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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Hello kmailloux. First I congratulate you on an amazing healthy life style! Your mention of mild chest pain caught my attention. I have a 4.3 cm ascending aortic aneurysm diagnosed a few years ago. I reduced my exercise after reading through people's experiences on this blog, but I am still very regular. I never exercised to your degree. My chest pain brought me in to get studies, where the aneurysm was discovered. My aneurysm is not what is getting treated, but the chest pain is. My angina results from cardiac micro spasm (diagnosed through an ACTH challenge test during a cardiac cath) along with endothelial dysfunction. I have very opened large arteries. Stress , both physical and perceived emotional/cognitive, are the main triggers. Sometimes its spontaneous. I would recommend to you to look deeper. Your chest pain may not be aneurysm related. Mine is not but it can still be fatal.. I am treated with two forms of nitro.... one for exercise (nitrobid ointment ... which is an old resurrected medication and extremely effective to allow me to do my cardio) and the other are sublingual tabs for rescue pain. I did have to redo my life style, but I can still actively participate in numerous cool activities and sports, just scaled back. I also chose to have the gold standard cardiac cath back when I did not know what was going on. It was recommended, and I was scared. Information can reduce stress and guide our decision making. It should be empowering. I think you need more information. Clarify that chest pain. Good luck! And keep on trekking !!!
UPArtist

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@upartist

Hello kmailloux. First I congratulate you on an amazing healthy life style! Your mention of mild chest pain caught my attention. I have a 4.3 cm ascending aortic aneurysm diagnosed a few years ago. I reduced my exercise after reading through people's experiences on this blog, but I am still very regular. I never exercised to your degree. My chest pain brought me in to get studies, where the aneurysm was discovered. My aneurysm is not what is getting treated, but the chest pain is. My angina results from cardiac micro spasm (diagnosed through an ACTH challenge test during a cardiac cath) along with endothelial dysfunction. I have very opened large arteries. Stress , both physical and perceived emotional/cognitive, are the main triggers. Sometimes its spontaneous. I would recommend to you to look deeper. Your chest pain may not be aneurysm related. Mine is not but it can still be fatal.. I am treated with two forms of nitro.... one for exercise (nitrobid ointment ... which is an old resurrected medication and extremely effective to allow me to do my cardio) and the other are sublingual tabs for rescue pain. I did have to redo my life style, but I can still actively participate in numerous cool activities and sports, just scaled back. I also chose to have the gold standard cardiac cath back when I did not know what was going on. It was recommended, and I was scared. Information can reduce stress and guide our decision making. It should be empowering. I think you need more information. Clarify that chest pain. Good luck! And keep on trekking !!!
UPArtist

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Thank you so much for your feed back.. and yes I am trying to pin point the chest pain. It drives me crazy, trying to figure out what is causing it. the Doctors don't want to do more testing because I am a very healthy 60 year old ... expect and aortic aneurysm, that could be life threatening. I am new to this all and still trying to come to grips with it.. it doesn't help when the doc's and nurses give you the standard "don't lift more than 50 lbs" Im 5'2" and 125lbs how is that the same as a 6'2" man of 250 lbs.. doesn't make sense to me.. As does the as much cardio as you are use to guideline.. I am used to Marathons - is that much blood going thru the aorta good for the aneurysm ? no one seems to know.. Any helo is great.

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@kmailloux

Thank you so much for your feed back.. and yes I am trying to pin point the chest pain. It drives me crazy, trying to figure out what is causing it. the Doctors don't want to do more testing because I am a very healthy 60 year old ... expect and aortic aneurysm, that could be life threatening. I am new to this all and still trying to come to grips with it.. it doesn't help when the doc's and nurses give you the standard "don't lift more than 50 lbs" Im 5'2" and 125lbs how is that the same as a 6'2" man of 250 lbs.. doesn't make sense to me.. As does the as much cardio as you are use to guideline.. I am used to Marathons - is that much blood going thru the aorta good for the aneurysm ? no one seems to know.. Any helo is great.

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I too am a bit dismayed in the lack of more exact precautionary directions, I’m a 6’ 212 lb male with a 4.7 abdominal aortic aneurysm under watch (6mos) and don’t lift over 50 lbs has been the mantra, I’ve even had it as vague as “don’t lift anything heavy “ I was doing an electrical job the other day and leaning forward on a ladder pushing a heavy drill upward through wood, kinda like isometric force and thinking is this ok ? I guess I’ll know at next monitor scan , I think they just use rule of thumb because there’s know way of knowing which straw it will be for each patient , I’m focusing on keeping BP low and weight reduction and I guess after next scan if larger, elimination of all straining activity , I’m sure that will be life after any repair anyway! I’ve been sky diving, kayaking, play golf sad to know a lot will change going forward

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I have an ascending aurora aneurysm diagnosed 2 years ago at 4.0 cm. Before that the heart check up ultrasound tests I was doing every couple of years were at about 3.5. It is now around 4.2. I was also shocked to see this because I have always exercised (running for 30 years and years road cycling 10 years) I have gotten a bit different guidance from heart experts. All agree that blood pressure must be kept normal, no heavy lifting (over 100 lb) and no smoking (I never smoked). The specialists at a major heart hospital also told me to keep heart rate below 120 bpm but my local cardiologist does not agree and said I could go back to road cycling as a I was doing before. I doing a lot of walking now and keeping tabs on the numbers but not sure I will get back on the bike outdoors since we have a lot of hills.

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The excercise recommendations are all over the place. I do think it should be more individualized based on the patient's consistent excercise regiment already in place Me - I am easy I only walk but I was advised to keep my speed no more than 2.0 on the treadmill, and no heavy lifting . It is ok with me as at 71 and living a mostly seditary life it is a perfect fit. As long as I can walk with suitcases next to me on wheels and enjoy cruises I am fine. Thank goodness I enjoyed all the fun things such as ziplining and water rafting in my 50's and 60's. 😉

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@23997929

I have an ascending aurora aneurysm diagnosed 2 years ago at 4.0 cm. Before that the heart check up ultrasound tests I was doing every couple of years were at about 3.5. It is now around 4.2. I was also shocked to see this because I have always exercised (running for 30 years and years road cycling 10 years) I have gotten a bit different guidance from heart experts. All agree that blood pressure must be kept normal, no heavy lifting (over 100 lb) and no smoking (I never smoked). The specialists at a major heart hospital also told me to keep heart rate below 120 bpm but my local cardiologist does not agree and said I could go back to road cycling as a I was doing before. I doing a lot of walking now and keeping tabs on the numbers but not sure I will get back on the bike outdoors since we have a lot of hills.

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Are you on a beta blocker? Once I started on that I found that I can no longer get my heart rate to 120 bpm when rowing at a good clip. Now I use the perceived exertion method and my Dr. said as long as I can carry on a conversation I am ok.

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@mermaid1

Are you on a beta blocker? Once I started on that I found that I can no longer get my heart rate to 120 bpm when rowing at a good clip. Now I use the perceived exertion method and my Dr. said as long as I can carry on a conversation I am ok.

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I have used Quinapril which is an ACE inhibitor for many years to control my blood pressure. It does not limit how hard I can work out.

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@luckybear

I too am a bit dismayed in the lack of more exact precautionary directions, I’m a 6’ 212 lb male with a 4.7 abdominal aortic aneurysm under watch (6mos) and don’t lift over 50 lbs has been the mantra, I’ve even had it as vague as “don’t lift anything heavy “ I was doing an electrical job the other day and leaning forward on a ladder pushing a heavy drill upward through wood, kinda like isometric force and thinking is this ok ? I guess I’ll know at next monitor scan , I think they just use rule of thumb because there’s know way of knowing which straw it will be for each patient , I’m focusing on keeping BP low and weight reduction and I guess after next scan if larger, elimination of all straining activity , I’m sure that will be life after any repair anyway! I’ve been sky diving, kayaking, play golf sad to know a lot will change going forward

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That is my exact findings with this.. it's the "general " guidelines that I can find with an internet search.. nothing is customized for the person. Yes I am cleared to train for a 50k race.. but is that ok? my BP is very low and that is all they seem to focus on ... and not lifting 50lbs or "straining" . I will know more with my next scan as well - was on a 6 month but the doc moved it up to 4.5 months.

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I too struggle with what is safe and what isn't. It can be very frustrating. I was basically told to live my life...don't lift more than 50 lbs, and do not strain. What exactly does that mean....do not strain? Sometimes getting out of bed in the morning is a strain! Fortunately my BP is not high and really never has been. Have had high cholesterol most of my life and am now on statins, which have lowered it to normal levels. I question everything I do now. I low snow shoveling (I know I am not normal...lol) but that seems to be a big No in general. My dr said it would be ok as long as I am not straining and it isn't too heavy. There's that word again...straining. Obviously it isn't like lifting a pillow, but then again it doesn't feel like I am moving tree stumps around (which I have done). Right now I have been stacking firewood....and alternating between thinking I must be nuts and I am not straining or lifting more than 50 lbs so it is ok. I just don't know. Have heard that tennis, golf, baseball are all not good. Don't feel like any of those involve "straining". This whole thing has caused me so much anxiety. I am constantly taking my blood pressure and checking my heart rate. I wish there was some type of test that could be done on a monthly basis that checks the aorta. Waiting a year between exams is kind of scary. I was diagnosed about 18 months ago. Have had 2 CT scans and am stable at somewhere between 4.3 and 4.5 cm. Going for my next exam end of May.

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@kkubsky

I too struggle with what is safe and what isn't. It can be very frustrating. I was basically told to live my life...don't lift more than 50 lbs, and do not strain. What exactly does that mean....do not strain? Sometimes getting out of bed in the morning is a strain! Fortunately my BP is not high and really never has been. Have had high cholesterol most of my life and am now on statins, which have lowered it to normal levels. I question everything I do now. I low snow shoveling (I know I am not normal...lol) but that seems to be a big No in general. My dr said it would be ok as long as I am not straining and it isn't too heavy. There's that word again...straining. Obviously it isn't like lifting a pillow, but then again it doesn't feel like I am moving tree stumps around (which I have done). Right now I have been stacking firewood....and alternating between thinking I must be nuts and I am not straining or lifting more than 50 lbs so it is ok. I just don't know. Have heard that tennis, golf, baseball are all not good. Don't feel like any of those involve "straining". This whole thing has caused me so much anxiety. I am constantly taking my blood pressure and checking my heart rate. I wish there was some type of test that could be done on a monthly basis that checks the aorta. Waiting a year between exams is kind of scary. I was diagnosed about 18 months ago. Have had 2 CT scans and am stable at somewhere between 4.3 and 4.5 cm. Going for my next exam end of May.

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I agree with you ... the "straining" and don't lift more than 50lbs same guidelines but I would bet we are very different in size - assuming you are male.. I am a 120-125 lb female that is 40% of my body weight. Same for you?? the general guidelines are so vague and seem to be the same for everyone. They do not take into consideration size, sex, past exercise age or anything.. to make this individual to the patient. It is super frustrating. My first scan came back at 4.3 cm - mine is caused by a bicuspid aortic valve - which they say I was born with. So if mine grows it will be valve replacement and portion of the aorta repaired. Mine was discovered in Dec 2022 - so my second scan is in a week and 1/2 - I moved it up when they called to reschedule. I am hoping it will give me piece of mind a little. Or it will have grown and we will have to figure it out from there. Oh - and totally normal with the snow shoveling... I always feel very acomplished when it was done! though I am glad I was not able to do the heavy stuff we got this last storm!! I have a good friend for that! Thanks for the feedback, I don't feel so alone in this unchartered land ..

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