Training has nothing to do with this, it's a genetic defect in the type of collagen that's present in the first section of your aorta. Sorry to say this but 4.5 cm *****, because it's below the surgical threshold, but still in the danger zone for aortic dissection. Typical growth rates are on the order of 0.1 mm per year, so it can take a long time to progress to 5.0 cm. I would strongly push my cardio to get surgery and get this resolved so you can get back to your normal life. I don't know any of the surgeons at CC, but they're a leading center. You want someone who has done hundreds if not thousands of these, not somebody who as done 10 or 20. I'm going on 9 years since surgery, I've ridden over 9K mi this year and just did Levi's Granfondo (104 miles/9,000' climbing) this past Sat!
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