Ascending Aortic Aneurysm and Exercise

Posted by bryanfox @bryanfox, Aug 31, 2019

New to this, nervous (like everyone). 44YO male, 5'10", 195 lb, diagnosed with 4.3cm ascending aortic aneurysm last month. Doctors put me on beta blockers, resting BP around 128/70 since I started with them (it was over 140 before, but only in the last year did I see abnormally high BP). I go to the gym 5 times a week. Cardiologist told me to continue exercising, but not to lift over 100lb (I use machines, not freeweights, so I'm not lifting over 100lb anyway). But I'm curious about cardio as well - I go 3-4 miles on the elliptical 3-4 times a week, and I sweat. I'm sure my BP is raised while doing that. Is this healthy?

Interested in more discussions like this? Go to the Aortic Aneurysms Support Group.

Not sure, I was recently diagnosed with a 4.1 aneurysm and my doctor said he will check it again next year I’m a little concerned about that..

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@bitsygirl

This is scary. A 4.5 cm "aneurysmal dilation" of my ascending aorta was found during a calcium scoring test two months ago. I still haven't been able to get in to see a cardiologist to learn more about what is going on. I've done a fair bit of reading and 4.5 cm seems to have a low risk of dissection (at least for the ascending aorta). Can I ask what you were doing when it dissected? What did it feel like? How far away were you from help? I am in a tiny town in the middle of nowhere. Glad you made it through!

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I know exactly how you feel. I reacted the same way when I found out during a CT for calcium scoring. In the 2 .5 years since I've learned to calm down, in part because I go for a CT with contrast dye and echocardiogram every 6 months. I found a good cardiac surgeon recommended by my primary care Dr. who is up to date on the most recent recommendations.
There is a huge difference between having an ascending aortic aneurysm and having a dissection. With 3 scans behind me I now know that for me there is no evidence of dissection and that has remained stable, the aneurysm is stable and may very well have been there my whole adult life. That gives me peace of mind and I no longer wake up every day worrying that I'm going to have a blow-out of my aorta. I did get a medical alert bracelet so that should something happen medical personnel will know to first check for a dissection.

I learned the most important thing is to make sure my BP is managed and to stay active and heart healthy. Educating yourself is the best way to get peace of mind.
I've had to change my exercise routine and medication as well as learn to ask for help when lifting heavy objects. That has taken some effort on my part. No traditional weight training at the gym - now it is lighter weight and more reps. We added a Beta blocker to my existing BP medication to lower the pressure and flow of blood through my aorta. I use Pilates/yoga breathing any time I lift anything, even a bag of groceries. No more using my body as a pack mule to haul stuff around.
Hope that gives you some ideas for taking control and feeling less helpless in the face of a unexpected diagnosis. Just remember, your chances of survival just jumped immensely by knowing you have an aneurysm.

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A wonderful sharing story. I work at remaining calm and letting myself relax more. Your positive story and sharing gave me a great boost this morning. I continue in traveling just not lifting the heavy bags.

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@mermaid1

I know exactly how you feel. I reacted the same way when I found out during a CT for calcium scoring. In the 2 .5 years since I've learned to calm down, in part because I go for a CT with contrast dye and echocardiogram every 6 months. I found a good cardiac surgeon recommended by my primary care Dr. who is up to date on the most recent recommendations.
There is a huge difference between having an ascending aortic aneurysm and having a dissection. With 3 scans behind me I now know that for me there is no evidence of dissection and that has remained stable, the aneurysm is stable and may very well have been there my whole adult life. That gives me peace of mind and I no longer wake up every day worrying that I'm going to have a blow-out of my aorta. I did get a medical alert bracelet so that should something happen medical personnel will know to first check for a dissection.

I learned the most important thing is to make sure my BP is managed and to stay active and heart healthy. Educating yourself is the best way to get peace of mind.
I've had to change my exercise routine and medication as well as learn to ask for help when lifting heavy objects. That has taken some effort on my part. No traditional weight training at the gym - now it is lighter weight and more reps. We added a Beta blocker to my existing BP medication to lower the pressure and flow of blood through my aorta. I use Pilates/yoga breathing any time I lift anything, even a bag of groceries. No more using my body as a pack mule to haul stuff around.
Hope that gives you some ideas for taking control and feeling less helpless in the face of a unexpected diagnosis. Just remember, your chances of survival just jumped immensely by knowing you have an aneurysm.

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Thanks for sharing your experience. It is calming to hear first hand from people who have had a similar experience. I have moved to high reps too -- around 15. I was already on Losartan for BP, but it was still borderline. Through diet (low glycemic + very low fat) and IF, I have it down now to 100-115/70-75 without additional medication. I ended up with a 98th percentile Agatston score in addition to the aneurysm. So my guess is that it is from atherosclerosis?? The whole thing came out of nowhere, because I exercised regularly for more than 20 years, ate reasonably (low-ish fat, chicken, turkey, vegetables ...). No sign of diabetes. Thinking maybe stress?? I almost wish I had a terrible lifestyle so there'd be greater hope to turn the atherosclerosis around. Hopefully I'll get to meet with a cardiologist soon and get some more information.

Thanks again.

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@bitsygirl

Thanks for sharing your experience. It is calming to hear first hand from people who have had a similar experience. I have moved to high reps too -- around 15. I was already on Losartan for BP, but it was still borderline. Through diet (low glycemic + very low fat) and IF, I have it down now to 100-115/70-75 without additional medication. I ended up with a 98th percentile Agatston score in addition to the aneurysm. So my guess is that it is from atherosclerosis?? The whole thing came out of nowhere, because I exercised regularly for more than 20 years, ate reasonably (low-ish fat, chicken, turkey, vegetables ...). No sign of diabetes. Thinking maybe stress?? I almost wish I had a terrible lifestyle so there'd be greater hope to turn the atherosclerosis around. Hopefully I'll get to meet with a cardiologist soon and get some more information.

Thanks again.

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That reminds me...my Dr had me get a genetic test for aortic aneurysm because it affects treatment pathway. I think we sometimes forget that there are genetic components to BP and heart disease, despite our best efforts. My primary care Dr. reminded me of that last time I complained that my husband can eat crap and exercise less and still have lower cholesterol and BP than me.

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@bitsygirl

This is scary. A 4.5 cm "aneurysmal dilation" of my ascending aorta was found during a calcium scoring test two months ago. I still haven't been able to get in to see a cardiologist to learn more about what is going on. I've done a fair bit of reading and 4.5 cm seems to have a low risk of dissection (at least for the ascending aorta). Can I ask what you were doing when it dissected? What did it feel like? How far away were you from help? I am in a tiny town in the middle of nowhere. Glad you made it through!

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I was going up the steps to our barn - twice. I think there are 12 steps. My eyes felt funny and I was perspiring heavily. I had knee surgery a year in advance. I thought I was out of shape from kneed surgery. Then I began to see little black and white flashing light out of the corner of each eye. I live on a farm, out in the middle of no where too. We are fairly close to a local hospital. I immediately went down the steps and when I reached the bottom, I yelled for my husband. The next thing I knew I was sitting outside of our barn on a grappling bucket. He was standing next to me. I said did I yell your name? He said, yes twice. I told him I didn't feel good and he said I didn't look good (I'm not sure what that meant). He said he wanted to take me to the hospital. I said I wanted out of the sun because it was hot. So we started walking towards the shade and I began to vomit. He took me to the hospital ER. They tested me for stroke and heart attack. They found nothing. I was admitted and laid flat for 15 hours and transferred to Mayo. The surgeon and his team were waiting for me when I arrived. I immediately went into surgery. I am a very lucky person.
Wishing you the best and others. It is scary but I try to live my life I just don't lift like I used to.

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I have an ascending aortic aneurysm. I joined here to learn more about lifestyle adjustments and hopefully, help with the anxiety it has provoked. I am 60 yrs. old, female, borderline LDL (high HDL), and have Raynaud's Phenomenon. I am 5’7 and 127 pounds. My aneurysm measures 3.9 cm and it is mildly aneurysmal. My genetic testing came back positive for a mutation of the MYH-11 gene. So, it is familial. However, I don’t know of any family that this was found on.
I love lifting weights and they have been heavy - deadlifting 265 lbs, squatting 200 lbs, bench 110 lbs. The news to reduce my weight to 50 lbs was difficult. I understand the rationale, but then I was told 30 lbs when the genetic factor was discovered. I have been to a CV surgeon and cardiologist. My BP is 100-110/60 normally, but I was put on losartan 12.5 mg at bedtime. HR 55-60 resting. I am tolerating the medication. I have lessened my weight by 40-70% on average. I breath through all exercises. I do not do back squats and deadlifts with a straight bar or trap bar. No overhead presses. No straining and no holding my breath.

I feel the weight guideline is a bit odd. For the most part, I can follow the 30-50 pound limit, but some things especially with the lower body (example hip thrust 50 lbs is nothing - the bar and 5 pounds). No use to do this even with many reps. I have kept weight low for the most part. Doing exercises to pre-exhaust the muscle. Many times this is with body weight. I feel in this instance using a scale of 0-10 for level of exertion might be helpful. One could do an exercise with 20 pounds and you could potentially strain. You could do a different exercise with 65 pounds and it is easier than what you just did with 20 pounds. Does anyone else feel it to be confusing to use a weight limit? I think keeping weight down, but utilizing a scale of effort or exertion is most helpful. Has anyone else been given advice to use an exertion scale?

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@mermaid1

I have grilled my surgeon on this several times and he keeps telling me I can workout and lift weight as long as I am not straining (holding my breathe or huffing and puffing so much that my heart is not pumping steadily. Now that I'm on a beta blocker I can't get my heart rate up to 80% of max, so I've stopped worrying about heart rate. It's been a year of 65-70% max heart rate and steady yoga breathing anytime I lift anything and my AAA has not increased or shown any indication of dissection. I'm keeping my fingers crossed, but it is better for my health to exercise moderately than not at all.

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Hi,
I think your MD is spot on , as I was given same advice and have been involved with a progressive weight machine regimen coupled with aerobic exercise. My latest MRA shows no growth of 4.4 AAA . I think the trick is how you are breathing when you work out. You can breath fast, and hard, and that's ok, even for HIIT exercise, just don't hold your breath or grunt when pushing weights or regular life. I too have beta blocker and my resting heart rate is in 40's to 50's typically when at rest. After I work out, my BP drops a good 20 to 30 points, though temporarily. In a prior post I opined why I think that general rules about how much weight one should lift etc. unless the individual is assessed is counter productive and fear inducing needlessly. The good news is that after 5 months on my self-styled program, I have lost weight, have more muscle, and don't dwell on my condition anymore.

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@hollywoodal

From what I've read, statistically athletes have a slightly larger Aorta.

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I read the same thing, especially for endurance athletes like marathoners. I used to do triathlons in my 20's and 30's but back in my late 30's, a CT scan showed no problems. I think it was my succumbing to a high stress and sedentary life style that did me in. Now on the road back.

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FYI. My last scan, end of May, showed 4.2 cm. I also send the scan results to the senior specialist at the Cardiothoracic Surgery at a Houston University hospital who does the operation when the limit is reached. His recommendation in line with prior advice was “Please keep your blood pressure under control- normal is 120-80. And please no strenuous activities.” Next scan recommended in 12 months from last.

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