February is Heart MonthMonths after he started working out for cardiac rehabilitation, retired airline pilot Peter Adhemar noticed his abdomen had firmed up.He thought he was starting to get the desired male “six-pack” muscular definition, but it wasn’t that at all.After he had a five bypass operation to clear blockages in six of his coronary arteries in January 2012, Mr Adhemar took an eight-week cardiac rehabilitation programme run by the Bermuda Hospitals Board.He credits the programme with giving him the ability to change to a healthy lifestyle. He began to exercise regularly, eat more healthily and he gave up alcohol entirely.“I had lost 30lbs. I was adhering to everything they advised me to do,” he said. “The advice they gave me proved valuable.“It was because I got myself fit that I was better able to survive my most recent event.”He was working out at the gym three to four times a week and noticed some changes to his body he mistakenly took them to be positive.“Sometime in the summer I noticed hardness in my stomach,” he said. “I could feel my heart beating through it but I thought nothing of it.“I thought it was the result of getting fit. I was actually quite pleased and felt like I was returning to the body of a 30-year-old.”Mr Adhemar’s GP, Gerhardt Boonstra, recognised straight away that what his patient thought was a six-pack was actually his aorta.“He sent me for an ultrasound scan right away,” said Mr Adhemar. “By the time I got back to work Dr Boonstra’s office called me and said to go straight to the hospital and do nothing strenuous.”Mr Adhemar was then seen by physician Council Miller who explained his aorta had enlarged considerably and he would have to go overseas to have the condition fixed.The average diameter of a healthy aorta is between two-and-a-half and three centimetres.“Dr Miller explained that when the diameter of the aorta reaches five centimetres or higher, an operation is necessary mine was 7.2 centimetres,” he said.By the time Mr Adhemar reached Johns Hopkins his aorta had grown even larger.“It had expanded to 8.5 centimetres, and could have ruptured at any time,” he said. “I have been subsequently advised that I had probably days, or at the most a week or two, left to live.”To correct the problem a vascular surgeon implanted an endovascular aneurysm repair stent.“I asked my vascular surgeon what had caused this to happen, could it have been the previous bypass surgery,” said Mr Adhemar. “He told me an enlarged aorta has five primary causes: 1) smoking, 2) smoking, 3) smoking, 4) smoking and 5) genetic factors.”Mr. Adhemar said he had smoked a lot of cigars until the age of 40.“They said my fitness level helped in my survival,” he said.Useful website: http://www.vascularinfo.co.uk/surgery/Endovascular_Aneurysm_Stent_Repair_EVAR.aspx