Level Physical activity with a 4.3 Thoracic Aortic Aneurysm

I am not a doctor, but I am a sudden aortic dissection survivor, so I would take this very seriously and get very specific exercise guidance from an aortic specialist, not just general reassurance. I would suggest that you find a cardiothoracic surgeon to review your scans and advise you as well. You’re gonna wanna make friends with the nearest cardiothoracic surgeon at a major heart care center near you who has a specialty experience in repairing aortic aneurysms. 5.0 cm is the typical threshold for surgical repair, so you’re not there yet but you’re close. One of the super important things is that you get an annual scans to monitor its progression.

A 4.3 cm thoracic aneurysm is often monitored rather than repaired, but competitive bike racing is a different issue because it can involve sustained high heart rates, surges, hills, sprinting, breath-holding, and sudden blood pressure spikes. The heart rate number matters less than blood pressure, exertion level, and avoiding hard strain.

I would ask your cardiologist or an aortic specialist for written exercise parameters, including blood pressure limits, heart rate guidance, whether you need a stress test, and whether cycling is safe at conversational pace. Until then, I would avoid racing, max efforts, heavy climbs, sprint intervals, and anything that makes you strain or hold your breath.

For many of us, the safer lane is moderate aerobic exercise where you can talk while exercising, with smooth effort and no surges. That might still allow riding, but not competitive riding unless your doctor specifically clears it. Peace.

I fully understand my racing days are over. Those heart rates of 160 and
over for extended periods in a race are no longer doable for me. I was just
hoping to casually ride longer distances with heart rates in the 130 to 140
with short bursts around 150. Just riding for exercise and not competing.

I want you to think of an aneurysm like this: you walk out and you see that the front left tire on your car has a huge bubble. The nearest mechanic is 100 miles away and you can’t change the tire yourself. Should you get in it and drive 85 miles an hour down the freeway and wait for it to burst? Or should you drive slowly on back roads until you can safely reach the mechanic and have the tire changed? My point is that they strive to keep my heart rate down around 50 if possible. They strive to keep my blood pressure at or below 120/70. You sound like you’re in a lot better shape than I’m in, but none of that matters if you had a sudden dissection. They don’t have enough time to prep you and get you opened up to repair it if it happens suddenly. I know it’s not what you wanna hear, but it’s what I’ve been through and I can tell you that it’s a nightmare when it happens suddenly and you’re not prepared for it and they’re not prepared for it. You need to be able to think about whether or not you’re gonna be in a major metropolitan area with an experience. with an experienced cardiothoracic surgeon on call to conduct the surgery. If you have any doubt about that, I would say that bike rides like you’re describing are probably not a good idea unless you’re doing them in the basement of a cardiac care center. You are incredibly lucky because you know you’ve got a problem. I just talked to my old business partner, whose friend had an aortic dissection at the age of 42. He did not survive. He was fishing out on Kelly Island on Lake Erie and he didn’t have a chance because there was no possible way they could get to him fast enough. Where you live and how close you are to medical care makes a huge difference. If it were me, and trust me, it was me in 2015, I would not tempt fate and be doing strenuous cardio that raised my pulse rate and my blood pressure. Talk to your doctor, but be aware that the number one factor for survivability of an aortic dissection that happens suddenly is how close you are to a major surgical center. Peace.

You may want to search through this forum, exercise for competitive athletes has been asked multiple times and there’s a lot of information shared. There’s a FB group dedicated to athletes with aneurysms and you may find more info there including references from recognized aortic disease experts (cardiologists) that do research in the topic.

@moonboy has described the general recommendations, high BP is the enemy, any activity that raises your BP needs to be avoided, normally that is more prevalent with strength exercises when people tend to hold their breath while trying to maintain spine stability, that’s why the conservative approach is to avoid heavy weights, crunches, planks, etc

Cardio exercises in moderation should be ok but as Moonboy says check with your cardiologist, moderate high HR may not be an issue but extreme HR may be.

On the other hand a life of exercising and keeping your body healthy will pay dividends if and when you need surgery, it will lower the risks and will help fast recovery. Mine was repaired 6 years ago, exercised all my life and I was out of the hospital in 5 days, back to work in 3 weeks. I’m at full intensity workouts now.

You will be fine

@houston13 is a lucky duck. I spent my first three weeks in a coma. Then it was 8 weeks before I did the “office Zombie” thing where everyone looked at me like I had been brought back from the dead. I had. Look at me now @houston13 !!! Here 11 years later for my daughter’s prom yesterday. Happy for every day on earth. Peace