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.

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

23997929 | @23997929 | 1 day ago

In reply to @mackayverd "I 68 and had an ascending AA diagnosed at 4.2. I still have six months to..." + (show)

Mine was diagnosed at 4.0 almost 4 years ago and then went to 4.2 in a year. Now steady at 4.5 the last year and a half. Based on information from my local cardiologist and also from the head of cardiothorasic surgery at a university hospital who also reviews my scans, surgery is recommended at 5.0 cm (unless they see a rapid increase in readings). They explained to me that surgery is major and high risk, around 5% fatality rate, but depends on the hospital. Not having surgery before 5% the risk is down to well below 1%. They also told me that people who manage it (no heavy lifting, no strenuous exercise, keeping blood pressure low etc) have a low risk and as one of them said "you would go from something else totally unrelated".

pamela78 | @pamela78 | 2 days ago

In reply to @mackayverd "I 68 and had an ascending AA diagnosed at 4.2. I still have six months to..." + (show)

It's my understanding that insurance doesn't want to cover surgery until you reach 5.0, unless something else is going on. I also asked my cardiologist about getting surgery earlier rather than later. I'm nearly 80 and don't relish having this major surgery when I'm even older. He said I should wait until the benefits outweigh the risks. This is a serious operation. Given what I know now about the long recovery for most patients, especially older ones, I may not have surgery at all. I'm at 4.2 and will have another CT scan in July. Fingers crossed it's still the same. I've never been keen on exercise but I try to walk most days, weather permitting. I've given up on gyms. Those of you who depend on exercise to stay sane and feel healthy--like my son and daughter--always amaze me. I guess it's how some folks feel about opera. You really like that? Anyway, common sense tells me that overdoing the exercise is asking for trouble. Move it or lose it, but don't push so hard you blow a gasket.

mackayverd | @mackayverd | 2 days ago

I 68 and had an ascending AA diagnosed at 4.2. I still have six months to go, but may do another ct scan to see where I am at.

What I don't understand is why in hell don't they just operate on it and fix it? It has risk, but it is better than this slow torture and not knowing how much you can really do. I hunt chukars, one of the most strenous outdoor sports. Walking up and down steep slopes. But no one can say do it or don't do it. Frustrating!

will3886 | @will3886 | Apr 22, 2024

In reply to @upartist "Hi Will3886. I see you got checked because your brother had heart issues? That points towards..." + (show)

Thanks for the comments
I will have that discussion asap

upartist | @upartist | Apr 22, 2024

In reply to @will3886 "Good info Thank you Glad your doing ok" + (show)

Hi Will3886. I see you got checked because your brother had heart issues? That points towards a possible genetic component to your aneurysm. You need to have that discussion with your cardiologist soon. Some familial TAADs (thoracic aortic aneurysm disease) lead to early dissection. Not all, but some. If you show one of these genetic markers, the algorithm for the timing of repair is altered accordingly. I urge you, with a 4.5, to have this discussion in order to make informed decisions. I to love hiking! I used to run and I get your desire to let loose on those amazing trails! Good luck!!!
UPartist

will3886 | @will3886 | Apr 22, 2024

In reply to @mplopez5 "I have two heart docs one is cardo and the other is surgeon. I 63 4.3-4.5..." + (show)

Thank you

mplopez5 | @mplopez5 | Apr 22, 2024

In reply to @will3886 "71 yr old Male 185 # Just discovered a 4.5 acceding aneurysm No issue … had..." + (show)

I have two heart docs one is cardo and the other is surgeon. I 63 4.3-4.5 depending on test. Other than proper breathing when lifting live a normal life. Not saying it is ok to be power lifter but exercise diet and keep BP low. If you must ask doc for statin and b pressure med start low doses. This is the best you can do…..maybe it grows maybe not. My doc told me I may never need surgery.

will3886 | @will3886 | Apr 22, 2024

In reply to @degarden_girl "I am Female, age 79. I have an ascending aortic aneurysm, diagnosed in 2007 at 3.8...." + (show)

Good info
Thank you
Glad your doing ok

will3886 | @will3886 | Apr 22, 2024

In reply to @moonboy "It’s a tough question to answer because it’s all about whether or not you want to..." + (show)

@moonboy

It’s a tough question to answer because it’s all about whether or not you want to risk being out in the middle of nowhere when you’re Aorta dissects. if it were me, I would stop running and get the earliest surgical appointment to have open-heart surgery to get it repaired. Given the fact that you are 71, you are in great shape, I think that the surgery is worth it. It is much easier to deal with in a non-emergent situation Like you have right now. If your aorta blows, you’re not likely to survive it if you are not in an emergency room or very very very close to one. If you are in Rochester across the street from Mayo, you’ve got a chance. If you are in the suburbs and an hour from the nearest High-end cardiac center. Well, I think your chances are pretty low. I have had an emergency full dissection in San Diego California in 2015. I was 50 years old and overweight and hypertensive. It was an absolute personal and professional disaster. Most people who survive a complete dissection , which is a very small percentage, never go back to work. I can tell you that almost 9 years out I think about it every day and I make an effort to be extra kind to my wife and kids who suffered terribly in that experience. If you are a single person and you’ve got all of your will, power of attorney and healthcare directives put together than I guess you should do whatever makes you happiest. But, if you are married and have a family, which you love, I think it would be Whoo you to think seriously about having corrective surgery at if you’re re a candidate. I am very glad that I survived, but never a day passes where I don’t think about the fact that I am incredibly lucky to have made it. I was in a major metropolitan area on a quiet evening, where the on-call surgeon had 40 years of experience. You might not be that lucky so I really, encourage you to think about what’s important to you. If running is the only thing that matters, then I guess you run. But if you have other things that takes precedent in your life it may be time to slow down. I’d be happy to talk with you directly if you want to email me your contact information. Pete pbarry@lawpoint.com

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Thanks
No plans to do anything but walk
Doc wants to wait till measure 5+ to talk repair

degarden_girl | @degarden_girl | Apr 22, 2024

In reply to @will3886 "71 yr old Male 185 # Just discovered a 4.5 acceding aneurysm No issue … had..." + (show)

I am Female, age 79. I have an ascending aortic aneurysm, diagnosed in 2007 at 3.8. It is now 4.2. These things are often slow growing. My only exercise limitation has been to lift no more than 25 lbs.

I believe the aneurysm is considered for surgery when it is in the 5 to 6 cm range. This surgery is huge and the surgery itself has risks. I would not consider pushing for surgery before the aneurysm has become life threatening.

I personally think being near an ER is wishful thinking. I understand if the aneurysm is going to burst, that is the end. But the likelihood of it bursting before it gets in the 5 to 6 cm range is rare.

I suggest doing some on-line research at NIH, Mayo, Cleveland Clinic, Cornell Weill websites and then making another appointment with your cardio to discuss your questions and personal situation.

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