Exercise, Lifestyle and Life Experience with Dilated Aorta?

Hsminc: I have exactly what you have. ATAA: 4.2, Root 4.5. That was a year & 1/2 ago. Same reactions: depressed. Have weights & downhill skiing. Go to gym 3-4 times/week. 200 lb male and just turned 89. I know, everyone thinks I'm 70's. But this disease does not care about your age, just doctors do. I think they are vague due to our litigious society. Yesterday I was curling with a 40 lb cable and took blood pressure right after. 170/79 pulse 78. No clue that would go that high. Researched & found 180/95 = an immediate medical attention if it does not drop. New target = 160/75. Don't want to depress you further, but knowledge is power. Researched in medical library disclosed that doctor's have relied on aortic diameter to determine disease severity & risk of rupture & acute dissection. Blood pressure control is done with medications. However, AWS (Aortic wall stress) has generally not been measured. This could account for younger patients with controlled blood pressure still experiencing acute Aortic Aneurysm problems.
AWS = systolic B.P. X Aorta Radius divided by Aorta Wall thickness.
So, why don't they measure stress on aorta's walls? It's difficult, no way to do that yet except on cadavers. So, like the song says, "don't worry; be happy" because even with aneurysm's open heart surgery, the success rate is 98%. You will be there for your daughter and by then, the success rate should be 100%. Good Luck!

@c130herkengineer Yes, he went through genetic testing but they tested him for genes related to Marfans. He also had a thorough physical exam and the only indication was his "flat feet." This was done through the company that does a whole lot of genetic testing. The bloods were drawn at Mayo and we received the results through Mayo.
Is this a genetic predisposition? I, honestly, don't know but I am suspicious there is some genetic component. This first cousin's father died of a ruptured aorta but we are clueless about whether it was an abdominal aortic aneurysm or an ascending aortic aneurysm. No exam was ever done; he was in his eighties at the time and this was in 197x. His doctor (rural Minnesota) and family just said it was "old age."
The first cousin also has a descending aortic aneurysm and an abdominal aortic aneurysm. (My husband has neither.)
This cousin was a weight lifter, runner, and coached his kids' and grand kids' baseball and other games. The VA where he received care "forever" thought the cousin was in fantastic shape. Of course, they had no reason to do CT or other scans looking for "trouble."
My husband's mother (sister of the above) had giant cell arteritis and the ensuing strokes/ruptures in her brain are what killed her - they called them massive strokes. She had vasculitis and died at age 85. Thankfully, the PET scan that my husband had done did not show vasculitis. If my husband had vasculitis then we would opt for surgery as this would be an important risk factor for rupture.
My husband is 81, soon to be 82. He is very active and in reasonably good health otherwise. We do not smoke nor drink. We walk 3-4 miles every day, including up some pretty steep hills.
Since my husband was diagnosed with this aneurysm almost 5 years ago, he has not lifted anything heavier than 30 lbs and is basically careful. He has never been a weight lifter but did lift heavy stuff around our home. No more.
Hope this is helpful.

@hsminc Mine is diagnosed 4.3cm of the root. I was told immediately to stop lifting heavyweights and doing things with heavy exertion. I still lift and run, bike, hike, at moderate levels. I hope I can get 17+ years with no problems. Even though his cousin had a dissection it doesn’t sound as though he has a genetic or familial component. Has he had genetic testing? It gives me hope. Thanks for posting.

My husband had a similar diagnosis back in 2007, i.e., an aneurysm was 4.3 cm. He was told it was okay for his height and weight. He did nothing to change his lifestyle, listing heavy stuff, etc. It was unfortunate but we had "no clue" - I am not even sure that we knew the significance of the ascending aortic aneurysm. I sure don't remember it. We seriously woke up when his first cousin, who is one month older and a "fitness nut" was found dead on the bedroom floor with a ruptured aortic aneurysm in the same place as my husband's. His daughter, an EMT saved his life. He was airlifted to a large hospital (Abbott Northwestern) in Mpls where they did a fabulous job of repairing him. He is alive now with some deficits but he is alive.
Fast forward to 2021 and my husband was assigned to a new cardiologist cause the old one accepted a different type of job elsewhere. This new cardiologist ran an echo and then an angiogram with contrast. By now, his aneurysm had grown to 4.8-4.9. It has remained stable (last measured May 2024). He will have yearly tests although his potential cardiac surgeon said he could skip a few years. We have decided not to do that and will do it yearly.
A lot depends on whether you have vasculitis or any other risk factors. Find a cardiologist that specializes in ascending aortic aneurysms and also a surgeon. Community hospitals don't have the experience with this type of medical condition. Go to an academic center or a private center that does a whole lot of them. (For example: I don't know if the Cleveland Clinic is an academic center or a private entity.)
Good luck,.

@houston13 That’s a really informative video.

@sharron11 U of Michigan’s guide is very restrictive. DR. Prakash gives a fantastic rationale for the 2022 guidelines for aortic disease. My exercise cardiologist gave me the green light for several things that Michigan says shouldn’t be done. It really is person dependent. Take a look at Aortic Athletes. It will give you lots of comparisons with others dealing with this.

@sharron11 have you watched the video I posted earlier in this thread? Dr Prakash has done a lot of his research in the subject

Hi David,
I would like to know more about the do's and don't of exercising as well. Earlier, this year I read an article from the University of Michigan that provided some information. I will try and find it and post it here.

Thank you to moonboy and c130herkengineer!! I appreciate the understanding and advice.

I fully and suddenly dissected at age 50 while on business in California. It was simply the most excruciating pain I’ve ever felt and then three weeks in a coma after two open heart surgeries. I am very lucky to have this opportunity to talk to you. Most people who just dissect suddenly don’t live to tell the story. It’s time for you to honestly accept and assess your risk. Deadlifts, planking, and grunting on any exercise is totally dangerous because it spikes your blood pressure. That can kill you if your aneurysm bursts. You’re only at a 4.1 cm so you’re not likely a surgical candidate yet until you get to a 5.0. There’s no rush to that right? Deadlifters have notoriously suffered aortic dissection at very young ages because of the strain they put on their vascular system. Deadlifts spike blood pressure, so stop. Your family needs you. Stop doing things that bring heightened risk front and center. You’re doing the right thing by being here and asking questions about it from people who survived. Believe me. The last 10 years have been really traumatic for my wife and kids. They constantly worry that something bad will happen again. We owe it to our children, spouses, and friends to care for ourselves. Peace.