Introduction: Balancing the well-documented benefits of regular exercise, particularly its positive impact on cardiovascular risk factors like hypertension, with the potential risks for patients with aortic aneurysms presents a significant challenge. This narrative review aims to summarize the current evidence and guidelines to assist clinicians in making informed exercise and sports recommendations for patients with aortic aneurysms or post-aortic repair. Methods: Nine clinical trials on the effect of exercise on abdominal aortic aneurysms (AAAs) were identified, including one study on cardiopulmonary exercise testing (CPET) in AAA patients. As no clinical trials on exercise in thoracic aortic aneurysms (TAAs) were found, we extrapolated data from other studies on exercise in aortic diseases, including data from patients who have had an aortic dissection, as well as three studies on cardiac rehabilitation (CR) and one study on CPET after proximal aortic repair. Review articles and guidelines were also incorporated to ensure a comprehensive overview of the topic. Results: Currently, no clear correlation exists between intense sports activities and the development of aortic aneurysms or dissections. Conclusions: Light to moderate physical activity appears safe and beneficial for patients with aortic aneurysms and post-aortic repair. Given the lack of evidence linking athletic activity to aortic complications, caution is warranted in restricting such activities for athletes, underscoring the importance of shared decision-making. Regular follow-up and optimal management of cardiovascular risk factors are essential.

Background/Objectives: Venlafaxine (VEN) is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. Arterial hypertension (HTN), heart failure (HF), and arrhythmias are side effects of VEN. Cardiotoxicity (CTOX) as a feature of VEN-associated side-effects has only rarely been described. Methods: We conducted a search of our database for cases of VEN-associated CTOX, analyzing symptoms, echocardiographic findings, and laboratory results. Results: We identified five patients (three females, two males) with VEN-associated CTOX, aged 51 to 87 years at presentation. VEN dose was 150 and 375 mg daily and treatment duration was 1.5 to 15 years. Presenting features were HTN in three, “hypertrophic cardiomyopathy” in two, heart failure in three, and atrial fibrillation in three patients. Symptoms and signs of CTOX were reversible in all patients after discontinuation or dose reduction of VEN, suggesting a causal relationship between VEN and CTOX. Conclusions: VEN-associated CTOX can occur and progress to severe cardiomyopathy or heart failure. Potential risk factors include cardiac sympathetic stimulation, high VEN dosage, and prolonged treatment duration; however, CTOX may also occur at standard doses. Therefore, patients taking VEN should be routinely monitored for signs of cardiotoxicity, including monitoring of serum concentrations of VEN.