Exercise, Lifestyle and Life Experience with Dilated Aorta?

What an incredible reply. Thank you so much. I read your reply out loud to family and must have read it 5 times over myself. Thank you so much for the time and effort you’ve put into this. You’ve had a positive impact on my life.

I had my Echo in early July and have my CTA in late August. The CTA was mostly ordered to ensure my heart is ready for an ablation (4x with Afib over 20 years), but now since the worry and fear over the Aorta, I’ll be be very interested in the results for that reason also.

I spoke with my Cardio about genetic testing and she noted she’d only want to pursue that if I reached 5.0. I may speak with my PCP on the matter also.

Ironically 2.5 years ago my Cardio noted that my Aorta was 4.1 but showed no concern. It meant nothing to me since she showed no concern so I just carried on with being a gym bro, heavy squats and deadlifts, 6 days a week lifting heavy, creatine etc. a few weeks ago when she mentioned 4.3, I now had the MyChart app to log into and interpret the results online. That’s where the scare came from and I’ve been in my head ever since.

I haven’t touched a weight in a month, my dogs have earned the benefits as they’ve never had so many long walks. I’d love to get into some light weightlifting again just to feel “normal” and like you am in a state of mourning for the life I lived for decades. I’m not sure what the next step is.

But thank you, seriously, so much. This can be a very lonely feeling and knowing I’m not alone and someone so similar to me is working through this has helped a lot.

Where can I find Dr Prakash’s video?
Thanks

The best advice I can give you is to find a cardiologist who specializes in aortic diseases, they do all their research in the subject (they also normally specialize in bicuspid valves). Your aneurysm is small so maybe too early for a surgeon. If you have seen the video from Dr Prakash in this thread he covers the effects of exertion on BP and therefore aneurysms. The main issue is when exertion causes BP to rise, and that normally happens when you hold your breath and grunt for spine stability and pull/push heavy weights (which may include overcoming body weight like when doing crunches). Not knowing how to properly breathe when exerting is a big reason, it takes practice and discipline since sometimes we just forget to breathe especially if the effort is too high.

Think about the efforts that you are making and whether they are so hard you are not properly breathing while doing them. Limit the effort to what you can comfortably do without major exertion.

For context, I had a 5.2 cm ascending aneurysm and still have a bicuspid valve. The aneurysm was repaired in 2020, the valve will have to be replaced at some point.

Peace and all the best

I am in a similar situation as you. I have a 4.2 cm ascending aortic aneurysm, bicuspid aorta leaking valve. I am still working and doing a manual labor job that requires a lot of lifting, tugging, pulling, straining, etc. I read on line that I should not be doing any of that. The 1 dr I have seen so far told me to go back to work and not lift anything over 100 lbs and if I have chest pain to get to the hospital quickly. Should I I be restricted? I am getting a second opinion. If any drs read this then give us your opinion on what is safe to do.

As a fellow 6'4" + size person who loves sports/exercise, I was in your shoes a while back when I joined here. It shook my identity of who I am if I can't play basketball or lift a piano or squat etc....So I feel you for sure.

Good news is 6'4" puts you in an low risk category with a 4.3 size (https://www.jtcvs.org/article/S0022-5223(17)32769-1/fulltext) and this chart attached is helpful I found helpful from https://www.sciencedirect.com/science/article/pii/S0022522317327691#undfig1.

If it is quick growing and/or between 5 and 5.5 seem to be where the risk grows. We are both 6'4" and that is actually a benefit here for dissection risk and size.

I will state if they did not do a contrast CT, would advise it. Mine had the wrong size measured (smaller) with the non-contrast CT and echo (echo was closer though). It was actually in 5 cm range once measured with a contrast CT. Echos not considered a gold standard for measurement of this type of issue but is for Valve stuff. Also do genetic testing if you haven't got that scheduled already.

When it was believed to be smaller, it was recommend constant exercise without extremes. So biking was a check, sprints, mountain biking or hill runs through high grades was avoid if heart rate spikes or if I can't sing or talk. If I wante to do mountain or hills, use an ebike to keep the heart rate in a safe range. Lifting reasonable weight (lower amounts, more reps, don't hold your breath) check but not heavy lifting to increase blood pressure. Swimming constantly okay just no sprints. Yoga and Taichi and other slow flow stuff good but HIIT/Crossfit types of exercises are off the table. No combat sports or anything where someone could hit me in the chest like basketball. Etc, etc...You get the theme.

Consistent, measured exercise = safer/lower risk of a dissection
Fast heart rate or blood pressure spiking exercise or impact = higher risk dissection

For you, got to decide risk vs reward. Its a balance. Like you, I find a lot of community in sports and in intense exercise. Also I have read/heard athletes (https://www.acc.org/Latest-in-Cardiology/Articles/2024/09/09/10/21/CV-Sports-Chat-Dilated-Aortas-in-Athletes) and tall people just have a higher risk for these things for it appears no known reason if no family or genetic history has this. That sucks and I fall into this but it is a thing.

When I thought it was smaller and had to live with this for a long time before surgery, started a journey. First I had just slowed it down for a bit and shift my mentality while learning. Morned my loss of intense exercise and how it felt. Started to view it as a challenge a new way. Replace intensity with distance for example biking and swimming. Tried to keep my heart range steady in other exercises. I reached out to a science base trainer who actually had an anatomy background to discuss good ways to shift my lifting, training, and activity. One of the lifting changes discussed was lower weights, more reps and work on flexibility and moving up in weight slowly if at all. Also simply singing or talking during exercise to gauge exertion since I usually focus on the push. I did have to back off that one and stop lifting weights since my non-contrast CT and echo disagreed a lot in the size with each other during diagnose period and then due to my contrast CT basically moving me to a higher risk category. Before that though, found that it was possible to live a active, exercise focused life just with modifications and a different mentality.

You got this. You overcome challenges like you do in sport constantly. Hopefully my journey helps you feel a little better as you begin yours. Its a start of something new!

Hi, here’s one of the videos I mentioned:

Try to find a cardiologist who specializes in aortic diseases, not all of them do, it makes a big difference. The Dr in the video happens to be my attending cardiologist , I see him once a year, he answers all my questions, never vaguely, always with clear recommendations.

Anxiety after hearing the news and feedback on exercising are probably two of the most asked questions in this forum, do a search on the topics and you will find lots of information. You are in the right place, everyone here has gone through what you’re going through.

The right cardiologist will set a follow up protocol, he/she will determine the growth rate of your dilation and that will be key. Having the right care team (in my case it included the best surgeon I could find) with the right answers it’s huge to help with anxiety (at least for me). Stay active, exercise is the best medicine for anxiety, but be aware of the limitations. Have you tried yoga? . Lastly think of getting professional help, a good therapist can help

You will be ok