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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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shiloh376 | @shiloh376 | Dec 1, 2025
In reply to @kmailloux "Thank you so much for your feed back.. and yes I am trying to pin point..." + (show)
Profile picture for kmailloux @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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@kmailloux Hi. I am a 71 year old man diagnosed 8 years ago with an AAA that was 4.4 cm. I am very active and have gradually increased the intensity of my daily walks of about 2 miles walking at a brisk pace. I also lift light weights about 5 times a week gradually having increased the amount. I do lots of squats with no weight and pushups against the kitchen counter. In the gym I bench press using 25-35lb dumbells doing about 10 reps backing off as I begin to strain. I use exercise bands at home as well so I am exercising frequently. In 8 years my aneurysm has not grown at all. I have a CAT scan with contrasting dye to keep track at least once a year but more often lately since I have increased the amount and intensity of the workouts i do.

So I am curious. Here we are 2 and 1/2 years later and I am wondering how you are doing. Have you backed off on your exercise? Has there been any change in the size of your aneurysm? How are you doing? Brian

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charlanepj | @charlanepj | Nov 19, 2025

I absolutely agree with kmailloux. When found my aneurysm was a 4. I was told when it reached 5 we would discuss options. I ended up with an emergency dissection at 4.5 cm. Emergency everything just like kmailloux said. Be mindful, don't lift anything that causes you to grunt, moan, groan, hold your breath, or strain. ASK FOR HELP! I am a 71 YO female and this happened to me at 68. I am going in for another surgery for correction in February. I had no symptoms then and have none now.
Best wishes

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moonboy | @moonboy | Nov 18, 2025
In reply to @azguy1 "My aortic dilation is 4.0 cm. I exercise a lot hiking and climbing mountains. Often my..." + (show)
Profile picture for azguy1 @azguy1

My aortic dilation is 4.0 cm. I exercise a lot hiking and climbing mountains. Often my heart rate gets into the 140s-150s. I never know though if that bad or not. My doc told me no restrictions on exercise. Thanks for posting this thread.

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@azguy1

I remember feeling the same confusion when I first heard the words “aortic dissection.” Mine was already tearing by the time anyone realized what was happening, and in 2015 I ended up on an operating table for emergency open-heart surgery and a Dacron graft. Because of that, I pay very close attention now to what the numbers actually mean and what the body is trying to tell us.

A dilation of 4.0 cm is something to respect, but it’s not something that should steal the joy from your life. The fact that your doctor has cleared you without restrictions is reassuring. What I learned after my own dissection is that it isn’t the activity itself that’s the danger — it’s how we do it. The aorta hates sudden spikes in pressure. It hates breath-holding. It hates that heavy Valsalva strain we slip into without thinking. You can climb mountains, hike hard, and let your heart rate rise, but the key is keeping every movement smooth and every breath open. When the breathing stays loose, the pressure stays steady, and the aorta stays happier.

I still exercise every day, but I do it with attention instead of fear. If you feel good, if you’re breathing easily, and if your doctor has given you the green light, you’re doing the right things. Knowing your measurement and paying attention to the mechanics of how you move is what keeps you safe. That knowledge is power — and it’s power I wish I’d had before my dissection.

You’re not alone in this. Keep moving, keep breathing, and keep respecting that aorta without letting it run your life. Peace.

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azguy1 | @azguy1 | Nov 17, 2025

My aortic dilation is 4.0 cm. I exercise a lot hiking and climbing mountains. Often my heart rate gets into the 140s-150s. I never know though if that bad or not. My doc told me no restrictions on exercise. Thanks for posting this thread.

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andytheman | @andytheman | Nov 15, 2025
In reply to @andytheman "Yeah you’re right. When you explain to your PCP what happened and he doesn’t respond then..." + (show)
Profile picture for andytheman @andytheman

Yeah you’re right. When you explain to your PCP what happened and he doesn’t respond then I should dump him. My laughing cardiovascular surgeon should go next. Especially when I asked him if it could burst and he nonchalantly said that it could. Then practically running out of the exam room. He wasn’t taking me seriously. I had questions I couldn’t ask because he blew me off.

The first hospital I went to said that they found a torn aneurysm and was being transferred to a specialized hospital for emergency surgery.
The second hospital, the cardiovascular surgeon agreed but said that since it wasn’t bleeding at that time I should call my jerky cardiovascular surgeon ASAP and he blew me off. That’s a ratio of 2 vs 1 dingbat.
I googled “Cardiovascular surgeons near me “and at least a dozen showed up with most having doctors hospital privileges at some of the best hospitals including a heart hospital. My cardiovascular surgeon never told me the size of it. Even if it was small I still want to know what size it is so I don’t get a surprise.

I poured over the trauma hospital’s portal which I downloaded years ago and there I found it tucked away in a doctor’s notes “History of aortic aneurysm, and it said 3cm.
You know how long I’ve been dying to find out and I finally found it? A year ago I began to wonder and I just forgot to ask him. That shouldn’t have to be my responsibility in order to find out He should have told me instead of “see you next year!”

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@andytheman
My torn aneurysm has grown from 3cm to 3.9 as of last year. I’m currently waiting for my appointment with my cardiologist to tell me what it is now.

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andytheman | @andytheman | Nov 15, 2025
In reply to @andytheman "I have a torn aortic aneurysm in my abdomen. It only measures 3 cm but it..." + (show)
Profile picture for andytheman @andytheman

I have a torn aortic aneurysm in my abdomen. It only measures 3 cm but it is torn. I went to a hospital emergency department for an unrelated issue and the doctor walks into my exam room and said “we are going to transfer you to a trauma hospital for emergency surgery”

I asked why and he said that a CT scan showed that I had a torn aortic aneurysm. I said ok then was transferred to a trauma hospital. While in the trauma hospital a cardiovascular surgeon said that I would have to come back into the hospital but right now it isn’t bleeding so we feel that you are stable enough to be discharged. I felt uncomfortable with that but I accepted it.

The cardiovascular doctor said for me to see my cardiovascular surgeon ASAP. I made the appointment with him for the next day and he laughed and said “I don’t see anything through a sonogram.”

He was obviously Annoyed that I dare visit him and he was quick to attend to the patients that had appointments that day.
He poo pood the whole appointment and he walked out saying “all hospitals say ASAP and we have ways to take care of these things!”

What if I’m briskly taking a walk and I collapse? Most people would think I had a heart attack and push on my chest. That would do nothing and I could die as burst aneurysms are usually fatal. As he was walking out of the exam room I asked him if could burst and he said “it could!” Then said “see you next year!” I made an appointment for a year from now.

I happen to have a replacement aortic mechanical heart valve and am on blood thinners which could cause me to bleed out. Should I seek a second opinion.
I messaged my PCP last week and he has failed to respond. I feel like a walk-in time bomb!

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UPDATE: My torn aneurysm has grown to 3.9 so it isn’t sitting still

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salad2 | @salad2 | Nov 15, 2025
In reply to @kmailloux "Thank you so much for your feed back.. and yes I am trying to pin point..." + (show)
Profile picture for kmailloux @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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@kmailloux

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ronludington | @ronludington | Aug 17, 2025

What I would like to know is how do you know what your normal aorta size was. Stated above a 4.3 might not be that bad if your original size was large allready.
I'm 6 feet 230, but my chest size is 50 plus inches. Maybe that has nothing to do with it, but I am (what I consider) larger than average. Hoping that actually is a factor. (But I am at 4.6 and am waiting to see a surgeon in November)

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houston13 | @houston13 | Aug 15, 2025
In reply to @landy88 "Thank you for this reply. I find it helpful because I haven't been monitoring HR or..." + (show)
Profile picture for landy88 @landy88

Thank you for this reply. I find it helpful because I haven't been monitoring HR or BP on my own, so your comments give me something that I can notice for trends. That data could help me have better conversation with my doctors...whenever I hear from them...!

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I use a BP monitor that feeds the info to an app in my phone, I have it so it takes 3 measurements 30 sec apart and provides the average, I can then export all that info and send it to my Dr. when required . I take it twice a day before I take BP medications and try to keep the times consistent.

All the best!!

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landy88 | @landy88 | Aug 15, 2025
In reply to @houston13 "At 3.8 your aneurysm is very small, far from any concern in my mind. The main..." + (show)
Profile picture for houston13 @houston13

At 3.8 your aneurysm is very small, far from any concern in my mind. The main issue with any exercise is if it raises your BP, we know from many experts that holding your breath while exerting heavily raises your BP , in your case you are talking about breathing rhythm in an aerobic exercise, my reasoning tells me it should not rise significantly, if at all, but someone that has done studies with aerobic exercises would know the answer. I can tell you that after swimming or biking regularly my BP actually lowers (not immediately but when I take it in the evenings), but of course I don't know what happens during.

My aneurysm is already repaired (5.2 cm repaired in 2020, at 54 years old) , but I do get checked every year as I have a bicuspid aortic valve and they deteriorate with age. I exercise regularly and that includes high intensity 1 hr spinning classes, I get my HR to 160. During my check ups my cardiologist has told me whatever I'm doing is slowing down the valve deterioration, and he has done studies on exercise and aneurysms (the cardiologist in the video I have posted). He also told me though that although already repaired, controlling BP is important as in some cases dilations may occur at the point where the graft and the aorta were joined, or in my case anywhere else as I seem to have a genetic propensity.

On the other hand, being so active and maintaining your body in great shape will pay dividends if you ever need to have your aneurysm repaired, but at the size it is right now, that may never happen. I am sure your Drs are monitoring the growth rate, and that in my mind would be a point of reference.

Sorry I couldn't give you a straight answer, if I find more info I will post it

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Thank you for this reply. I find it helpful because I haven't been monitoring HR or BP on my own, so your comments give me something that I can notice for trends. That data could help me have better conversation with my doctors...whenever I hear from them...!

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