Do you think the jiu-jitsu (e.g. Often times, especially for patients with tissue heart valve replacement devices, the valve simply wears out. Did you run? Depending upon the size of the prosthetic valve, there is so e built-in obstruction to blood flow that is e aggregated during exercise. We are now seeing moderate stenosis, hence replacement in the not too far distant future. Thank you for your time. Thank you so much for all of this insightful information. Hey would like to continue to be active but is worried about which procedure would be best for him. A normal aortic valve looks like the Mercedes logo, a circle broken up by three lines that meet in the middle. This might reasonably translate into some measurable improvement related to physical exercise. There are four valves of the heart, which are divided into two categories: Atrioventricular valves: The tricuspid valve and mitral (bicuspid) valve. I did run 1-2 times/week for a 1.5 months now, the situation is getting a little better but still I feel like a 80 years old. 1, 2 Much of the data relating to its complications derive from necropsy studies since reliable . There are 2 broad categories of heart valve substitutes that can be used to replace the human aortic valve: mechanical valves or bioprosthetic (tissue) valves. I am now in no mans land of not needing immediate surgery (per the pressure number in left ventricle) and not being able to run more than 30 min. I have a few questions because I was instructed not to lift more than 10 lbs and that I could resume surfing in a year. "I had been doing some work around the house working with a heavy ladder, he told PEOPLE of his activity in the days leading up to his heart attack. 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? Athletes in this circumstance should collect opinions from their doctor(s) and make very careful considerations before returning to exercise. Either way I often think my cardiologist looks at me as if Im nuts and that my current 175 miles a week training should be thought of as beyond expectations post open heart surgery. Is this true that you wont be symptomatic with only mild AR? There are many causes of light-headedness and chest discomfort that are not related to the heart. This has caused a Thoracic aortic aneurysm that is 4.3 cm. Current guidelines suggest no restrictions on activity for athletes with BAV who have no stenosis/regurgitation and who have a normal sized aorta. I dont have any ayptoms. View HelpingHeartsCharitys profile on Facebook, View @HelpingHeartsMDs profile on Twitter, View HelpingHeartsCharityMDs profile on Instagram. I used to do quite some running 10 years ago (still at amateur level), I was doing lots of 10k and 20k and even I managed a marathon in 3h:26min (but at that time I didnt know about the BAV). Bicuspid aortic valve is the most common congenital cardiovascular anomaly, occurring in 1-2% of the population. I have been doing this for the last 5-6 years now and am hopeful it can continue. About a year ago a pulmonologist discovered a grade 2/6 heart murmur during a workup for a sleep study. 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. Hi . My name became public 25 years ago this week. i.e. They are also predisposed to enlargement of the ascending aorta, the large blood vessel that carries blood flow away from the heart. Im not aware of studies explicitly about athletes after Ross procedure for BAV. My son is 15 years old, he was born with BAV /aortic stenosis. Finally, athletes are not spared. I am wondering if you know anything about these drugs and how they can impact aortic growth? How much exercise is too much for someone with a functional BAV? Your doctors will be in the best position to offer advice because they will be most familiar with your case. Hi Dr. Creswell. We want our patients to know that whatever the level of care they need, our team will design and implement the health plan that works best for them, Starnes said. The free weights are about 10kg and Im not doing any really heavy weights. Sometimes it comes even when not exercising. Your doctor will be in the best position to know all of the relevant information and offer sound advice. After that, most patients can gradually return to activities that put stress on the sternum and upper extremities. And now my aortic root is 42 mm. The lines are the edges of the valve leaflets that open and close to let blood through. His only complaint or change is shortness of breath with stairs. Very likely an operation will be needed at some point in the future. My questions are: Kinda like a marathon but it will take me at least 9 hours. Heart disease and stroke are the number one killers of women, Streisand, 74, told PEOPLE about why she helped found the organization. At my last evaluation, my aorta measured between 4.3-4.5 cm, depending on where the measurement was taken, and the regergitation was classified in the moderate range. Here are stories of some celebrities with this condition: Not everyone who has a congenital heart defect knows about it, so its important to be vigilant about the health of your heart. I had it replaced in 2014 and am now 16. Ordinarily, we reserve operation for patients with severe aortic regurgitation who have some decrement in the LV function. Im not sure I have all the answers from afar. Semilunar valves: The pulmonary valve and aortic valve. Finally some solid information about exercise and life post AVR, thank you very much for that. It would be great to know what happens to groups of patients after AVR and aortic replacement that have returned to their various sports. Considering the results of my stress test and TOE, do you think it could be my heart and should I seek 2nd opinion. After an MRI, Ive been diagnosed with BAV and mild aortic coarctation. The incidence of bicuspid aortic valve and complications. My primary question relates to sports. I cant distinguish if its muscle pain or somewhere inside chest, its not sharp or dull, somewhere in between. They all cause a small bit of obstruction to blood flow as it leaves the heart. I know what theyre saying and after that I know that I have mixed feelings because I feel depressed about not being active like I used to be, but then I feel selfish as I am not being grateful. Thanks for the article! 2; The 72-year-old soap oprea legend started feeling a tightness in her chest in Fall 2018, but waved it off until the end of October, when she had to be rushed to the hospital. Practice Essentials. I like to practice MTB and running competitively in local races. 140 miles at race pace. My problem is with cardiologists stating do not lift anything over 50lbs. In late March, Schwarzenegger was heavily involved in a chess tournament with his donkey Lulu. As of Monday, my BP at the echo appointment read 115/66. This is the only measurement that has gone down . Is this a possible explanation? Will surgery mean I can do more or less training? Im highly considering this option, after 4 months of research and appointments with doctors. Early after operation, and for perhaps the first month, we typically limit activities that place stress on the shoulders and sternum. For healthy individuals who have BAV with no other heart or aortic problems, follow-up imaging with echocardiogram and/or CT could probably be undertaken annually, or perhaps less often once stability is ensured. Went through the process of antibiotic therapy and. I used to run a lot. No other issues. Perhaps other readers will comment. Therefore, in the current study, we aimed to compare procedural and 30-day outcomes after TAVI between type 0 and type 1 BAV . Bicuspid Aortic Valve | Circulation Hi, my name is Hector and I am 34 years old. Bicuspid Aortic Valve - Symptoms, Diagnosis, Treatment & Surgery Jeff/Doc, I otherwise feel very healthy, other than (I think) normal slowing down that comes with age. Patients with BAV who have a normal size aorta, with no stenosis or regurgitation of the aortic valve, can participate in sports without restriction. I have also had a stress test, which showed no issues at all. My son was diagnosed with BAV, by chance, when he was 7. Im 32 years old and back in 09 I discovered I have a BAV. The guidelines were developed by an expert panel based on the scientific information available at that time: The issue has not been studied very well, but one recent study suggests that continued participation in sports for periods of up to 5 years does not change the natural history and progression of BAV. Based on the information Ive provided, I would greatly appreciate your advice and opinion on the matter. And my wife is screaming at me every time I try to exercise :)). Since Im not close to good medical care, are their specific things that I will start to notice if my heart valve is causing a problem? For those same patients, we recommending avoiding strenuous dynamic exercise line swimming, running, soccer, tennis, cross-country skiing, etc. To the extent that any operation fixes the stenosis or regurgitation, we might expect better efficiency from the heart. Thats probably what the doctors are watching for. We see his pediatric cardiologist every 6 months. Elite triathletes and heart problems 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. 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. Sounds like youre on the right track by getting things evaluated. That said, guidelines from the 36th Bethesda Conference suggest that BAV, without enlargement of the nearby aorta or problems with the aortic valve, shouldnt preclude any sports activities.including weight lifting. No thrombus, vegetation were noted Hamilton mother of twins, Cherie was diagnosed with bicuspid aortic valve disease (BAVD), a disease where the valve has only two leaflets. Required fields are marked *. I have found in my case( an athlete with bav)the typical response from doctors is, thats life, you cant do it anymore, be grateful for what you have. Its a hard thing to describe to my cardiologist that my legs and HR are not cooperating when the pace picks up. 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 . My aortic root is 4.06 cms. Consensus guidelines from the Proceedings of the 36th Bethesda Conference recommend: The first recommendation does not include the endurance sports. His cardiologist said he cant play. The doctor said she would see if she could talk about his case with the surgical panel but she said even if he did have surgery he couldnt have a career in sports??? Males are affected 3:1 compared to females. Finding this site is such a relief / source of hope for me thanks so much Dr. Larry!. Consensus guidelines suggest restricting activities in athletes with BAV and aortic diameter >4.0 cm. In some cases, the aortic valve can be repaired and the enlarged aorta can be replaced with a Dacron tube. I dont know about the relative effectiveness of various ARBs used for this purpose. My last CT scan in November showed a change from 4.3 (May) to 4.5 (November) however I was only given these results yesterday. 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. Do we have a choice with him only being 15??? Hi all, Before 2 years my aorta was 37mm . 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). My questions are: can my root dilation remain stable? Use of this site constitutes acceptance of our User Agreement and Privacy Policy and Cookie Statement and Your California Privacy Rights. My daughter (16 y/o) has a St Jude mechanical mitral valve (adult size valve even though she has had it for 7 years). I can imagine it might be difficult to make arrangements when you live in one country and your doctor(s) work in another. Dear Dr. Creswell, I was running 9 to 10 minute miles. Miley Cyrus - Singer & Actress - Tachycardia. In general, we recommend no weight lifting in patients with BAV if the aortic diameter is greater than 4.0 cm. There are just so many causes of shortness of breath, lightheadedness, and chest pain.even besides the heart-related causes. My Echo Stress Test is normal but when I finish obviously the pressure is higher (190-80 at the end) . Is a CT or MRI absolutely necessary for measuring the aortic diameter? Bicuspid valve stenosis treatment involves surgery to replace the valve. This have affected my son psychologically since he loves playing soccer what should I do. these conditions occur mostly during my exercises at the gym and Im left very lightheaded and shortness of breathe. Monica Lewinsky: 25 Randoms on the 25th Anniversary of the Bill Clinton Calamity. 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. As I have aged I have upped the reps to 15 or more and two or three sets max, sometimes doing a set or two of 5 reps with heavier weights. I had a Medtronic Freestyle valve fitted in May 2002, did exactly as directed regarding exercise etc. A week after he made the varsity team as a freshman he was told by the doctor he couldnt play. Dr. Larry, I do appreciate your insightful article very much. Thats the main reason for choosing a tissue valve in my case. Thanks for sharing your sons story with BAV. there was a tiny strand of tissue on the septal aspect of the muscular LOVT (LCOT Vmax 2.1m/sec;20mmHg peak gradient. However my Sinus of valsalva is dilated between 45-47mm (depending on the machine used). They are located between the ventricles and their corresponding artery, and . I dont believe this has been well studied. This year he was told he couldnt do heavy lifting but all other sports are still ok. My son seems to sprain his ankles or have other injuries often that last longer than others kids, I also played sports and had injuries but they never lasted as long as his do. Baldwin Publishing, Inc. strongly suggests that you use this information in consultation with your doctor or other health professional. I would like to get back into it, but obviously I have been having some concerns. Follow up for development of these functional lesions is indicated. No LV chamber chamber dialiation, normal LV wall thickness, good LC systolic function, No regional LV wall motion abnormality. It sort of flutters open and shut. EKG and echocardiogram were done showing BAVD. My son is 12 years old. No pulmonary hypertension Also, due to a bout of DVT and elevated d-dimers Im on Warfarin for life. Its also clear-cut that patients with significant enlargement of the aorta to greater than 5.0 cm need operation for replacement of the aorta. She was originally under the impression she felt the way she did simply because she was exhausted. Good to hear that youre making a good recovery from your second operation. Unanswered questions include: Can a bioprosthetic valve wear out more quickly than expected? The problem is I have developed an aneurysm on my ascending aorta of 44mm. 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. All severe aortic stenosis patients who are experiencing symptoms should ask for a TAVR evaluation. Males are about twice as . That is except for the last two months hes had several illnesses ( influenza, bronchitis, URI). I took it up 7 years ago. "Until then, stay close.. May 10, 2010, 4:50 PM. Thank you so much for your clear explanations. At approximately three months I became very ill and was diagnosed with prosthetic valve endocarditis. I have read that strength training is beneficial for heart health. He will be rechecked with an echo, BNP blood test & MRI every 6 months. No LA, RA, RV, chamber dilation Although bicuspid aortic valve is typically asymp tomatic at fi rst, it is commonly associ-ated with progressive valvulopathy and tho-racic aortic disease. Dear Dr. Creswell, 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. The aortic valve is between the left lower heart chamber and the body's main artery, called the aorta. No aortic root dialation. 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. I have had three annual Echocardigrams, the first two showed mild stenosis, mild LV thickening. There is a risk of sudden death in individuals with BAV, probably related most to aortic stenosis or aortic dissection/rupture. Thank you! According to reports (and my new cardiologist), this congenital variation . Bicuspid Aortic Valve Symptoms and Treatment | Baptist Health Ive done the Philly a Marathon a coup,e times and know that its a terrific event. If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. I was born with a BAV and but I didnt notice performance issues until the Summer of 2016, so I brought myself to the doctor. This makes the aortic valve a tricuspid valve. I love running. If reoperation is needed in your case, this would be something to discuss. Ive heard from a fair number of endurance athletes after having aortic valve operations of one sort or another. Aortic stenosis will limit athletic performance at the top end. Aortic Valve: Function, Location & Anatomy - Cleveland Clinic 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. Unfortunately, I really cant point you to such studies. The fusion (sticking together) of the valve leaflets causes abnormal valve opening and closing. Bicuspid aortic valve can be found in 1% to 2% of the general population . This can be very frustrating to athletes who are used to being more active. The doctors tell me I will be able to run again at a level near to what Im accustomed to (50-60 miles per week) but are reluctant at this point to specifically tell me the limitations and restrictions Im to endure. Thanking you in advance, Im not surprised that youve received a conservative recommendation about exercise. Over the past 3 years, my endurance has declined significantly, and now I cannot run a lap on the treadmill without some walking; however, my numbers from the semi-annual utrasound have not changed much. Prescriptions for safe exercise will need to be carefully tailored to your particulars. And, if so, how did things go? Bobbie. The surgeon I used told me that he had performed keyhole surgery once but wasnt sure if it would be of much benefit to me. And I dont know if my Cardiologist follows the same guidlines, but I dont think hes under the impression that Im any kind of athlete either. Most patients spend about a week in the hospital after operation and then are able to go home. Do you have any info or recommendations about this? 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. There are several variations of this procedure that are applicable in specific situations. So for that first month, we usually advise no driving, lifting, pulling, pushing, reaching, etc. A bicuspid aortic valve is a congenital condition, meaning that people are born with two rather than the normal three cusps on their aortic valve. Unfortunatly that`s pretty much all the advice i`ve been given so far, so little out there on what i can actively do and what i can`t. If Im trying to do 10 it will be harder to get those 2 up but it wasnt that hard before. This would be a major operation.and would certainly be invasive regardless of the particulars. Your situation is complicated.and it wont be possible to give a complete answer here without additional information. Thoracic aortic aneurysm, an abnormal bulge in the part of the aorta located in the . Although bicuspid . It was reported on April 5 that the 75-year-old Jagger underwent successful transcatheter aortic valve replacement (TAVR) at an undisclosed hospital in New . I am an amateur runner, I do not participate in competitions. I am 46 years old today, 22x marathoner, 4x Ultra (50 miles) and 5x natural fitness competitor. On the bright side, there is ample evidence that, in the modern era, life-expectancy is not shortened for individuals with BAV compared to the general population. Others won't have symptoms until adulthood, if ever. 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. eventually was told everything was ok. Thanks a lot for your answers. March 10, 2016 at 1:50 pm. It is quite frustrating, Im running with some guys that have a hard time believing that I run a marathon. Zdenko . 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. Before that, I had never seen a cardiologist ever. My Dr. gave me the all clear to go back to my exercise routines. Bicuspid aortic valve with Marfan and other HTAD when the ascending aorta is dilated >45 mm. You are a very good man. Its now 8 months after surgery and Im pretty much back in my every day life, was even granted to attend my pilot medical tests which are due in 2 weeks. Less than one month ago Schwarzenegger was (virtually) hosting the Austrian World Summit of the Schwarzenegger Climate Initiative, which introduced speakers like Prince Charles, Jane Goodall, and Pakistani Prime Minister Imran Khan. No aneurysm. My question is: is it okay for me to participate in weight lifting with BAV? Robin Williams - Aortic Valve Replacement & Mitral Valve Repair. Your sons cardiologist would seem to be in the best position to offer specific advice. Thanks for sharing the article about the PEARS technique. when I discussed this with my Dr. he reassured me that its not my heart causing it. The pitfall, though, is that our native aortic valve is itself very efficient. My cardiologist gave me green light for everything except strenuous exercise (used to train for ironman and similar challenges). In 1997, Dr. Starnes led a team of three surgeons who replaced the aortic valve in then-actor Arnold Schwarzeneggers heart. Yes, moderate aortic root dilation can remain stable. BAV is the most common cause of heart disease present at birth and affects approximately 1.3% of adults.
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