Ascending thoracic aneurysm: What should I do and not do?

@oldwillie
Hello.....lots of things to consider and prioritize in your case. Is there Family close by that can help you, either with your Wife's care, or yours if you have surgery? Your other health issues may govern your recovery if you have surgery. While it's sounds like you have great confidence in your surgeon, what is his experience level regarding open heart surgery, which is what you would have. Also, how well rated is the hospital you would use for this? It's important to have the best possible care before, during and after what could be considered a long and potentially difficult surgery and recovery. You need to be very realistic regarding your own physical condition and stamina to judge whether you could handle the aftermath of this very serious surgery. While the size of your aneurysms does dictate the need for surgery, you should have some very direct and frank conversations with your surgeon, and Family regarding the seriousness of what you're considering and the aftermath. You also might consider a "Virtual Second Opinion" that is offered on-line by Cleveland Clinic....considered one of the best aortic centers in the country. It is an out-of-pocket cost for this, but the expertise they provide is priceless. Best wishes in arriving at your decision and for your future health!!

Hi people, I'm a new guy. I'm 79 and have been following three anurisyms for years. An aortic root is now 5.3cm and one a couple inches up on the ascending aorta is about the same. My heart surgeon at Trinity in Hartford, CT., is very experienced and says it's time! I've been caring for my very ill wife for a long time and was hoping to try and hold off on surgury until she was gone. Do you think if I'm a couple of years older, that I may not be a good candidate for the surgery? I'm otherwise in fair shape. Maybe a little overweight and have parkenson's, but I do well with that! Any advice would be appreciated.

Thanks for your well wishes.
I advocate for myself a lot.
I try not to miss a beat.
After all, it’s my body!

Your duodenum is the lower part of your stomach. You have much to deal with and I wish you well. Knowing your body anatomy is key to understanding your test results.

I had another esophagus “stretch “ so I stop aspirating. It didn’t work so a week later I had a second one and it was another doctor and he said “ did your gastroenterologist tell you that you have an ulcer? I said no. One year later I failed the barium swallow test. The pill did not go into my stomach for over 5 minutes then they stopped the XRAY. My gastroenterologist scheduled a bigger “stretch”.
So far so good.
My test this time my gastroenterologist said he went down to my duodenum.
My stomach spinsher does not allow food to go down into my stomach on time. It eventually opens to allow food and liquids to flow down. The top part of my stomach won’t allow an easy passage so I aspirated to the point that the food backed up my esophagus and into my lungs. It gave me pneumonia. I had to be hospitalized for a week as I also developed sepsis.
The torn 1.7 aortic aneurysm was recently found to be at 3.9 and I’m on Coumadin and it is torn.
Apparently my doctor told me that he went down to the duodenum.

My right vocal cord is still paralyzed and I fractured my spine with 3 MRI’s coming up on the 28 of July.
The L1 vertebrae is compound fractured with nerve involvement and middle back and neck possible fractures. So food takes its time to get into my stomach but the endoscopy went down to somewhere around my duodenum. I will AI the esophagus. Thanks

First, let me tell you that you have misunderstood the dimensions of your esophagus. Your esophagus does not run down to your navel area. Your esophagus runs from your throad down to the top portion of your stomach. Please pull up a diagram on line so that you can see for yourself.

Everyone is giving you the best info, I would only add that you need to find the best thoracic surgeon accessible to you, someone who has done hundreds of repairs in a major medical facility. Also a cardiologist who specializes in aortic diseases, not all of them do and it makes a big difference. Get evaluated by both and follow all their instructions. Ask all the questions you may have.

I had a 5.2cm ascending aortic aneurysm repaired 5 years ago, I was 54 years old. Mine was found while having leg surgery from a bike accident. My surgery was “planned “ as it wasn’t a dissection, and having a very experienced team made everything go very smoothly.

Keep your body healthy, stay active but avoid exerting per @moonboy’s recommendations. You want your body at its best in case you ever need surgery.

You know you have it and can monitor and plan, not everyone gets that opportunity, you will be fine.

All the best and keep informing yourself

Thanks for sharing your story. I’m no doctor, but I have been through an aortic dissection before, but mine was closer to 6cm when it ruptured. Biggest things are keeping blood pressure down, eating healthy with low sodium and low cholesterol, and staying active, even if it’s something light like a walk. Don’t be scared! Modern medicine is amazing, and just keep in touch with your care team and ask any questions you may have. ❤️

Hi there. First, take a deep breath—you’re going to be okay. I was in your shoes back in 2015 when I had an emergency Type A dissection. I survived, had open-heart surgery, and I’m still here living a full, active life more than 10 years later. So let me help walk you through this.

A 48 mm ascending aortic aneurysm definitely gets your attention. You’re not imagining things—this is serious, but it’s not a medical emergency today. Most surgeons consider surgical repair when the diameter hits around 50–55 mm, depending on your individual risk factors (like connective tissue disease, family history of dissection, bicuspid valve, etc.). At 48 mm, you're in what I call the watch zone—close monitoring is key.

As for medication, the answer is usually yes. Most patients with an ascending aneurysm are started on beta blockers like metoprolol to help slow the heart rate and reduce blood pressure, which lessens stress on the aortic wall. If your blood pressure is still high, an ARB like losartan might be added too. These meds can’t shrink the aneurysm, but they can help slow its growth and reduce risk of dissection.

In the meantime:
1. No heavy lifting—nothing that makes you strain or hold your breath (Valsalva).
2. No intense pushing or pulling (like snowblowing, weightlifting, etc.).
3. No sudden spikes in blood pressure—try to avoid extreme stress, stimulants, and overexertion.
4. Stay well hydrated, especially in the summer. Dehydration increases strain on the vascular system.
5. Avoid deep twists or yoga poses that compress the chest or force prolonged breath holds.
6. Get a copy of your CT or echo—and ask your doctor for your exact measurements and how they’re monitoring growth.

You’re not alone in this. I know this feels overwhelming, especially waiting for more information. But knowing about it now is a gift. It means you can manage it, monitor it, and act early if needed. You’re already doing the right thing by reaching out and asking questions. You’re informed, you’re proactive—and that’s the best place to be. Peace.

Hello and regards. I was just diagnosed with a 48 mm ascending aortic aneurysm. Not sure what to do waiting for my Doctor to contact me. I am 60 years old. Is there medication that I can take ? Any other suggestions for me? Kind of freaked out about this.