Exercise, Lifestyle and Life Experience with Dilated Aorta?

@gocougs I have not. I was diagnosed last month. My aortic root is only 4.3cm. Seven years ago I had an echo for non-heart related reason and just now found out my aorta was borderline at 4.0cm. Had I known it was borderline I’d have stopped the weights. I’ve hiked with 100lb for 28-37 miles. I did HIIT with 100lb sandbags.

I am hopeful that it won’t grow appreciably and I’ll get 15 years. I am also dealing with a benign pituitary tumor that doubled in size in seven months. Plus a fast rising PSA that may result in a biopsy. I am retired military and have had several close calls. Now I have decided I want as much time as I can get. Surprisingly, that has made me be comfortable with my new restrictions. Aortic Athletes talk about adapting and keep on going. One guy ran a marathon two years after dissection and open hear surgery. That has inspired me to push it as far as I can.

@c130herkengineer

It’s hard to take when somewhere north of 10000 workouts in to this (and loved everyone) I’m lucky if I get to be the old dude hammered on drugs and doing 2.0 on the treadmill. Doing my best to do the “it ain’t fair” routine when I see some real never ran in their life types but then they will never know the feeling of hitting bench 10 x 225 , driving a golf ball 300 + or crushing the last mile on a tuff grade on your bike.

Thanks for the note. Did you have the surgery?

@gocougs Throwing no shade on your experience. It is devastating as someone who pushed hard in the gym or on the trail. Bike, run, hike, powerlift. At age 57 I was coaxing 5 reps of 275 on flat and 250 on incline. I quit squatting 350 when I tore a quad last year and couldn’t run a 50k. I am 57. Great cholesterol, BP, glucose. 45 RHR and now I am lifting the bar and 30lb dumbells. No isometrics. I get on the elliptical and keep it below 126bpm.

Let it out. I did. I am still in shock. I just wish I was 72 (never thought I’d say that). Finding out just before turning 58
has been a cataclysmic event. No running the Antarctica marathon. Ever. Hang in there. The decision will ultimately be yours, but if you do it there’s a world of possibilities. Look up Aortic Athletes and see what people who’ve had surgery are doing. I am glad I caught it before I was just going along as the dissections are horrific.

Well this has been my week of total funk. I am a 72 m, 6'2",207 and been chasing the "pain cave" for 50 years. Any run, bike, or lifting that didn't finish on a hill or grinding out one last rep was wasted. My Total Chol is mid high but my HDL's and triglycerides (77,63) are rock star level and so are my ratios. To prove to my PCP I'm good to go he convinced me to have a CAC. So, boom it's high and to boot my ascending aorta was 5.2.

Yeah, I'm devasted and a complete paradox. My resting HR is 43, my two minute HRR is 45 (and can hit 60 with a real hard finish). VO2 max is 39. Can incline 135 x 8, RDLs 205x10 etc.Bio age is 45-50. So much for immunity. Some literature is leaning towards sheer stress(pain cave long term) can remodel your heart, make it and the aorta bigger but the pump volume can still stretch out the lining. So who knew?

My height and cardiac efficiency give me some hope, but I'm definetely in the go/no go for a graft. Sucks. My PCP's for decades gave me solid info that my normal slight high chol and BP were ok, athletic norms and being super fit was all that counted. Well, maybe not so much. Trying to avoid monday morning mind set of why not statins and BP meds. Which I hate.

So with lots of research I'm treading water of sad/depressed and scaling back all my workouts to hit 110-115 HR for slow and steady aerobics and all lifting is 12-15 reps dropping at least one weight stack or weght. That keeps me in no valsalva (which I never have done) and HR steady at 85. Unless a miracle, follow up labs will confirm size and then it's debate the if/when to have surgery. If it gets the worst off the table, then hard to say no.

Thanks for listening.

@leonh That is amazing! Glad you can remain active. Were these measurements taken by echo? From all I’ve read there can be differences in measurement between echos if being read by different people. Your’s seems to definitely indicate a downward trend. Have you had a CT? I am glad you are hitting it. I have reduced my weightlifting dramatically, no running, and biking somewhat, but keeping myself in zone two until I see a cardiologist. My root is 4.3 cm. Second measurement by echo, the first being 4.0 in 2018 and this recent one last month.

Just some experience to share on athletic activity:
I have, for most of my adult life been a bicyclist. My ability to stay active varied over the years depending on other pressing issues in life.

After Covid came along in 2020, I started to focus on it again. So in the summer of 2022 following what I believed was an uneventful stress test, I had a call from my cardiologist urging me to come in promptly for an exam and what he described was ‘probably a stent’.
Instead he found a badly calcified bicuspid aortic valve…. Accompanied by what he described as ‘mild dilation’ (4.9 cm) of the aorta at the ascending arch.
Given the … apparent lack of concern over the dilation. I thought a TAVR to fix the valve looked really far preferable to open heart surgery.
An older surgeon saw me first and wanted to repair the artery.
A younger surgeon who had a lot of experience with TAVR’s felt the dilation (or aneurysm if you want to call it that) thought it was manageable. I did the TAVR on Friday and was driving and doing errands on the following Tuesday.
We agreed I would have regular exams on the condition of my aorta on at least an annual basis.
Although I felt fine, I was nervous going back to cycling.
I resumed it after about six months. At the annual exam, my aorta had actually shrunk (only a tiny amount to 4.8, but any is good). At two years, it was 4.6. After the second year of good measirements, I really have started putting my heart into cycling… no pun intended. I sprint and climb mountains… and my cardiologist cheers me on. At three years, my cardiologist thinks there was a measurement error… at 4.1. cm. Maybe so, but it certainly doesn’t seem to be getting worse.

I have, for the most part, quit worrying about exercising and the aneurysm at this point. I have some concern about how long my artificial valve will last… hammering it as I do. They are, however stackable.
My cardiologist says that keeping the heart strong by exercise improves the chances of surviving an event (I.e., heart attack) because the coronary arteries become cross-connected from athletic activity.

In a similar situation.86 yrs old love being physical,gym working around house and skiing.Still cutting lawn for a neighbor with walk behind mower.Knew I have abdominal AA but just found out about thoracic aneurysm of 4.6.Dr said I have a strong heart and pumping action is excellent.Still go to gym but mostly cardio and some light machine exercises.Lots of walking.Hopefully I can maintain a healthful life.Glad I found this site!

@davidtrey Hello, I am in a similar situation as you with the dilated aorta. Last year September I had a Low Dose Lung CT Scan that said my ascending aorta was mildly dilated at 3.9cm. February this year I had a follow up Chest CT Scan without contrast and it did not give a measurement but it said No Thoracic Aneurysm. I just completed my second Low Dose Lung CT Scan last week and it said my ascending aorta was mildly dilated at 4.2cm. Previously measured at 4.0cm. So what's up with this right?? Well in my research over the last few days I have read that the margin of error can be anywhere from 2-3mm and not clinically significant, and not necessarily representative of growth. There's a lot of information out there about different testing modalities, differences in radiologist interpretations, timing differences of where in the normal heart beating cycle the measurement is taken, especially when using NON Gated CT Scans. Which the Low Dose Lung CT scans I have been getting annually are NON Gated meaning not timed to occur at a specific point in the systole, diastole phases of normal heart rhythm. I've basically read that unless you are using the same imaging modality and that is a GATED CT scan that isolates the same time interval from one scan to the next and takes the measurement at that point every time, recent scan comparisons are likely unreliable. The research says to get a better idea of true growth means you have to have consistent scans taken the same way over a longer period of time. Sorry to be long winded but I guess I'm trying to say to myself and to you maybe lets not panic and freak out at this point. I plan on following up with a cardiologist about all this. Maybe you could ask yours about "margin of error" and whether or not you are getting gated or non gated scans each time. Supposedly the gold standard that they use for surgical planning when they need accuracy on these things is Gated CT scan with contrast dye. I would be the same as you about the weight lifting and stick to cardio and make sure your BP is well controlled. I hope for your sake and mine that taking measures for maintaining BP, healthy weight and healthy lifestyle will be all it takes to keep these things from growing. I've heard of many others in this forum who have been stable for decades and that gives me great hope. Wishing you good health!

Here it is, there’s a second one someone posted with an update from his research I will try to find it, this one is very educational

Where can I find Dr Prakash’s video?
Thanks