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]Mazzolai L, Teixido-Tura G, Lanzi S, et al; ESC Scientific Document Group. 2024 ESC guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J. 2024 Sep 29;45(36):3538-700.
https://academic.oup.com/eurheartj/article/45/36/3538/7738955
[17]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. 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.[17]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.[2]Mazzolai L, Teixido-Tura G, Lanzi S, et al; ESC Scientific Document Group. 2024 ESC guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J. 2024 Sep 29;45(36):3538-700.
https://academic.oup.com/eurheartj/article/45/36/3538/7738955
[17]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.