Next year I would like to finish my first marathon but now I dont know whether I should keep running. Yes, moderate aortic root dilation can remain stable. My exercise is limited to 30 minutes of moderate carido, with no weights. A faulty aortic valve isn't something you want to have considering that it helps blood flow out of the heart and through the rest of the body. I was concerned about his cough last weekend so I was assessing his lungs with my stethoscope when I heard a very pronounced diastolic murmur at his 3rd ICS. Willie Moses The readers here would love to hear back from you as you work through this. Many thanks again for answering this. I think its reasonable to think of things this way. A total of 25,556 newborns (51% male; mean age, 12 days) underwent echocardiography. I am playing basketball I am doing 100m and 200m and swimming . They call this type of heart attack the Widow Maker," she wrote. This site complies with the HONcode standard for trustworthy health information. In the blog post, I talked about the circumstances when operation is needed.as well as when sports are generally safe. What does heavy weights mean? with an efficiency of 69%, I have an appointment with a specilaist next week and am just wanting some, even if vague, answers. In fact, one young man died 5 years after operation (from other non related causes) and the study on his aorta tissue revealed that the device helped it to heal, presenting a healthy histology. In January 2021, she underwent open heart surgery to install an aortic valve. . Im a 30 year old male who is currently living in Asia with family. I had to take time off gym, when I returned I only did light weights and only walking on the 4x a wk and the same issues where still there. Athletes in this circumstance should collect opinions from their doctor(s) and make very careful considerations before returning to exercise. I played competitive amateur football (soccer) on Saturday and Sunday from age 16. Do you think I should slow down a little bit? Index to blog posts and online articles, Filed Under: Heart problems Tagged With: aorta, aortic aneurysm, arotic valve, bicuspid aortic valve, congenital heart disease, heart, heart surgery. I am 31 years old and had my BAV repaired at The Cleveland Clinic in 1999 when I was 15. We just saw them in January. The most common type was type 1 (1 raphe with the raphe positioned between the right and left coronary sinuses (75%), while the second most common type was also type 1 . She was originally under the impression she felt the way she did simply because she was exhausted. Not only the degree of aortic regurgitation, but also the degree of enlargement of the nearby aorta, should be taken into consideration when settling on limits for exercise. 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. I have also been advised that running intervals at over 80% max heart rate would not be sensible. They are located between the atria and corresponding ventricle. Perhaps meeting with a heart surgeon now, even if operation is not yet needed, might provide a forum for discussion about the options for surgery, the technical issues, and recovery. Medical therapy may be useful to slow or halt the progression of aortic valve disease and aortic enlargement by reducing the blood pressure and the blood pressure across the aortic valve. In fact, in some people they can go undiagnosed for years. eventually was told everything was ok. He was forced to stop playing football at 11. She partnered with the American Heart Association to encourage others to get CPR training that could potentially be life-saving. I had my BAV replaced in Feb. 2005 (porcine tissue) with a Dacron repair of the ascending aorta. Would you recommend taking beta-blockers at this stage? Ive heard from a fair number of endurance athletes after having aortic valve operations of one sort or another. The use of a less invasive transcatheter therapy in this . My son is devastated, depressed, and wanted to play ball in college. Thanks so much The aortic valve is between the left lower heart chamber and the body's main artery, called the aorta. The doctor said it wasnt serious, but that I should keep watch on it every year. It doesnt help that I am a nurse. BAV is the most prevalent congenital heart defect, but can go undetected for years - even into adulthood. Does the (unreplaced) aorta enlarge over time? "Were saying to put the focus back on you and make a date with your heart.". I have been advised not to run any more marathons or half-marathons, but that I can still compete at up to 10km races. 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 . I have recently had CT scan and MRI scan, following some chest pain experienced on track while doing marathon training. He wants to be normal. "I am lucky to be here.". You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. Thank you very much for writing such a thorough and well informed article. ODonnell, now 54, said her heart attack began after she helped an enormous woman struggling to get out of her car in a parking lot. I am a competitive cyclist, neither the Cardio or my Doctor said I should not be racing bikes anymore, does that sound reasonable to you, my doc did say to monitor the aortic root size yearly. Bethesda Conference reports), even though there is no certain link between sports and the aorta enlargement. There are just so many causes of shortness of breath, lightheadedness, and chest pain.even besides the heart-related causes. More difficult questions relate to what are acceptable sports/exercise if operation is not (yet) needed. Thank you to every doc and nurse on my team.". Dr. Creswell BAV is the most common cause of heart disease present at birth and affects approximately 1.3% of adults. Bicuspid aortic valve (BAV) disease does not usually cause symptoms. September 13, 2017 1:00 PM. So, my question then is really, what should I look out for? My son will be 16 next month. transcatheter aortic valve replacement (TAVR), Mick Jagger's Heart Valve Surgery: Top 5 Facts. In your experience how long are we talking before I have to have surgery and do beta blockers really help in prolonging the need for surgery. Thank you for nice article. What signs should I look out for? Hey has been physically active with restrictions of no contact sports, and no isometric exercise. When there is narrowing (stenosis) or leakage (regurgitation) of the aortic valve, the heart must do extra work. Stress echo revealed hypercontractile with normal response in all LV segments, no LV cavitary dialiation. Also, due to a bout of DVT and elevated d-dimers Im on Warfarin for life. Early after operation, and for perhaps the first month, we typically limit activities that place stress on the shoulders and sternum. She said it could still be 6 months to a year just depending on if there are any more changes to this next echo. I understand that we are only beginning to learn about the use of ARBs in patients who DO NOT have connective tissue disorders like Marfans syndrome. Theres no reason to not be CPR certified.. We have made the decision to stop playing high school soccer and will reevaluate in 6 months to determine about Spring team soccer (less intense). Should I stop jiu-jitsu as it is a mix of anaerobic exercise (which I hear is bad) and aerobic exercise (which I hear is good)? John Fox, NFL coach, suffered from Aortic Valve Disease. I feel like 95% of other people my doc sees are just happy to get back to their normal life which doesnt include pushing their bodies to extreme limits. He had a mild BAV and was told that he can play with no restriction. My cardiologist said that sometimes it remains stable and never grows anymore. Data from these studies supported the U.S. Food and Drug Administration's approval of TAVR for low-risk individuals - replacing a narrowed aortic valve through a small incision in a procedure . All severe aortic stenosis patients who are experiencing symptoms should ask for a TAVR evaluation. I appreciate your response, thank you for taking the time to write me back. lessons) No operation to replace/repair the aortic valve and yo replace the ascending aorta is minimally invasive. Thats just a marketing gimmick. Many patients with surgery for BAV, even if it involves aortic root replacement, lead rather normal lives afterwards. All rights reserved. With so many similar stories, do you know why there is not more statistical data or studies done with regards to sports and BAV and changes in aortic diameter? after surgery and was playing football again by September. In Jan 2016 My son was seen by the cardiologist and had some changes on his echo and the cardiologist said hey had mild progression of the aortic regurgitation( moderate to severe) with preserved LV function. In March 2019, media outlets hailed two new studies on transcatheter aortic valve replacement (TAVR) as potentially signaling the beginning of the end of open heart surgery for aortic stenosis. Some people with bicuspid aortic valve will have symptoms in early childhood. And what would moderate weight lifting be defined as? Diagnosis was made because pulse dropped to 30 (normally 52), and pacemaker was thought to be needed (no symptoms other than low pulse for a few days). Ed Helms - Actor - Undisclosed CHD. Thats important to keep in mind. Can you tell me what is to much, are push ups or pull ups heavy lifting, is 3 time per week 5 km running with 10-12 km/h pace to much? Latifah has taken on her mom's caregiving duties, along with relatives and a nurse, whenever she is on the east coast. 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. In 2017, there were 3,046 deaths due to rheumatic valvular heart disease and 24,811 deaths due to non-rheumatic valvular heart disease in the United States. Notify me of follow-up comments by email. Ordinarily, race walking is considered to be in the same category of activity as long-distance running. Thank you for what you do and for your responsiveness. 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 . The reason I ask is my Cardiologist said it looked fine in the echo imaging, but (and correct me if Im wrong please) I got the impression from what you said in this article that a CT or MRI is necessary for aortic diameter measurement. Randyyour situation has many similarities to mine; I would be very interested in sharing experiences. 1,3,4,15 It can lead to chronic heart failure and increase the risk of acute aor-tic syndromes and sudden cardiac death.15 Michelena et al16 studied 212 cases of asymp tomatic bicuspid . This can lead to stretching apart of the valve leaflets and leakage at the valve, known as regurgitation. Contemporary reports suggest that life expectancy with BAV is no different from the general population. Me, i`m nearly 43, male and have BAV. I cant lift over 40lbs and I cant continue my work as a tradesman as it requires lifting over the 40lb mark. My cardiologist is not concerned. my son has BAV he was born with. Operation is needed if there is severe aortic valve stenosis, severe valve regurgitation, or significant enlargement of the aorta. I think we should have a choice??? Thank you sincerely for your time and information. ANYTHING other than walking and golf? I have almost everyday all day shortness of breath which follows with chest pain and discomfort. Advice in this area must be individualized with your doctor(s). I am riding my 3 rd anual Belgian Waffle Ride today. Throughout the years he has played football and basketball. Im not sure theres enough information at hand to offer sound advice. Thats probably what the doctors are watching for. , Bicuspid Aortic Valve Disease, Acquired Valve Disease. His cardiologist said, i am sure he can play a full game with new issues but I have to go with new guidelines and indirectly left it up to me to make the decision which moved him to mild /moderate and put right at the Borderline. However, I absolutely love being competitive at running, and dont want to jeopardize that either. Although bicuspid aortic valve is typically asymp tomatic at fi rst, it is commonly associ-ated with progressive valvulopathy and tho-racic aortic disease. This also assumes that there are no other cardiac issues or medical problems to consider. CT or MRI may be more accurate. This gives a chance for the sternum, which was split during the operation, to heal completely. New guidelines from 2015 are in accord with your doctors recommendations about vigorous exercise as well as periodic imaging to measure the aorta. No aneurysm. I have been feeling better than before the surgery and I feel with better condition on the trails. Is that so, or can it be measured by the echocardiogram as well? When I had my valve replaced I was told that it would have a 20 year ish life but I think it should exceed that. We just saw the cardiologist in July and again same symptoms and no significant cardiac changes . Doctors at the Frankel Cardiovascular Center's Comprehensive Aortic Program have . James Cameron checks in from Pandora with a status report. For patients with bioprosthetic valves after heart valve surgery, the valve itself is not usually affected by weight-lifting activities. What a great resource! 2; Hi dr. Maybe thats not surprising, given that Im a heart surgeon and that many individuals with BAV need operation at some point. However, some people are born with an aortic valve with only two leaflets, known as a bicuspid aortic valve. Thanks for sharing an update. Congenital heart issues affect approximately 40,000 people born each year in the U.S. and are one of the most common types of birth defects. Anyway, his aorta was growing at a rate of 2 mm per year (he was growing faster:).and they put him on 100 mg Losartan. I have also had a stress test, which showed no issues at all. But Ill check it as soon as possible. Its very helpful for people with heart problems. My son is 15 and has grown about 4-6 inches in the last year. We dont have a crystal ball, though. Sbp. A 2nd opinion might help by bringing another set of eyes and ears to your problem. My problem is a perpetual fear and worry about having this diagnosis and having to someday undergo open heart surgery. If so, youre far from alone. Although bicuspid aortic valves can occur . 1 year ago I gave up smoking and started endurance running. Lack of breath? So my question: does there appear to be any performance advantage of tissue valves over mechanical or does the fact that Im on the anticoagulant anyway make the mechanical valve sort of a no brainer choice? Can you direct us to ANY research on the effect of endurance sports on AVR patients? Athletes with mechanical or bioprosthetic heart valves may participate in low and moderate intensity sports, Athletes who are taking blood-thinning medications should avoid sports where bodily injury, with potentially life-threatening bleeding, might occur. Very often, the specialists office will make note of the patients problem and make appropriate decisions about whether routine or urgent appointment scheduling is needed. Surgeon Q&A: What is TAVR Valve-in-Valve? During pregnancy. Log in, September 26, 2013 By Larry Creswell, MD 155 Comments. My name became public 25 years ago this week. He left it pretty vague. During the Ross Procedure, the aortic valve is removed. He isnt interested in anything else. Anyway, I just wanted to say I found this article particularly informative. Anyway, I will continue with running as much as I can, and now I have an excuse for my lousy performance. I certainly know of athletes who return to all forms of endurance sport as well as weight-lifting after operations like yours. He sees his cardiologist every year. Bicuspid aortic valve (aka BAV) is a form of heart disease in which two of the leaflets of the aortic valve fuse during development in the womb resulting in a two-leaflet (bicuspid) valve instead of the normal three-leaflet (tricuspid) valve. Im afraid Ill end up like my Mom. So it's got the Rock and Roll Hall of fame and great doctors. Apologies for my slow reply. Left Ventricular Mass (LV mass/BSA 93g/m2| 114 g/m2, Septal thickness 0.93 cm|1.0-1.1 cm, Posterior wall thickness 0.93 cm|1.0 cm). Check out Anthony DiLemmes blog, Anthonys Heart Valve Replacement Saga. We were to see them in 3 months. Anyway, it has slowed to 1 mm per year, and, via email, Dr. Dietz has suggested we may consider a switch to 300 mg Libersartan? She learned she needed an aortic valve replacement in 2009 and underwent open heart surgery, receiving a mechanical valve to replace her damaged aortic valve. Can you advise and or recommend a specialist? What is the average life span of a tissue valve? I wonder if there is also a psychological factor involved. He would be devastated to never be able to play again. Keep us posted! I agree that your doctor(s) are in the best position to offer advice regarding safe exercise based upon your particular circumstances. I agree that its somewhat surprising that more detailed information isnt available. We briefly talked about the Ross procedure vs mechanical valve replacement. Im a 57 year old male who had aorta repair and porcine valve surgery 3 years ago. 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. The issues of when, how, what sports are safe, etc. Pathology. Bicuspid aortic valve is associated with abnormalities in the coronary artery anatomy in about 2% of patients, including anomalous origins of the coronary arteries and upwardly displaced coronary ostia. The echo in Jan asc aorta Diam 4.2 cm z-score 6.4. Miley Cyrus - Singer & Actress - Tachycardia. Very often, follow-up CT scans and echocardiograms are needed every 6-12 months to keep track. For athletes with mechanical heart valves, the most important consideration is usually about potential bodily injury while taking blood thinning medications. There are certainly individuals with BAV who never have trouble down the line. I am 26 yera old , I have aortic aneurisem. Athletes with BAV and enlargement of the aorta to greater than 4.5 cm can participate safely only in low intensity sports (eg, golf, bowling, billiards). I know that there can be complication with Dacron graft or even aorta aneurysm building up but Ill stay on positive side since I have no tissue disorder and its highly unlikely that with properly working aortic valve I would develop another one in that short period of time. My question is if my weight&lack of training or my BAV is the cause of difficulty in running. Look forward to your reply and thanks for your time. New guidelines from the American College of Cardiology (ACC) were published just this week. Body contact sports may pose some danger to athlete patients who take blood thinners. triangle chokes, other blood chokes) could be putting pressure on my heart and cause my aorta diameter to increase? In the process of how I had the slow waltz with MG UNTIL DIAGnosed, will be ready in 3 weeks. Both are important in deciding if and when operation is needed. Thank you very much for your thoughtful response. A bicuspid aortic valve (BAV) is the most common congenital heart defect, occurring in approximately 1%-2% of the general population. "Schwarzenegger's pulmonic valve was successfully replaced.". No changes in regurgitation status (aortic regurgitation LVOT 19%); It usually consists of three flaps of tissue what are called valve cusps. I used to be very muscular prior surgery and 3 mounts ago I started with 5 km runs, push ups and pull ups 3 days a week, slowly progressing. I believe that many Cardiologist are not as experienced regarding how to advise high-performing athletes (even older ones like us). Aortic valve regurgitation: Blood leaks back into your left ventricle instead of only flowing into your aorta. Therefore, people . Hi Larry, The flaps are called cusps. There was only a 0.2 cm increase in the previous 7 years (so from age 21 to 28). Arnold Schwarzenegger (The Governator) - Heart Valve Replacement. I used to do HIIT and moderate to heavy weight 5 days a week before my physical complications. Max Page - Child Actor (Darth Vader in VW Superbowl ad) - Tetralogy of Fallot. Thanks for the article! . A CT scan made the diagnosis. However my Sinus of valsalva is dilated between 45-47mm (depending on the machine used). Do you recommend any particular diet, exercise, vitamins,etc.? I was also advised that it is really the static weight-lifting that could pose a problem. I am an amateur runner, I do not participate in competitions. Barb. Enlarged lv 37/58 mm rf 65 fs 36 There, Lucci learned that she had a 90 percent blockage in the main artery of her heart and a 70 percent blockage in another, and needed emergency surgery. I too am looking for information on effects to performance since I am a Masters racing cyclist with 25 years of racing/riding long events. Several famous people were reported to have had bicuspid valves: former first Lady Barbara Bush, the comedian Robin Williams, and California Governator Arnold Schwarzenegger. Consult your doctor to see if there are any restrictions that would be specific to your case. Bicuspid aortic disease occurs when a defect is present in the valve that opens and shuts to allow blood flow from the heart through the aorta. Aside from the problems with aortic valve stenosis or regurgitation or with enlargement of the aorta, individuals with BAV can also suddenly develop the problem of aortic dissection. Today at my hospital, we do most 1st time aortic valve replacements for aortic stenosis (narrowing) this way and have started using TAVR for patients with previous AVR using tissue valves who need re-replacement. The video is just 1 min 42 sec long. Replacement is much, much more common. I have an OnX mechanical valve. These leaflets open and close to regulate blood flow from the heart into the aorta, and prevent blood from flowing back into the heart. What Is Bicuspid Aortic Valve Disease? Most patients can resume all of these activities by 2-3 months after operation. Onside rations would be needed for hose with Marfans syndrome or other diseases of the aorta. Hello dear doctor. My resting HR is 60-70 BP 110-70, according to doctors have no tissue problems, never had hypertension and was told that I was born with weak threskupid valve. Heart disease and stroke are the number one killers of women, Streisand, 74, told PEOPLE about why she helped found the organization.