I haven’t read through the whole thread. So, this stuff is probably already in the mix. Apologies on any repetition, or on any things you have already expressed knowledge about.
We all want an aorta that is elastic. Stiff walled blood vessels are more prone to rupture. Elastic means it dilates when needed, and springs back.
Going a bit lateral in the research, I think it is worth looking at the internal lining layers of the arteries, and how those layers help maintain health and functionality of the arteries.
Dr. Malcolm Kendrick, though droll, is an excellent, knowledgable doctor, I think, to look up for information on the glycocalyx and the functions and health of the layers of blood vessel walls.
It’s always good to hear what Prof. Ben Bikman has to say as well (included video).
We don’t want to overload or injure the aortic wall. Dilatation indicates the blood pressure at that area was prolonged and too high, so the aorta adapted by expanding. Theoretically it should expand and relax with each pulse. Inflammation causes stiffness in the vascular walls and, over time, will limit the return to resting size.
By the read of it, you may have over-trained and over worked in a difficult, stressful work environment. Training will need to be adapted, I think, for a year or two, to allow healing. It’s good you left the toxic work environment. That’s the first thing to give your aorta, time, and no more intentional over-exertion, I reckon.
Healing things requires giving the body what it needs. Physiology, biomechanisms, and biochemistry will collaborate to heal things, if the injury causing problem is reduced or removed, and the building blocks for healing are provided in good nutrition and mindful modified behaviour.
I think Dr. Jason Fung has also written and observed good clinical results on a general vascular health approach in his work. That might be worth a look, and searching specifically about vascular health.
Maybe look into the use of nitric oxide as a treatment supplement if you are in the USA. It doesn’t get through customs in Australia in my experience. White powdered stuff in capsules, and tablets are treated with suspicion. Along with that nitric oxide option take a closer look at your dental health, and the work of functional dentists in improving your own nitric oxide production by promoting a healthy mouth biome.
There are a couple of leads here. I reckon get your aorta checked more frequently than once per year. If I had that condition, I’d be getting it staged bi-monthly. But that’s me. I’d be using it for staying on track and tracking incremental improvements.
Here is Prof Bikman with a bookmark on shear stress discussion in arteries which does relate to changes in blood vessel shape.