of things I cannot control?" For me, the answer was something I'd questioned most of my life. GOD. I've always been a deductive reasoner. I believed what I can prove I guess you could say. But, there it was, right in front of me all along. The only way I was going to "let go" of some of the things out of my control is if I finally allowed myself to unconditionally believe that GOD was real. It's hard to explain, but almost instantly I felt relief, calmness. 24 hours before a near Cat 5 hurricane hit us head on, I was calm. It didn't change the hurricane's path, didn't keep us from having challenges because of the hurricane. But, my unconditional belief that I wasn't alone allowed my not to worry. Since I made that commitment to not walk alone, my BP is lower and I feel much less tension.
Sorry for the long response. I've only shared this with my wife prior to writing this. I'm not trying to suggest my path for you, just letting you know what worked for me when nothing else would. I wish you well my friend!