Exercise parameters for the chronic type B aortic dissection patient: a literature review and case report

ABSTRACT

Introduction

The conservative management of a Stanford type B aortic dissection (TBD) is optimal blood pressure management, cardiac rehabilitation, and progressive return to activities of daily living (ADL) while preventing advancing dissection and aortic dilation. Recent case reports indicate higher levels of activity may be safe; however, the exercise parameters for chronic TBD conditions span a broad range and the research is limited.

Case presentation

The clinical presentation and outpatient cardiac and physical rehabilitation program for a 61-year-old male with a chronic TBD from his subclavian artery to common iliac arteries is presented. The exercise protocol was developed and based on the available literature for the management of chronic aortic diseases. Eighteen months after the patient’s acute TBD event, he began an exercise protocol designed to address the sport specific functional deficits related to his recreational activities. The program incorporated a variety of exercises from resistance training to cardiovascular exercise and high interval training. The therapeutic goals included restoration of cardiac fitness and improvement of core stability and appendicular strength, ultimately aiming toward a potential to return to recreational sport involving short duration, high intensity activity.

Conclusion

In conjunction with the appropriate anti-hypertensive medication treatment, understanding the concepts of aortic hemodynamics as they relate to exercise can serve as a guideline for clinicians in developing an individualized exercise program for their TBD patients. Moreover, these physical training programs may include particular exercise guidelines beyond general recommendations of light to moderate cardiovascular activities.

KEYWORDS:

• Chronic dissection
• medical therapy
• type B aortic dissection
• cardiac rehabilitation

Declaration of financial/other relationships

The contents of the paper and the opinions expressed within are those of the authors, and it was the decision of the authors to submit the manuscript for publication.

No potential conflict of interest was reported by the authors.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

There was no funding for this paper.