Patients should be advised to avoid contact sports and strenuous physical activities (such as 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.[10]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
[14]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
However, activities with low static and dynamic stress (mild aerobic exercise and daily activities) can be continued.[10]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
[14]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
The patient should also avoid cocaine or other stimulating drugs such as methamphetamine.[14]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
Patients should follow up for surveillance imaging and blood pressure control.[24]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.doi.org/10.1161/HCI.0000000000000075
http://www.ncbi.nlm.nih.gov/pubmed/35172599?tool=bestpractice.com
Smoking cessation and control of hyperlipidemia is important for overall vascular health.[14]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
It is recommended that patients maintain a heart-healthy diet.