Aortic dissection & aortic aneurysm information support group

Aortic dissection, aortic aneurysm - The aorta - Life after an aortic dissection

I am almost 45 years of age and had a Type A aortic dissection in December 2010, which was rather a shock to me as I am very fit and a little young for such problems. As a result of the dissection I had my ascending aorta and my arch replaced with a prosthetic one. I have recovered well, and resumed sports in April 2011 under the guidance of both my personal trainer and my physiotherapist. I started with simple things like Pilate's and am now back into running 7k to 10k and also have resumed kettle bell training. During exercise I always wear a heart rate monitor and I have on occasions taken blood pressure readings during exercise, as I know this is something I need to carefully monitor.
 
The only thing that has concerned me recently is a closing sentence of a letter my cardiac surgeon recently sent to my GP following a review with him, in which he states that I need to give consideration to my "high levels of physical activity, although the risk of this is ill-defined and probably small but nevertheless present". My GP interprets that as keeping my heart rate below 150 bpm, presumably so as to not send my blood pressure too high. However, keeping my heart rate below 150 bpm means I cannot really run, but merely jog. This means I either have to quit running and find something else to do or I need a closer assessment to determine what I should and should not do. I would love to continue pursuing sports, but don't want to do things that are not safe. I also appreciate there are no black and white answers, as this is quite a complex area of medicine.

 

Is anybody else out there who can relay their experiences to me? 

 

Hans-Peter

 

Tags: Type A, aorta, dissection, sports

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mahlzeit hans-peter,

my cardiologist and gp say that provided i don't do anything extreme and gradually build up exertion levels during exercise there shouldn't really be a problem. like your cardiologist though they do say that there isn't really much to back up their assumptions that it is safe.

as i understand it provided you build up slowly during exercise there should only be an increase in pulse and not necessarily an increase in blood pressure. seeing as an aortic dissection is not really caused by a defect of the heart itself, your pulse should not really affect your dissection - and it seems you still have your own heart valve which is also a plus if you want to do sports. 

i can't run because i get terrible shin splints for some reasons, but i cross train 40kms a week (5 x 45 mins) and my pulse never really gets above 130 now. i start at 50kw for 5 mins, then 100kw for the next 5, then 150 for 5 and then 200kw for 30 mins - if i am in any sort of state to cool down i'll do 50kw increments back down for 3 mins a step too.

by extreme my cardio and gp mean sprinting on the one hand or sitting on my arse in front of the tv on the other, and i still have the weight restriction of 5 kgs (although i regularly break this - it is impossible to shop with a 5 kg weight restriction). i guess they also mean things like base jumping and bungee jumping too, but there isn't much danger of that ;)

maybe you should jog the first kilometre and then pick up the pace gradually until you get to where you want... i think you might have to drop the kettlebells though - your blood pressure spikes when lifting anything, especially when your heart rate is up and you are bending over.

hope that this helps!

r

My surgeon and cardiologist told me to never lift more than 40 pounds and to exercise daily,but in moderation. I was told that to do otherwise could result in redissection or anuerisms. I consequently gave up many things that I loved doing such as contructing and setting up free clinics in Mexico or white water rafting. I have always prided myself in being big and strong and it has been difficult emotionally to limit myself.  I remember the 1st time I made love to my wife post-surgery was very scary, although I have gotten over that fear.

Moderation means different things to different people depending on their abilities and fitness levels. I think all of us are taking beta blockers to protect our aortas and keep our hearts from pumping too fast as well as for blood pressure control, so it is difficult to raise pulse rates too high. I would definately adhere to limits your physicians place on you. Although I have every gradually increased my pace as far as cardiac exercise goes without issue, I know I am probably not going to be able to do what I was able to do before dissection, but this is a small price to pay for staying alive. 

 My dissection and surgery were in April 2010 and it is still scary at times.  I think most of us fear overdoing because consequences can be so devastating.

 

The fact that many people who have enlarged aortas also have some form of a connective tissue disorder implies that we all need to be careful to not engage in any physical activities that may precipitate another major medical crisis.

Hi Hans-Peter,

 

I was interested in reading your story.

Its seems to me, & probably many of us on this forum, that whilst we all have a conditions of varying AD disorder we are medically treated in different ways.

Like you I was 45 when I had my AD & very active doing sports & very strenuous exercise. Unfortunately after my first episode I had to give this up completely, mainly down to the mass medication & Beta Blockers. In away I am jealous you can do so much, but on the other hand (after my second diagnosis & subsequent repair of a growing aneurysm) I am glad I gave it all up.

My exercise is now mainly an hour’s walk down the park with dogs & day to day activity around the house & garden. Life is tuff but I would rather be alive than the other option.

My only advice would be to play close attention to the surgeon’s advice, get a second opinion if needed and check you BP regularly. You have to way up the risks of continuing strenuous activity v less stressful options.

 

Rgds

Harry

Hello Hans-Peter,

I read your post with interest because I am looking for similar guidelines for lifting/sports/work. I am 41 and, apart from valve sparing aortic root replacement in December 2011, am, thankfully, in good health with no evidence of any connective tissue disorder.

When my aneurysm was found, I was told not to lift anything more than an average weight shopping bag and to avoid all contact or competitive sports. I was also told not to strain and avoid anything that would cause a spike in blood pressure (straining for a poo, lifting heavy things etc) and to keep my heart rate below 140-150 bpm. At the pre-op appointment with my surgeon, he anticipated that these restrictions would gradually relax over time after the op. Since the op, I've been told by both the cardiologist and my GP that I should "probably" expect these restrictions to remain for life. This was a bit of a blow because my job involves a fair bit of manual handling. However, I'm alive to tell the tale - and can now put up with the stares of people who watch me watching my wife struggle to load the car at the garden centre or supermarket etc. Incidentally, the only person who would place a figure on the max weight to lift was the Occupational Health Nurse from work who said no more than 4.5kg.

At present, I am walking at a good pace for about an hour or so each day. I tried cycling to the end of my road last week (about 400 metres), but this was a bit too ambitious - it put too much pressure on my chest and left me reaching for the Tramadol again for a couple of days...

I hope this helps...

regards,

James

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