Exercise, Lifestyle and Life Experience with Dilated Aorta?

I couldn’t find it, but I remember the OP posting that his ended up being 4.0cm after a CT scan. It may have been on the aortic athletes forum on FB.

Me, not so lucky. Echo on 9/25 was 4.3cm SOV. CT yesterday was 4.4cm in the largest dimension SOV. Thoracic surgeon at UPMC’s Heart and Vascular Institute was not concerned. He and his CRNP did state it wasn’t a dilation, but rather an aneurysm and to be followed by their team annually with a gated CT (gold standard for measurement).

I have mixed feelings now. I finally adjusted to the idea of living either this, but was hoping for Dave’s experience. He’s 6’4” so his height index puts him in the lowest risk (pretty nonexistent for him unless genetic issues are identified). I’m just under 6’ and my AHI os 2.42 so in the low risk (4% chance per year of dissection).

I’ve had a world class exercise cardiologist and a thoracic surgeon echo what Moonboy said: “Just don’t lift heavy.” I was a 250 bench 395 squat guy until last December. Per both consults it’s all about not holding your breath and skipping isometrics, which tend to hold your breath or grunt and exert extreme forces.

I still do compound lifts as they are more effective when weighed against time and effort. I’ve stopped long distance running and extreme hiking and biking. It sucks. But the thought of having Moonboy’s experience isn’t appealing. And his story is incredible. Life is often about luck.

I found out I have mild calcification of coronary arteries, but cardiac perfusion study was negative for CAD. So, it’s off to statin land. Also, both consults highly recommended I get on Losartan, an ARB, that has shown benefits to the aortic tissue in keeping it healthy.

I agree with Moonboy. Having access to a high volume surgery center, with specialized cardiac knowledge is a must. Eating right and exercising is a must as you want to be in the best shape if surgery happens. In the end it is luck. Great center, world class doctor and excellent health cannot prevent death 100%, bitmit sure ups the odds.

@moonboy
Sage advice. Thank you. With you on the other side of a repaired dissection, were you cleared to resume normal activities once fully recovered? In other words, did the graft (forgive me for assuming it was a grafted repair if it was not) bring you back to what could be considered a healthy aorta again? In other words, are you able to do all the things you cautioned against doing?

As for avoiding operating anything with a pull start engine, is that because of the movement arc or the abrupt nature of the pull-start?

@jro12345 I had an ascending aortic aneurysm repair 6 years ago, it was 5.2, as others here I was very active and exercised with intensity, stopped when the aneurysm was found, I had my surgery 2 months after found, within about 2 months of surgery I started getting active again and gradually increased the intensity, all under consultation with my cardiologist, it took me a year to get close to where I was before surgery, but I have modified my goals. I lowered the weights and increased the reps concentrating always on maintaining my breathing throughout every single rep, if I notice that I may be exerting to the point where I may hold my breath I stop and lower the weight. I do fairly intense spinning and my HR gets fairly high, I asked my cardiologist and he tells me HR is not an issue, BP is, so that cardio is ok. I do strength training several times a week, swim, spinning and yoga. I get checked every year and full aortic + neck + head MRAs every 4, so far no issues.

Everything that @houston13 says is true and accurate. For perspective, below is a picture of the exact make and model of aortic graph they installed in my chest. I was able to purchase an expired one from a medical supply company for $40 plus shipping. The one UCSD actually installed cost my insurance company $1.4 Million. I paid for shipping. I read my UCSD-La Jolla medical records to find out the exact brand and size because of my mindless curiosity. Graft is 28 mm of diameter (same as a standard soda bottle cap) and 30 cm long (roughly 12 inches). It's flexible like a vacuum hose. I suspect whoever was the proposed recipient of this one, never had a chance to have it installed.

In any event, in answer to your questions: I don't do anything but easy cardio. Walking. I like to work around the yard so I can rake and I like to build things so I hammer things, but nothing that spikes my blood pressure. My job is to be here for as long as I can be for my wife and kids and that does not include weightlifting or risking my life because my ego won't move aside for it. I think swimming, walking, and spinning all work well, as long as any trainer you use has cardiac rehab expertise. Again, our goal post-surgery is to lower your heart rate below >60 Beats per minute and your blood pressure below >120/70 ideally.

Finally, there is this discussion of the risks of dissection in aortic patients who weightlift: "[I]ndividuals with confirmed aortic root dilation should be strongly advised to refrain from strenuous exercises such as weightlifting. These patients may also benefit from blood pressure and heart rate monitoring during their exercise sessions. Exercise recommendations should be made by putting into consideration patient’s age, body mass index, underlying comorbidities and existing risk factors." https://www.swjpcc.com/critical-care/2020/8/7/acute-type-a-aortic-dissection-in-a-young-weightlifter-a-cas.html

Peace.

Graft

@moonboy as always agree with everything you mentioned, the only caveat is that we need to be cognizant that it is not possible to measure BP while exercising (HR not an issue many devices available), there are no devices that can measure BP while in motion and changing positions. Accurate devices (arm cuffs) require you to be sitting, static and with the device in a certain position, by the time you get ready to take your BP it would have come down quite a bit from the peak, and that peak can be significant.

Hi all! Please keep posting these questions and information. It is very helpful to all of us out here. I dont post often, but I am reading. My medium sized 4.4 aneurysm took a back seat to my baffling PFO,... a very large PFO. What is a PFO? I found out. My aortic disease cardiologist suspected something more, and referred me. I have had a rougher than normal recovery following the repair, But I am working on it. I love the exercise posts, and the Dr Prakash videos! They are very informative and encouraging. Thank you Houston13 and MoonBoy, for your dedicated flow of good info!!
Upartist

@houston13 is playing tennis not recommended if you have enlarged aorta?
My Dr saw thru X-Ray that I might have aortic aneurysm. Im having a Cat scan next week.

@vrjuls I’m not a Dr but I will tell you what i think based on everything I have learned through this journey , light cardio exercise is OK with an aneurysm as I was told by my Cardiologist, keeping your body in good shape is actually important. The main thing to avoid is exercise that may raise your BP, (as it has been mentioned in the thread any exercise that will lead you to hold your breath while exerting), so I would think tennis at a reasonable intensity should be OK