am I exercising too much with a 4.3 ascending aortic aneurysm?

Oh my gosh, it sounds like what I' ve gone through many times since getting the mach.valve in 2003.
Luckily I'm a very pro-active patient! So I go into every situation loaded with questions, after I've read up on whatever is going on, First!
But obviously when its a sudden decision or an emergency, that doesn't help!
Coumadin RULES my life, as I'm sure it does your's too!
I will never understand why nothing has been done in regards to research, for finding a better way to control blood thickness or thinners, for Mech. Valve patients.
Mine RARELY stays in range, because everything we eat or take, can affect it! Even after 23 years, I'm never suprised when I test, and its too high or low!

And I aree with you abt. diff.reactions to the size of our aneurysm's, from diff.members of our cardiology teams! And that's maddening because we, as the patient's, are clearly anxious about having an enlargement in the 1st place, and they throw numbers around like its no big deal!🤷‍♀️😡

@patti1416 I have been on Coumadin for years and my aortic artery aneurysm is at 3.9 until I have it checked in 2 months. Yes it has a
“Tear “ in it. My cardiovascular surgeon doesn’t seem to be too concerned about it.
I don’t like being on Coumadin due to my mechanical aortic heart valve with a torn aortic artery aneurysm. My last INR was 3.0 last week borderline high end. Thin blood with a torn aneurysm bothers me more than it does my cardiovascular surgeon apparently. He must know when it’s time to correct it? I don’t know. A few years ago they found a 3.7 cm with a tear in it during an unrelated CT scan and they were like “ oh my God we need this repaired now “. They dressed me back up and threw me into an ambulance for a quick ride to a higher rated trauma hospital and when I got there they took an immediate CAT scan and confirmed the torn aneurysm but the cardiologist for that hospital said “ well, yes you have one but it’s not bleeding and doesn’t need to be treated today” “ but you will need to come back later under a non emergency appointment “.
That was it. I was like “ look, it’s torn, and I’m Coumadin with an NRI that is always variable in thinness “ and he went on to another patient. I have great insurance so it wasn’t that! First thing I know I was being given my discharge paperwork and waiting for an ambulance to take me home. All because it wasn’t bleeding at the time.
One hospital took a fit and the second one was like “ well, it’s not bleeding!”
Are they waiting for an all out rupture that can be fatal quickly?
It looks like if you have a torn aneurysm but you’re not fatality bleeding because it’s less than 5.0 cm
(The golden number) you can be ignored other than a once in a year quick sonogram? Granted, it’s far from a 5.0 cm but why wait for a rupture??
These doctors aren’t so bright. My original cardiologist said “I don’t see anything!!!” The second cardiologist treated it like “ oh wow, we need to operate” the third cardiologist says yup it’s 3.7 cm and said “ see you next year “ my current cardiologist says “ it’s at 3.9” “see you in 6 months “.
It’s not like I had a poor insurance plan. My insurance covers everything 100% so why wait? Is it because I’m on Coumadin and they are afraid to go in?
That’s not an excuse. I’ve had surgery that required a 5 day hold on Coumadin and bridging with Levonox . So what’s the big deal?
Are they afraid that I may bleed to death and my family will sue him and the hospital for “ killing “ me?

Hi, I'm glad I came to this site so I can meet my soul mates with aortic aneurysm! Not a club we want to be in, but support helps!

As a 23 year long Coumadin user, also due to mech.valve, Im wondering why you need to stay worried about thin blood as long as your INR is in range. I'm assuming your cardiac team is addressing both issues? Have they said you are at a higher risk for the tear to "bleed out", and if so, have they adjusted your range for your INR, to maybe allow it to stay a little bit thicker?
After 23 years with these issues and all the issues that always have to be arranged around a good Coumadin level...I know that Dr's sometimes have blinders on. They may only focus on your need for the meds, but not it's affect, either real, or just an anxious worry( which I totally get you would be anxious, me too!)
Have you discussed your worry and found out if they can offer a solution that eases your fear a little.
I am currently(2/12/26), living with some off putting readings ftom an EKG in Dec, that indicate mine may have enlarged again( it waa 4.3 at last echo). Due to shoulder replacement I desperately needed and was already scheduled for, I didnt make my scan appt. sooner than March 31. To double check. And like you, I'm anxious abt it but diff.reason. I was already a little out of breath when doing stairs, alot of yard work, etc. But since my surgery I am def.more out of breath doing things, especially any thing that requires me to lean over..And with cats, everything I do for them, requires leaning over, lol.

So I will try to move my echo up, but in the meantime. I hate this anxiousness!
I'm sorry I wrote so much, its always what I'm teased about! Guess I'm just glad I found my PEOPLE!😊
If I don't hear from you, it was nice to read your history/ issues with the Aneurysm. And I hope the outcome is good!

@tcrowe Wow! You are indeed very lucky to have survived that aortic tear, but now that you are on the other side if it, you should be ready to get back to exercising and strengthening yourself. I am almost 2 years post surgery and doing great. I agree it is always good to get a baseline CT scan when you get to be a 'certain age' so any structural problems in the heart can be addressed before they become an emergency.

Correct. Last I heard my aortic artery aneurysm was at 3.9 cm. Not bad except for one thing. It has a tear in it and I’m 72 with an aortic mechanical heart valve and on permanent blood thinners. If my blood gets too thin I could bleed out. Thin blood with a torn aneurysm means I could leak out as my blood’s INR is below range and could bleed even from shaving. That’s what bothers me thin blood and a torn 3.9 aneurysm.

@andytheman
I have an aneurysm in the ascending aorta that measures 4.4 cm. I am monitored yearly by CT scan with dye to check for changes, am also told that 5 cm is the time they would operate as the repair surgery is also pretty serious. I am 75 and told by my thoracic cardiologisr that it’s possible to live with this issue for years without it ever getting large enough to require surgery.

Exercising hard causes your blood pressure/heart rate to rise and pulsate faster and harder through your blood vessel with a weakened wall that can rupture even at normal heart rate/blood pressure and your aneurysm increases faster! When an aneurysm ruptures, we get a brain hemorrhage and need to go to the emergency room quickly to survive and reduce brain damage!

I hear how frightened and worn down you are, and I want you to know your reaction makes sense. Waiting while your body carries something this serious is brutal on the mind. I survived a Type A aortic dissection in 2015. Mine announced itself with sudden, tearing chest pain, and I was rushed into emergency open-heart surgery. My ascending aorta and arch were repaired with a Dacron graft. I’m here because the right team acted decisively, but I also learned something important afterward: when it comes to the aorta, you are allowed to question, push, and get more eyes on the problem.

I cannot believe they made you wait that long initially, and the fact that you made it through that period says a lot about how lucky you’ve been so far. That tearing pain you describe is not nothing. Even now, the emotional toll of being told to come back in three months, over and over, can be as damaging as the physical risk. Living in constant surveillance mode is exhausting.

Here’s my strongest advice, as a patient who’s been there. Get a second opinion at a major medical center that sees aortas all day, every day. Not just a good cardiologist or surgeon, but a high-volume thoracic aortic program. Make friends with the most experienced thoracic aortic surgeon you can find and put your case directly in their hands. Places like UCLA, UCSD, Cleveland Clinic, Mayo Clinic, and the University of Minnesota have teams whose entire focus is complex aortic disease. Those surgeons are used to gray-area cases, chronic dissections, borderline measurements, anticoagulation issues, and the question you’re asking: why wait.

Size thresholds are guidelines, not commandments. Symptoms matter. Growth rate matters. Anatomy matters. Your peace of mind matters. If something feels off to you, that deserves respect, not a calendar reminder. I was told after my surgery to avoid heavy straining, breath-holding, and anything that spikes pressure. Even now, years later, I’m careful. I’m not saying this to scare you, but to underline that you’re right to want clarity and a plan you can live with.

You’re not wrong for being uncomfortable. You’re not being difficult. You’re being alive and paying attention. Advocate for yourself hard, and do it at a place that has seen thousands of aortas like yours. I’m glad you’re still here. Don’t let anyone make you feel like your questions are an inconvenience. Peace.

I can’t believe that they made you wait so long and also the fact that you made it after all that waiting. That intense tearing type pain is a burst aneurysm. I have no pain so I guess they are waiting for it to burst and possibly kill me! I have a feeling that due to the fact that it isn’t bleeding they figured they were waiting for the last minute before they repaired it . I’m not comfortable with that. The first hospital last year found it by a cat scan for something else and panicked and sent me directly to a bigger hospital better suited to repair the torn aneurysm but that hospital cardiologist said “ well it isn’t bleeding but you will need to come back but you don’t need surgery today !”
Why not fix it now? Why wait? I couldn’t understand it. Here we are almost 2 years later and I just had an echo and even though it was at 3.9 2 years ago instead of the 5cm criteria they are doing nothing!! It could have grown. I’m so upset. It’s not burst and it’s not bleeding but it’s a good time to repair the torn aneurysm before a major event occurs. May be because I’m on blood thinners they fear going in. I don’t know. They act like it’s their little secret ! I am getting what feels like “heavy arms” which is one of the symptoms of a torn aneurysm but it doesn’t seem to be a big deal to my cardiovascular surgeon. By the way, he does have a specialty as an aortic artery specialist so I’m assuming he knows what he’s doing but it’s the constant exams I’m having and they don’t call me back to the office until “ see you in 3 months “ for a follow up. It’s killing me to wait.

@andytheman absolutely get a second opinion. November 9, 2025 I was getting ready for church, my family had gone a head of me because I was running late. Shortly after they left I felt a stabbing pain that went in through my chest and came out my back. The pain was indescribable. I can’t imagine pain being any worse than losing a limb or a burn. Something kept telling me it was not a heart attack, we went to the ER and after a 3 hour wait I was finally taken back, asked a few questions I was taken to have a CT scan. The tech immediately told me I had an aortic tear. They rushed me back to the exam room and told me I was about to have emergency surgery. An hour and half later I was under the knife. They told my husband that patients with this type of tear don’t make it to the hospital but those that do have less than a 1% chance of survival. But guess what I made it. I am healing well physically but struggling emotionally. I am a firm believer that ever doctor cannot know everything and apparently this doctor did not. I am an advocate for Aortic Dissections because they are over looked more times than they are diagnosed. Find yourself a thoracic surgeon, get a CT San and there be no more guess work. Go with the working signs you body is giving you. Cardiologist don’t know what they need to know about Aortic Dissections.
Do not wait!