The Unexpected: Aortic Aneurysm Risk Factors
But have you seen how tall, athletic and handsome he is?
Life is like a choose your own adventure book, only sometimes you’re not doing the choosing. One such plot twist came in the form of Shawn’s aortic aneurysm —a life-threatening condition that we had never considered. Why? Because, up until that moment, he did not fit the profile of someone at risk. He was at a healthy weight, ate a fairly clean diet, and was athletic, playing basketball and pickleball at an intensity level that would wear out most guys his age. Yet here we are, surprised by a diagnosis that seemed to come out of nowhere.
If you’ve never heard of an aortic aneurysm before, it’s essentially a bulging or ballooning of the aorta, the body’s largest artery. If that bulging area ruptures, it can be fatal, so it’s a serious condition that requires lifestyle changes, vigilant monitoring and eventually surgery. What’s particularly unsettling about this diagnosis is that it’s typically associated with people who have known risk factors—think chronic smokers, those with uncontrolled hypertension, or individuals with a family history of aneurysms. That wasn’t Shawn.
The Emotional Rollercoaster
Learning that you have this condition when you’re in otherwise good health is a surreal experience. He went from never really thinking about his health to realizing how fragile life can be, all in the span of a few minutes. It was like a ticking time bomb had been discovered inside his chest, and the immediate questions that flooded our thoughts were overwhelming: “How long has it been there? Could it rupture at any moment? What’s the next step?” Then learning the next step is a major surgery; the only treatment for this condition is open chest surgery where they remove the damaged portion of the aorta and replace it with a synthetic graft. Shawn’s aneurysm is currently 4.8cm, and surgery is usually recommended at around 5cm. The good news is that once you get through the 3+ month recovery from this surgery, you have a normal life span with no restrictions.
The emotional impact was profound. Shawn was pretty stoic about it, but I found myself swinging between denial, anger, and fear. Denial because he had no symptoms—nothing felt different. Anger because he had no real risk factors and still ended up here. And fear, of course, for the uncertainty that now colored our future. What we had taken for granted— his health—now seemed precarious.
The Science of the Unexplained
While it’s rare, some people develop aortic aneurysms without the common risk factors. Sometimes it’s linked to genetic predispositions that haven’t been discovered yet, or to abnormalities in the connective tissue of the aorta itself. Occasionally, it’s simply a fluke—a chance occurrence that defies medical expectations.
Some aneurysms occur due to minor structural weaknesses in the artery walls that go unnoticed until they balloon out. Though unusual, it can happen to people who, on paper, look perfectly healthy.
Moving Forward: A New Normal
After the initial shock wore off, we had to face the reality of our new normal. Shawn’s new normal. Cholesterol lowering meds, beta blockers and a statin. Twice daily blood pressure measurements. Salt is his new enemy, as it’s impact on blood pressure is noticeable, and so his diet (and somewhat mine) has changed dramatically.
Anything that spikes your heart rate for an extended period is out. Basketball and pickleball were eliminated, and so was lifting anything heavier than 25 pounds. Walking became his only acceptable exercise, and so he starts every morning with a 4-6 mile walk. I join him every morning my schedule allows.
In the meantime, he’s become hyper-aware of his condition. Sneezing and coughing are fraught. Stress management has become crucial, as stress can impact blood pressure, a major concern for aneurysms.
The uncertainty of when, not if, he would need surgical intervention loomed over our heads. After weeks of frustration discussing the “what if’s” with two different cardiologists, we decided to go for the best care available - The Mayo Clinic.