I don't mean to sound rude, but you are acting very irresponsibly. Someone who has had a dissection and who has family responsibilities should not be running marathons. Exercise and watching your health is one thing, but marathons are unnecessary and put a strain on your cardiovascular system. For your sake and for your family's sake, knock it off.
That said, a 3.9cm in the distal ascending aorta certainly is a bit enlarged, but precisely HOW enlarged depends on your body size, which you haven't given us. Regardless, someone with a history of dissection should be watched carefully. You should consult with a top-notch surgeon who can evaluate your case and tell you if you should have surgery now or later - I wouldn't rely on what someone here tells you.
Yes, you should cancel your 5k race. You should not be competing in stressful athletic activities. If you want to jog a 5k at your own pace, perhaps that is OK - ask your doc - but competitions should be out of the question.
I believe some studies have shown a correlation between athletic activity and aortic size. Olympic powerlifters tend to have aortic roots in the 4.1-4.2 cm range. Marathoners tend to have roots that are enlarged for their body size, too.
In addition to moderating your athletic activity and at least consulting with a surgeon, I'd suggest you look into ARB therapy. Click on my screen name and view my old posts -I've discussed it ad nauseum on these boards, so no need to repeat here. ARBs have been shown to halt and reverse aortic dilatation at the level of the root. We are not sure if it works in the distal ascending aorta, but if nothing else, the ARBs will lower blood pressure, and that is always a good thing. And who knows, they might help you control the dilatation. A Japanese study, for instance, showed that one ARB (valsartan) reduced the incidence of aortic dissection by 81%. Similar studies are coming out of Johns Hopkins and other institutions, too.
PS - You might not have Marfan syndrome, but you appear to have some sort of connective tissue problem.
I have a question for you since you said you'd had a dissection. A couple of months ago I had a scary experience when I bent over and felt a tearing sensation travel straight down the middle of my chest. It was as if a zipper was being undone. I took a deep breath and the pain radiated into my back. It happened again and then everything was OK. It hurt but not what I would consider excruciating pain.
I mentioned this to my cardio. I've had an echo since then and there were no problems but my aneurysm only shows up on the CT, not on an echo.
Did you experience anything similar to this prior to your dissection? I'm just wondering if I don't have some kind of a small tear in the aorta that could work into something worse.
Thanks!
Hi,
Sorry to hear this! Do you have a bicuspid aortic valve? If so, they can be prone to more aneurysms. I had an aneurysm repaired in '99 and now have another one measuring 4.5 cm.
I don't think most aneurysms of the ascending aorta need to be repaired until they reach a measurement of about 5 cm. Of course sometimes the size of the person comes into play and it may be done earlier.
There's no way to tell how fast an aneurysm will grow - some people wait years and years before repair is necessary. What's important is to keep your BP and heart rate down as those can make it grow faster. I'm not a doctor so please don't take my word as gospel but I have a feeling your cardio may tell you not to run. Mine doesn't want me on a treadmill or doing anything very strenuous. Again, I'm not a doc.
Best of luck and hope this helps.