Thanks for the post.
Q:"Do I need to keep my heartrate from exceeding 100 bpm or refrain from lifting anything over 20 lbs. in order to keep my mildly dilated 4.0 cm aortic root from enlarging?"
No one can answer this question for you. We often recommend that patients not engage in isometric exercise (weighht lifting) when they are found to have aortic dilations or aneurysms. There is no evidence for this practice, but the extreme, short-lived increases in blood pressure that occur during isometric exercises could theoretically lead to further expansion of a weakened aorta. Evidence for this theory is largely anecdotal, but many of us have known or heard of patients who developed rupturing of their aorta during exercise.
Q:"Is a 4.0 dilation something to be concerned about, if it has never become larger?"
Progression is the concern. Monitoring is prudent. The longer it stays the same size, the more reassuring is the case. A 4cm aortic root dilation, however, is quite mild. This could be normal in some taller individuals.
Q:" Is there anything to be done, to keep it from getting larger?"
Proper control of blood pressure is the key -- which sounds like is the case already for you. Avoidance of cocaine is obviously a must.
Q:"Could cocaine use (from 30 years ago in my ignorant youth) have caused my aortic root to enlarge at that time?"
Hope that helps.
Slightly different question. I had my ascending aorta replaced with a graft (Hemashield) early this year. I do not have Marfans or Ehler-Danlos, and my surgeon said he believed my condition was congenital in nature. The rest of my aorta looked fine on CT, my aortic valve was fine (no regurg), and my coronaries did not need reimplantation into the graft. My aorta did not appear to be diseased, just dilated, according to a perfusionist friend of mine who scrubbed in.
Question: am I subject to the same constraints of lifing weights as a person who has an aortic dilation, or is my graft strong enough that this isn't an issue? Clearly, the Hemashield is extremely strong - what about the suture areas? Note that I'm not talking about competitive weightlifting, just normal activity and some fitness lifting.
I think this is a great question. I have always wondered if past cocaine use may have contributed to my atrial fib/flutter and enlarged aorta.
Do any of you guys know a good dealer in the Los Angeles area:)
I doubt 30 years ago could be a major contributing factor.
I would certainly want to find out so I can raise money to
open a chain of clinics to treat the results of the biggest drug epidemic in the history of man kind....
I would say one thing though, if one has any predisposed
underlying defect, coke certainly has the ability to make it
So even 10 years later I would say has no bearing.
A related discussion, aortic root