Exercise, Lifestyle and Life Experience with Dilated Aorta?

@houston13 Thank you for the response. I have been trying to find a way (wrist watch type etc.) to measure B.P. but to no avail. Dr. Prakash is right on because even a slight bump will cause our B.P. units to read Ërror".
I have read everything you have submitted and find your writings very compelling and insightful. Thanks for sharing.
@dew88

@houston13 could you please resend the link to the video?

@vita831 Sure, here it is:

@houston13 thank you!

My husband has a 4.6cm ascending aorta and we just returned from a 10 day much needed vacation from Sedona, Flagstaff and Grand Canyon! It was filled with walking, hiking, sight seeing and overall living life. He has perfect health eg. BP, cholesterol, no prior history or family history of aneurysm, outside this recent ascending aorta find. He lives life aware of the condition but also aware that life must not be lived in fear. He monitors his BP and heart rate regularly. When he gets tired or breathy he takes a break. He doesn’t lift heavy weights, instead, he uses resistance bands, dumb bells and kettle ball for weight baring exercises. He stays active by walking the dog daily and playing pickleball several times a week. He endeavors to eat a low cholesterol diet full of fiber, lean proteins and fresh organic fruits and vegetables. As his wife, this diagnosis scared the life out of me but I am supportive of his mindset and I do my part to help him on his journey, our journey through this life.

thank you very very much for doctor Prakash's video. incredibly educational. simple and to the point. might be the best communicating doctor i have encountered. i have been waiting a long time to view it. i can't thank you and him enough.

i will definitely watch!!!! ty

Davidtrey. Our stories are similar. In 2015, went to a cardio doc for a different issue (turned out unfounded) who instead detected a 4.1cm enlarged aorta at the SOV. This was measured via Echo then with a CT. At that time, I was 42 and lifting heavy (for example sets of 8-10 reps of bench press @ 250 lbs was my max set on bench). Doc offered very little by way of detail (admittedly I didn’t ask for any) and was not concerned like yours wasn’t. He did suggest I lift “a little less weight”. So, I knocked off 10% of weight from each exercise but didn’t make any other changes to lifestyle.

Went in for an Echo every year or so and measurements ‘appeared’ to decrease each time – lowest was 3.7cm. My ignorance made me think I was fixing my own problem. I’m an idiot. COVID hit and my doc retired. In 2023 I found another cardiologist. He measured my SOV at 4.7cm (Echo) compared to my last 3.7cm and sent me to see a cardiac surgeon. I then did the same deep dive into MyChart to over-analyze all my prior test results and married them up to the various studies and charts found from hours of Google searches.

Opinion #1 – Consult with a cardiologist who specializes in enlarged aortas. All cardiologists are well-versed in functions of the heart but not many have a firm knowledge of enlarged aortas. The surgeon I was referred to ordered a CT scan which determined it to be 4.2/4.3cm. Subsequent CT/Echo’s put it at 4.1cm. I’m right back where I started in 2015.

Opinion #2 Don’t sweat the millimeter or two difference in test results (up or down). The aorta specialist I now see has me focused on abrupt and large increases in size and 5.0cm (just like 6’4 Bignelie said). When I hit 5.0cm, if I hit that, I’ll have it surgically corrected. You 6’4 giants may get an extra ½ a cm but I’m only 5’10.

This isn’t me telling you to ignore the lighter weight recommendation like I initially did. Definitely take heed. I put down the heavy weights in 2023 – now walking with some light jogging mostly. After 2.5 yrs, I am just now getting into weights again. Lighter weights with high reps – mostly dumbbells and cable machines. I won’t lift to failure or exhaustion. I stay away from compound exercises involving large muscle groups and isometric ones as well. I’m not dying to do them and I don’t intend to die from them either. I redid my home gym as a way to jump start myself back into it. All 45 lb plates have been given away or stashed out of sight. Stay away from Google or take what you find with a big grain of salt. I’ve done more than my fair share of research. Treatment of enlarged aortas can seem like voodoo medicine. Different cardios have different benchmarks, opinions, preferred modes of measurement, convention of measurement (outer aortic wall to outer wall, inner to inner, leading edge to leading edge?). For example, the aortic surgeon I see measures outer wall to outer wall via CT. The 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease recommends CT measurements be taken from inner to inner.

You mentioned your daughter. Opinion #3 Do genetic testing. It was recommended that I do. I did. It came back normal (for an idiot). Then it was recommended that I have my kids tested. Which I did. My son was deemed normal. My older daughter measured 3.8cm at her ascending. Her cardio deemed this within normal range for her size (she’s 5’8”). I don’t necessarily agree with that being normal or not worthy of monitoring. I hope to convince her to get it checked again – it’s been 2 years now. Unfortunately, my 17-year old other daughter was tested and diagnosed with a mildly enlarged aorta. Like me, it’s her SOV. If nothing else my worry for myself suddenly subsided a whole lot. It’s all focused on her now. Her genetic testing came back with a mutation in a gene known to be associated with enlarged aortas but the type of mutation wasn’t known to have that connection. Thus, she isn’t deemed to have a genetic mutation that resulted in an enlarged aorta.

Opinion #4 Get your daughter tested. At the time of my kid’s diagnosis, she was heavily into sports (had good chance to go D1 level – daddy opinion), heavy weight-lifting and MMA to the point where she was looking to competitively fight. It has been an ongoing struggle getting her onboard with giving those things up but she has heeded her docs recommendations, for the most part. I found this page today when I was researching isometric exercises, pushups specifically, because I learned last night that she does pushups at the gym (not to failure, nothing static and breathes throughout).

Sorry. This has become a book. I’ll end with this. There is so much (too much?) information out there on enlarged aortas. I try to lean most heavily on the information that is well-populated and accepted in the enlarged aorta community. The fringe stuff I tend to ignore because it can be too much. No more deep dives for me. I’m heeding doc advice and moving on with my life. Good news is you are aware of it and can monitor it and be smart about it. In time, if you haven’t already, you’ll settle back down to your new normal. Best of luck!

As somebody who suffered a complete aortic dissection in 2015 and barely managed to survive it, here's my advice: no heavy lifting, battle ropes, grunting, planking, straining, snowblowing, or operating anything with a pull start engine. Get your BP down and under control right now. Frankly, I wouldn't take advice from anyone except someone who survived a dissection or a cardiothoracic surgeon who is an expert in aortic repair. Aortic measurements can vary by a few millimeters depending on the type of imaging that you use and who is using it. That said, once you get to 5 cm, it's time to get cracking and schedule that surgery. Trust me when I say this: you do not want to suddenly dissect because you will likely not survive it. Having a planned surgery is like getting a tire repaired at a fully staffed and stocked tire shop at 8:00 a.m. on Monday morning. A sudden dissection is like trying to change a tire on Friday afternoon, in the middle of a busy freeway, in 112F heat. Doubt me? Ask a thoracic surgeon who has been paged in for one of these at 3:06 a.m. Peace.