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aortic dissection can be serious and can cause aorta rupture.
aortic aneurysm of 4.5cm is large. is it getting bigger.
I am more worried about the aortic dissection.
have you seen vascular surgeons about this for assessment? did they recommend surgery for repair now or watching the situation?
do you have high blood pressure or high cholesterol? these can increase risks for problems with your blood vessels.