I've posted the official US consensus guidelines (Thoracic Aorta Disease) a few times before, but probably makes sense to now do so here as well:
http://circ.ahajournals.org/content/121/13/e266.full.pdf. See page 80 (e344).
An excerpt of the same:
"The prescription of exercise represents a dilemma in the management of patients with thoracic aortic disease. Because it is thought that the sudden increases in dP/dt and systemic blood pressure associated with physical and mental stress may be a trigger for AoD in many patients, the concept of avoiding such stresses makes sense. However, maintaining a regular routine of aerobic exercise has day-to-day benefitsin helping patients achieve an ideal blood pressure, heart rate, and body weight. Moreover, many patients simply enjoy engaging in sports such as tennis, basketball, golf, bike riding, etc. and wish to continue in such activities if at all possible. There are no outcomes data, and scant data of any variety for that matter, to indicate how much exercise is safe or beneficial for patients with thoracic aortic disease. However, aerobic exercise, sometimes referred to as dynamic exercise, is associated with only a modest increase in mean arterial pressure and AoD rarely occurs during aerobic exercise.
Consequently, most experts believe that aerobic exercise, particularly when heart rate and blood pressure are well controlled with medications, is beneficial overall. Nevertheless,if patients wish to engage in vigorous aerobic exercise, such as running or basketball, one might consider performing a symptom-limited stress test to ensure that the patient does not have a hypertensive response to exercise. Conversely, with isometric exercise, there is a significant increase in mean arterial pressure. When the Valsalva maneuver is used for the lifting of heavy weights, there is a superimposed increase in intrathoracic pressure, followed by a dramatic increase in systemic arterial pressure with systolic pressures reaching 300 mm Hg or greater. As a result, most experts believe that heavy weight lifting or competitive athletics involving isometric exercise may trigger AoD and/or rupture and that such activities should be avoided. Working with patients on an individualized basis to streamline these goals based on insufficient data can be challenging. For patients who are very much interested in maintaining some sort of weight lifting program, choosing sets of repetitive light weights appears to make more sense than permitting heavy weight lifting. For example, instead of bench-pressing 200 pounds, one might recommend selecting much lighter weights in repetitive sets to minimize the hemodynamic consequences. Patients often ask exactly howmuch weight is permissible to lift. Unfortunately, it is not possible to provide a blanket answer to that question, as it all depends on the patient’s size, muscular strength, physical fitness, and how the weight is actually lifted. Rather than try to define a numerical limit, it may be useful to explain that patients can lift whatever weight they can comfortably lift without having to “bear down” or perform the Valsalva maneuver.
In addition to the physiologic stress of exercise, certain sports, recreational activities, or sudden stress or trauma to the thorax can potentially precipitate aortic rupture and/or dissection. Thoracic stress or trauma can occur during competitive football, ice hockey, or soccer or may result from a skiing accident, a fall while water skiing, etc. Therefore, experts often advise patients with thoracic aortic disease to avoid these types of sports. Furthermore, rapid chest rotational movement while straining or breath holding (Valsalva maneuver) may be a common denominator in many patients who develop aortic dissection (ie, basketball, tennis, golf, baseball bat swing, chopping wood with an ax, shoveling snow, and rapidly lifting heavy objects).
