Advise the patient to avoid contact sports and strenuous physical activities (e.g., isometric heavy weight lifting, pushing, or straining that would require a Valsalva manoeuvre) to reduce aortic wall shear stress due to sudden rises in arterial blood pressure during exercise.[2]Erbel R, Aboyans V, Boileau C, et al; ESC Committee for Practice Guidelines. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. Eur Heart J. 2014 Nov 1;35(41):2873-926.
https://academic.oup.com/eurheartj/article/35/41/2873/407693/2014-ESC-Guidelines-on-the-diagnosis-and-treatment
http://www.ncbi.nlm.nih.gov/pubmed/25173340?tool=bestpractice.com
[18]Bossone E, LaBounty TM, Eagle KA. Acute aortic syndromes: diagnosis and management, an update. Eur Heart J. 2018 Mar 1;39(9):739-49d.
https://www.doi.org/10.1093/eurheartj/ehx319
http://www.ncbi.nlm.nih.gov/pubmed/29106452?tool=bestpractice.com
Aerobic exercise may be acceptable after careful consideration and discussion, ideally keeping the patient's heart rate less than 100 beats per minute. Patients should follow up for surveillance imaging and blood pressure control.[5]Fleischmann D, Afifi RO, Casanegra AI, et al. Imaging and surveillance of chronic aortic dissection: a scientific statement from the American Heart Association. Circ Cardiovasc Imaging. 2022 Mar;15(3):e000075.
https://www.ahajournals.org/doi/full/10.1161/HCI.0000000000000075?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
http://www.ncbi.nlm.nih.gov/pubmed/35172599?tool=bestpractice.com
Smoking cessation and control of hyperlipidaemia is important for overall vascular health.[18]Bossone E, LaBounty TM, Eagle KA. Acute aortic syndromes: diagnosis and management, an update. Eur Heart J. 2018 Mar 1;39(9):739-49d.
https://www.doi.org/10.1093/eurheartj/ehx319
http://www.ncbi.nlm.nih.gov/pubmed/29106452?tool=bestpractice.com
Counsel the patient to maintain a heart-healthy diet.