I do think that this condition can weigh heavily on patients minds, though, and in your case perhaps particularly so because of the experience of your mother. Does lifting weights up to 100 pounds and being cleared for push-ups, pull-ups, all cardio, etc., sound reasonable? Together, you should be able to settle on what sports activities will be safe based on those facts. Thanks for sharing. This have affected my son psychologically since he loves playing soccer what should I do. His cardiologist said he cant play. Unfortunately, I really cant point you to such studies. You are a very good man. He has mild AS and AR and is otherwise asymptomatic. Many athletes with bicuspid aortic valve (BAV) may continue to participate in their sports.provided there are no other problems, either with the aortic valve or nearby aorta. Therefore, people . Okay, thats greatbut I left feeling uncomfortable with the diagnosis. Frankly Im worrying quite a bit about thisand I feel like its causing additional chest pain and shoulder pain. One situation that seems particularly ripe for differences of opinion is that of the athlete with BAV, no significant stenosis or regurgitation, but with an aortic diameter of 4.5 to 5.0 cm. Thank you sincerely for your time and information. Bicuspid aortic valve is a heart problem present at birth. First, youre not alone! Im highly considering this option, after 4 months of research and appointments with doctors. Call 911. He is on meds to slow it down. I am a 36 yo male who was first diagnosed with BAV at the age of 17. swimming? My question is if my weight&lack of training or my BAV is the cause of difficulty in running. I found myself in emergency surgery 12 months ago with 50% leakage, an enlarged heart and an ejection fraction of 30. 2023 Cond Nast. They are located between the ventricles and their corresponding artery, and . Im 39 also diagnosed with BAV when I was 31. Its a lot harder in the UK to see your cardiologist so you cant get the answers quickly. I recently also did a 24hr EKG (holter) which was fine. I am 38 and very active (running, cycling, strength training etc). Aortic dilatation is a common feature of BAV with a prevalence ranging from 20 to 84% , due to differences in assessment techniques, study population, aortic size thresholds, and heterogeneous nature of the . I do not do any kind of sport and I want to have healthy life at make sure my situation not getting worse and I weight 90 kg. He/she can talk with you about the generalities of operation in your circumstance. My family is pressuring me to quit strenuous cycling but I am thinking that switching to longer rides at lower heart rates would not accelerate valve wear or otherwise be bad for me. Thanks very much for this Dr, it is really helpful to get someone elses opinion on the subject and Ill definitely raise those points with my cardiologist next time we meet. More difficult questions relate to what are acceptable sports/exercise if operation is not (yet) needed. This was 7 months ago. Your surgeon will be in a good position to understand the exact details of operation that might be relevant when deciding whats safe.. Parenthetically, it may be time for an update. Ordinarily, athlete patients with mild degrees of valve regurgitation can continue to participate in their sports. I just thought it was muscle strain., My body cleared the blockage itself, said the game show host, who credited the aspirin he was taking for what he thought was simple muscle pain. Tetyana. Probably wise to follow the advice of your doctors who know the details of your situation. . I dont know about the relative effectiveness of various ARBs used for this purpose. Thats important to keep in mind. In fact, like most people, the 25-year-old had never heard the term before. It is unclear however if there are cardio thoracic surgeons who perform minimally evasive repairs yet. Thanks so much My son is a baseball player, so that is good. Normal great vessel size Adam has been featured by the American Heart Association and Medical News Today. Is it possible that the valve will get loose? Enlarged ascending aorta 42-43 mm It is two to three times more common in males than in females. these conditions occur mostly during my exercises at the gym and Im left very lightheaded and shortness of breathe. What advise can you give to someone in my position? We all appreciate it. When we go back to re-replace a patients prosthetic valve, for some reason, it usually has to be chiseled out from the heart. Again, this is a topic that is not yet well-researched. I can tell my story. Im obviously quite anxious that Ill drop death! The doctor allows me to do moderate sport defined by her like not 20k each day; 20k per week should be fine. And judgment would be needed. No LA, RA, RV, chamber dilation On said it wont make a real difference, the other said oh yes, that was like a blockage, you will feel the difference. This blog helped me a lot in my panic days, it put me at ease when I was worrying to much, just to see and to know your enemy and to realize that you are not alone is great help. We just saw them in January. I currently lift reasonably heavy weights in the 8-12 rep range, including body weight excercises such as pull ups and push ups. When he was 7 we noticed his heart racing at age 11 his bicuspid aortic valve was diagnosed We have been told his valve is at the top of the normal size chart. Ive seen several cardiologist and they are divided in recommendations. Over time, these patients need to be monitored for continued proper function of both the pulmonary valve (that was borrowed) and the new substitute for the pulmonary valve. His only complaint or change is shortness of breath with stairs. March 10, 2016 at 1:50 pm. My aorta diameter is 4.0 cm and has increased by 0.8 cm (from 3.2 cm) in the past 5 years so the diameter is increasing rapidly. Aortic stenosis and bicuspid aortic valve (BAV) ps. Aortic Stenosis One young man's complications from a bicuspid aortic valve were life-threatening, but perseverance and expert care helped him make it through. The doctor said it wasnt serious, but that I should keep watch on it every year. Please refer to this article if not: https://academic.oup.com/ejcts/article/50/3/400/2197426. Frequency of congenitally bicuspid aortic valves in patients 80 years of age undergoing aortic valve replacement for aortic stenosis (with or without aortic regurgitation) and implications for transcatheter aortic valve implantation.Am J Cardiol. Thanks for sharing your sons story. That is except for the last two months hes had several illnesses ( influenza, bronchitis, URI). Symptoms of bicuspid aortic valve disease most commonly develop in middle age in people with a history of a childhood heart murmur. They can occur separately or together. 1) Son has to stop football training as well as any physical activity, even at school (P.E. "I had many of them, but I thought, 'Nah.' He left it pretty vague. Im not surprised that youve received a conservative recommendation about exercise. Kimberly was born with an abnormal valve, but didn't begin to develop symptoms until her 40s. Now I take brisk walks and run on the treadmill only occasionally. Others won't have symptoms until adulthood, if ever. Im a 30 year old male who is currently living in Asia with family. Hi, Further to this most recent discussion point I was advised that isometric exercises, such as planks and other pilates type activities, as I understand them, are perfectly safe with BAV. We are wondering is there a science to knowing when he should have the surgery? I am 26 yera old , I have aortic aneurisem. But for those WITH such problems, we do recommend curtailing either static or dynamic activities, or both. My questions are: A normal aortic valve looks like the Mercedes logo, a circle broken up by three lines that meet in the middle. no tiredness, no dizziness, etc. Aortic valve repair is sometimes possible. Now at 33 years of age the valve is 23 years old and has served me very well. Just still unsure however if my bioprosthetic valve affects my cross country running times. Your advice is always invaluable and most appreciated. I take BP medication namely Amlodopine & Ramipril which has lowered my BP. As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. Check out Anthony DiLemmes blog, Anthonys Heart Valve Replacement Saga. Onside rations would be needed for hose with Marfans syndrome or other diseases of the aorta. The heart has a difficult time coping with extra demands of exercise. They are also predisposed to enlargement of the ascending aorta, the large blood vessel that carries blood flow away from the heart. Surgeon Q&A: What is TAVR Valve-in-Valve? with an efficiency of 69%, I have an appointment with a specilaist next week and am just wanting some, even if vague, answers. I cant wait to be back, completely rested with my heart recharged, my passion for the work ahead purposeful and my joy at lifes pleasures high," the statement continued. Having a congenital heart defect means you are born with a problem with the heart's structure. It's the most common type of congenital heart disease (heart defect that's present at birth) and often goes unnoticed until later in life. How severe are the problems? Weve known the risks and my daughter has done well to avoid scrapping for the ball etc. I was physically examined by a medical board at new Delhi for the post of a chemist in geological servey of India but they declared me unfit as I have BAV . Mild to moderate ai BAVD is a malformation of the aortic valve present at birth that leaves you with two flaps instead of three, tripping up blood flow to the aorta. "I had to make lifestyle and diet changes, she said. You might be wondering, with no disrespect to the great people of Cleveland, why Schwarzenegger, who surely has access to the finest hospitals under the sun, would choose to have surgery there. The rest of the aorta is normal (visualized to just above the bifurcation in the abdomen). I used to run a lot. "Thanks to the team at the Cleveland Clinic, I have a new aortic valve to go along with my new pulmonary valve from my last surgery," he wrote. I asked my surgeon and also the echocardiographist about my sports performance after full recovery, about 6 months after the surgery. Still it puzzles me that for you as for me it seems to degrade more after the diagnosis for a condition we have since birth. Like you, I have been frustrated by the lack of experience and information that the cardiology community has for folks like us, although it is encouraging to read everyones posts here and see that we are not alone. I do not feel any of the effect of my condition when I run or workout. I am now 60. Aortic valve replacement is recommended for nearly all patients with severe valve stenosis (valve opening less than 1.0 cm2), Aortic valve replacement is recommended for patients with severe valve regurgitation if there are symptoms due to the regurgitation (eg, shortness of breath with exertion) or evidence that the heart is suffering because of the regurgitation (enlargement of the left ventricle), Repair or replacement of the beginning portion of the aorta is recommended if there is enlargement of the aorta to greater than 5.0 cm. Could I continue to train and just cut out the blood chokes? ), Your email address will not be published. Consensus guidelines suggest restricting activities in athletes with BAV and aortic diameter >4.0 cm. My son is 12 years old. But neither of these procedures are durable for the long-term. Ive been told by my cardiologist that they think I should probably avoid competitive rowing and weight lifting. transcatheter aortic valve replacement (TAVR), Mick Jagger's Heart Valve Surgery: Top 5 Facts. Hi dr. In the 2.5 years from surgery, I returned back to riding within the first 3 months and later back to longer, decent training pace rides and racing but feel like I have lost my top end mojo. I would really like to know if I can (or shouldnt) push myself as hard as I used to. March 6, 2023, Erin Feaker I was just curious if there any way to know if my valve is affecting my times at all? The recovery from heart surgery can be hard to predict for any given patient, but we know that young otherwise healthy patients tend to do well. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. It has allowed me to do the thing I enjoy doing in life. The current guidelines suggest that sports activities do not need to be restricted for patients with BAV who have no valve regurgitation/stenosis and who have no enlargement of the nearby aorta. Replacement? Yes, as the patient grows, so will the aorta.and eventually you get to the traditional >40 mm cutoff where activity restrictions are advised. Do you have a congenital heart defect? Thanks for my previous response a few weeks ago. My daughter (16 y/o) has a St Jude mechanical mitral valve (adult size valve even though she has had it for 7 years). This is ridiculous. I agree that your doctor(s) are in the best position to offer advice regarding safe exercise based upon your particular circumstances. Do you think I should slow down a little bit? Thats about as specific as he got. No operation to replace/repair the aortic valve and yo replace the ascending aorta is minimally invasive. Thats just a marketing gimmick. Regards Aortic replacement. Perhaps your primary care doctor or cardiologist could help you find another specialist in your area who could help with thatlook over all of the pertinent information and share an opinion about whats safe. In my practice, we often do such second opinions (about all sorts of issues) and I have found that athlete patients usually value the information that comes from such visits. The important considerations in athletes with BAV are the degree of regurgitation of the valve and the degree of enlargement of the aorta. A bicuspid aortic valve (BAV) is the most common congenital heart defect, occurring in approximately 1%-2% of the general population. Any words you have for us would be greatly appreciated. Hamilton mother of twins, Cherie was diagnosed with bicuspid aortic valve disease (BAVD), a disease where the valve has only two leaflets. During that first month we recommend ample walking as the best form of exercise. 2. Thanks for sharing an update. I am 18 now, and I am interested in weight lifting. Aorta diameter (34 mm|34 mm); I used to do HIIT and moderate to heavy weight 5 days a week before my physical complications. I certainly know runners, cyclists, and triathletes in that circumstance who are active and doing well. Always best to heed the advice of your doctor(s) who will be in the best position to offer advice about safe forms of exercise. Hi Sean, Every 6 months it is getting larger. Diagnosed last year while looking at something else. I was wondering if you could give your opinion on my scenario. Hi Dr Creswell, Bicuspid aortic valve with Marfan and other HTAD when the ascending aorta is dilated >45 mm. 2) According to your explanation I rather not do cycling sports, but can I have low intensity sport like cycling or swimming twice a week for 90 minutes each, or 3 times for 60 minutes? Would this constitute as too much in your opinion ? It has served me well enabling me to live the vigorous, full, complete life you are all so familiar with. The Ross procedure borrows your sons pulmonary valve and uses it to replace his aortic valve and aorta. Kinda like a marathon but it will take me at least 9 hours. If untreated, it can lead to blocked blood flow. Your sons cardiologist would seem to be in the best position to offer specific advice. Thoughts. In March 2018 he underwent emergency surgery to have this replacement valve replaced. I dont know what to do .. The aortic root is moderately dilated (max 46mm sinus to opposite commissure but you can measure 48off axis). I have some issues with a dull pain right below my left breast that seems to come more often with a poor dietbut just doesnt seem like it could me esophagus related? View HelpingHeartsCharitys profile on Facebook, View @HelpingHeartsMDs profile on Twitter, View HelpingHeartsCharityMDs profile on Instagram. In January 2021, she underwent open heart surgery to install an aortic valve. For those same patients, we recommending avoiding strenuous dynamic exercise line swimming, running, soccer, tennis, cross-country skiing, etc. I am an amateur runner, I do not participate in competitions. After his procedure, Arnold posted the picture above with the following statement, "Thanks to the team at Cleveland Clinic, I have a new aortic valve to go along with my new pulmonary valve from my last surgery. Could you express your opinion on this issue? lessons) The issues of when, how, what sports are safe, etc. The HAART 200 is an innovative device that helps in the repair of BAV, allowing patients to avoid aortic valve replacement. Hes a 30-year-old 8th grade science teacher, a cyclist and outdoorsman, who is chronicling his story with BAVfrom diagnosis, to evaluation, to preparations for upcoming valve replacement surgery. Jones' goal with the AHA is to help women "actively put themselves on the track to heart health." Flaps of tissue on the valve open and close with each heartbeat. Dear Dr. Creswell, If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. Defects can involve the walls or valves of the heart, or they may affect the arteries and veins near the heart. I have been feeling better than before the surgery and I feel with better condition on the trails. My question here is what is the damage I can cause to my heart, mechanical valve, if I keep my heart rate at hi intensity levels? Sadly, no crystal ball is available. Im not sure how you should best sort out the differing recommendations from your doctors. Im 32 years old and back in 09 I discovered I have a BAV. I mean, when competing, my average heart rate is close to 159 and my max HR is around 170. As I restart my resistance (weight training) program what should be my upper limit weights? The data regarding the progression of disease in athlete patients with BAVare limited. Bicuspid valve stenosis treatment involves surgery to replace the valve. There are a multitude of patient-specific circumstances that must be considered when deciding if and when operation is needed. And, if so, how did things go? This has caused me a great deal of anxiety because I feel like I am being told to act like an old man before my time. Last echo measurements LDid 6.3cm z-score 2.4, LVIDs 4.1 cm z-score 2.0, LVPWd 1.2cm z-score 1.9, asc aorta Diam 4.0 cm z-score 5.8. In addition to being patients, there are many celebrities who, like you, parent a child with CHD as well. My son is 15 and has grown about 4-6 inches in the last year. My cardiologist said that sometimes it remains stable and never grows anymore. A cadaver if valve is then used to replace his pulmonary valve. My personal approach to endurance athletes in this situation would be to offer operation if the patient wanted to continue to participate in endurance sports (after operation) and was willing to assume the risks of operation. A repaired valve may not be as efficient as the native, healthy valve. A few hours after helping the woman, she began to experience chest aches, soreness in both arms, nausea and clammy skin. This also assumes that there are no other cardiac issues or medical problems to consider. Thank you so much for all of this insightful information. Maybe you can help me with some questions. An echocardiogram last June revealed a function BAV. I am perfectly happy to stick to the 10km max distance for races, but my key concern is that if I do run some faster training sessions then I might have a sudden death. Are there any things I can do now to help minimize my risk? Bicuspid aortic valve can be found in 1% to 2% of the general population . If labeling my fitness level I wouldnt use the term athlete, but I used to work out pretty vigorously 5 days a week until about 8 months ago (weights, medium endurance cardio, no longer distance running than 5 miles, interspersed with HIIT). Push for earlier date? Hello Dr. Creswell, Enlargement of the left ventricle can be an indication that the heart suffers from the aortic regurgitation, even if the regurgitation doesnt produce symptoms like shortness of breath. Likewise, if I did a 60kg bench press I could easier than say an 18 year old girl started at the gym tried that, they would have to strain beyond belief. I get the fact that lifting excessively can cause a spike in blood pressure, but only under certain conditions (i.e. Arnold Schwarzenegger was born with a bicuspid aortic valve, in which the aortic valve has only two leaflets, instead of the typical three. When Ive had patients in your situation, Ive usually recommended getting the screening when its CONVENIENT. I see Im not alone. After the first month, patients are generally allowed to return gradually to all of their previous activities. No stenosis, no calcification. I dont believe there is any evidence that would help us know if some forms are safer than others. At issue are the potential long-term effects of repeated episodes of high heart rate and high blood pressure that accompany intense exercise. Many endurance athletes are able to return to their sports after operation for BAV. I am a 23 year old male, have BAV with mild AR. I have a St. Judes Bovine valve now. The truth is that there is not much scientific information about what happens to such athletes if they do return to endurance sports. triangle chokes, other blood chokes) could be putting pressure on my heart and cause my aorta diameter to increase? I am mostly a runner, 4 times a week, with 10 21 km races. Best for athletes like you to have a discussion with their doctor(s) and settle on a defined, mutually acceptable course of action about which sports activities are safe. Background: Transcatheter aortic valve implantation (TAVI) has achieved satisfactory outcomes in the selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%). I am also in grey zone waiting for surgery. The lines are the edges of the valve leaflets that open and close to let blood through. Although the vast majority in each group (97%) underwent TAVI via the transfemoral approach, bicuspid patients were less likely to receive conscious sedation (57% vs 62%) and more likely to be treated with the largest 29-mm valve size . I have almost everyday all day shortness of breath which follows with chest pain and discomfort. This is an area where second opinions may be helpful in sorting out whats safe. We generally limit weight-lifting (or other sports/exercise that have a high static component) for athlete patients with BAV and mild enlargement of the aorta. We expect the current generation tissue valve to last at least 12-15 years before problems. We were to see them in 3 months. I am now down to seeing my doctors every 3 years or so and have been doing very well. Those figures are funny to me because before I was doing three or four times more intense training beside my job (air force pilot). And its always valuable to frame up discussion in terms of how much risk is acceptable. There is a readable section related to BAV. And any valve substitute (with valve replacement) is clearly not as efficienteven if the substitute is better than a diseased valve. Review of the clinical records of 152 patients aged 20 years and older found to have a bicuspid aortic valve at autopsy revealed aortic stenosis in only 28 percent. Thanks for the enlightening article. PS I am really interested to know if HIIT is too intense a system of exercise for people with BAV. It sounds like youre off to a good start with your recovery. Many patients with surgery for BAV, even if it involves aortic root replacement, lead rather normal lives afterwards. So, my question then is really, what should I look out for? As I mentioned in previous comment my recovery is going great. They ruled out Marfans syndrome because his aorta was dilating. Chris Pratt to Marry into the Kennedy Family. I feel as though Im recovering well and, having no other conditions or comorbidities, rapidly. The mechanical valve conduit replaces the valve with a mechanical valve and the aorta with a Dacron fabric tube.

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