Doc: Exercise can hurt, help with dilated aortic root
Dear Dr. Roach: I am a 66-year-old male in good health who was just informed by my doctor that the diameter of my aortic root has increased to 4.3 centimeters.
Last year, the echocardiogram showed a number of 4.1. I have heard and read that running, which makes the heart rate go higher, can contribute to the enlargement of the aortic root.
Is there any truth to that?
I hate to give up exercising.
Dear G.S.: Dilation of the aortic root is an early stage of an aortic aneurism. The larger it is, the more dangerous, as it becomes more prone to rupture.
At the size yours is, regular surveillance is recommended. This is what your doctor is doing.
If the aortic root enlarges to 5 cm or greater, elective repair usually is recommended. Yours seemed to grow 2 mm in one year, so in a few years you may need a repair.
However, it is difficult to measure the aorta precisely, and it is possible that your rate of expansion is different from what was seen on the echocardiograms.
A CT or MRI scan is likely to have more precise results, and it is recommended that people with an aortic root measuring between 3.5 and 4.5 cm get screened annually.
Exercise is a two-edged sword. On the one hand, it has many cardiovascular benefits.
On the other, too-vigorous exercise, in theory, could accelerate the enlargement of the aortic root.
One recommendation is to keep your exercising heart rate below 70 percent of your maximum heart rate. A stress test is the most precise way to find your maximum heart rate, but there are several formulas to predict it, the most accurate of which (for men) is 207 minus 70 percent of your age, which for you gives a target maximum heart rate of 113.
A high-quality exercise monitor would be a good purchase, and some have alarms that go off if you go over your target heart rate. It may be that jogging (or even brisk walking), rather than running, will be your best exercise.
Heavy lifting is not recommended.
Email questions to ToYourGoodHealth@med.cornell.edu.