This is ridiculous. The problem is I have developed an aneurysm on my ascending aorta of 44mm. 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 . Thank you so much for your explanations, Im 30 years old with BAV 2 instead of 3 leaflets since birth, doctors recommended me to have Echocardiography test each year and so. These leaflets open and close to regulate blood flow from the heart into the aorta, and prevent blood from flowing back into the heart. Hi Dr Creswell, Thank you for the blog that addresses the athletes point of view, and feelings. 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. Zdenko . 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. No enlargement of aorta or any other problems. The rest of the aorta is normal (visualized to just above the bifurcation in the abdomen). I found a cardiologist with whom Im quite happy with. Specifically, Im wondering about inversions like forearm stand, head stand, and hand stand. Sadly, most school/sports physical exam programs dont include echocardiogram.and the absence of a heart murmur in a child wouldnt preclude the diagnosis. So I saw an incredible surgeon and we are going for the Ross Procedure in Feb. Now that we know the type of surgery does this improve my chances or one day returning the CrossFit addicted life I miss? While my surgeon said that I can do whatever normal healthy person would do my cardiologist gave me some restrictions basically not to raise my HR over 120. The aortic valve lies between the heart and the aorta, the main artery . 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)? The incidence of normally functioning bicuspid aortic valves is 0.6% to 0.9%.5 . They all cause a small bit of obstruction to blood flow as it leaves the heart. Hey is a frustrated guy. 1. I am a cycling Masters racer (Cat 2) for last 25 years . Went through the process of antibiotic therapy and. As chemist mostly works in a lab not in the field. What is a TAVR? This has been true as long as I can remember in all sports I seem to have to put a lot more in to get the same out as others. I have found your article(s) very useful amongst what I see as so much mis-information out there. To make matters worse, I had a bout of AFIB, about 6 months ago. Maybe a genewho knows. Interestingly, bicuspid valves are one of the most common forms of heart valve disease. No operation to replace/repair the aortic valve and yo replace the ascending aorta is minimally invasive. Thats just a marketing gimmick. SPORTS FIGURES/ATHLETES. My cardiologist tells me that I need to be monitored yearly and that I should exercise without limitation (for cardio) I have symptoms however that include chest pain and shortness of breath and palpitations. He has mild AS and AR and is otherwise asymptomatic. I will update you all after his Friday appointment. I have been advised not to run any more marathons or half-marathons, but that I can still compete at up to 10km races. Is there any research on this? Is it like keyhole surgery? Im paranoid to exercise too much for fear that I will do damage to the valve. I am 26 yera old , I have aortic aneurisem. During pregnancy. I appreciate your response, thank you for taking the time to write me back. The heart has a difficult time coping with extra demands of exercise. My cardiologist is not concerned. The guidelines do not address the frequency of surveillance for individuals with BAV and no enlargement of the aorta. Dr. Creswell I had my BAV replaced in Feb. 2005 (porcine tissue) with a Dacron repair of the ascending aorta. So unfortunately it sounds like i am part of that grey area. I have been factual with him and told him worst case scenario is he is done with both and have pushed him to see the positives of exploring other things to do. Ive recently joined the gym to get fit an toned up but I cant get a clear answer from the cardiologist of what weights I cant actually do at the gym. That would include weightlifting. Its always good that investigators are looking for new solutions to old problems. Advice here will be based on opinion rather than accumulated evidence in large numbers of children with BAV. Yet Im personally aware of a good number of athletes whove returned to endurance sport after operations of various sorts for BAV,presumably after discussion with their doctors. We expect the current generation tissue valve to last at least 12-15 years before problems. That post is a starting point for todays discussion. I cant distinguish if its muscle pain or somewhere inside chest, its not sharp or dull, somewhere in between. thanks for sharing all this interesting info. I just want to know what things I will see change so that I dont look past the change in my valve and miss my window to get the valve replaced. 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. 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). Thoracic aortic aneurysm, an abnormal bulge in the part of the aorta located in the . I have a 15 year old son with a BAV, Aortic stenosis, Noderate regurgitation and dilatation of his ascending aorta. The video is just 1 min 42 sec long. I am 6ft 3 . My questions are 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. May 11, 2010 -- Barbara Walters said on Monday that her upcoming heart surgery, a procedure known as an aortic valve replacement, will hopefully correct a problem of which . I have been feeling better than before the surgery and I feel with better condition on the trails. He loves sports and is wanting to do more and more. I have been given no restriction to date in any physical exercise as my valve is in decent condition. I was diagnosed age 4 and am now 35. And any valve substitute (with valve replacement) is clearly not as efficienteven if the substitute is better than a diseased valve. (Or do I just need to train even harder??). Many patients with surgery for BAV, even if it involves aortic root replacement, lead rather normal lives afterwards. Aortic valve repair and aortic valve replacement are done to treat aortic valve disease. My cardiologist has told me that, based on how my heart sounds, he doesnt think hell ever have to operate on me. Approximately 1%-2% of the population are born with an aortic valve that only has two cusps. (I'm a 17 year old female)After a heart echocardiogram yesterday we found out I have a bicuspid aortic valve, I originally went in to the cardiologist for extreme fatigue, constant racing heart (avg around 130bpm resting), palpitations, spells where I almost faint, feet swelling and turning purple, etc . Nonetheless, I think theres considerable confusion about this condition, in terms of diagnosis, implications for the athlete, and its treatment. My average weekly training plan includes 50k of running (5 days) with 80% done on pulse below 154-152 and only 20% done at pulse about 175-179 bpm. Patients with BAV who have a normal size aorta, with no stenosis or regurgitation of the aortic valve, can participate in sports without restriction. Maybe you can help me with some questions. How severe are the problems? Would this constitute as too much in your opinion ? Arnold Schwarzenegger (The Governator) - Heart Valve Replacement. James Cameron checks in from Pandora with a status report. Negative Stress Echocardiography This would be a major operation.and would certainly be invasive regardless of the particulars. Its conceivable that an echocardiogram a week afterwards could be abnormal simply because of the race. The pitfall, though, is that our native aortic valve is itself very efficient. Celebrities With Heart Disease - Celebrity Heart Health Survivors. I would like nothing more than to have this repaired so I can return to my lifestyle, I cant understand why I cant have it fixed as it is my choice to have surgery. I cant thank you enough for your responses to all the above questions. This is the only measurement that has gone down . Schwarzenegger was born with a condition known as bicuspid aortic valve, in which the heart's main artery, the aorta, has only two cusps instead of three. 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). I have only played a few games of football in the last 5 years due to a knee injury but I have continued running for fun and do 5k in a reasonable 25 minutes. To continue to live this amazing life so full of challenges and friends, including so many of you in the audience, I have chosen to replace the valve with a new one. With aortic dissection, the aorta can develop a tear on its inside wall, leading to unraveling of its layers, and even rupture. In some cases a particular arrhythmia that is responsible for your feelings of palpitations or light-headedness could be identified.and options for treatment could be presented. Thank you so much! Guidelines specifically for athletes come from the Proceedings of the 36th Bethesda Conference in 2005. Aortic valve stenosis: Your aortic valve narrows, reducing blood flow through it. I got Edwards magna perimount 25mm bovine AV and Valsava graft for aortic root replacement. Answers to your questions. ( I was much worse though). The pertinent questions for your cardiologist is whether there is any stenosis (narrowing) or regurgitation (leakage) of the aortic valve and whether the size (diameter) of the nearby aorta is normal. This international evidence-based nomenclature and classification consensus document is intended for universal use by clinicians, imaging specialists . 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? with an efficiency of 69%, I have an appointment with a specilaist next week and am just wanting some, even if vague, answers. Most patients (like me), however, start to experience problems during their 30s, 40s, and 50s. (Yes, I have been going for regular check-up since in was about 7 years old. In your case, though, the infection might well influence the healing process. This is an area where second opinions may be helpful in sorting out whats safe. these conditions occur mostly during my exercises at the gym and Im left very lightheaded and shortness of breathe. Thanks. And slow enlargement of the aorta is common for patients with BAV. Do you think I should slow down a little bit? Context Bicuspid aortic valve is the most common congenital cardiac anomaly in the adult population. Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. My questions are: I dont know all of the important details. Thanks for sharing the article about the PEARS technique. Is a CT or MRI absolutely necessary for measuring the aortic diameter? It has a male predominance and often occurs in multiple members of the same family, suggesting that it may have an autosomal dominant inheritance, perhaps with variable penetrance. What is your opinion about dissection in low/controlled messures? Additional types of patients who should ask for a TAVR evaluation include: Bicuspid aortic valve patients who are experiencing symptoms. Jeff. 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 dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. Ive not found any programs for evaluating repaired athletes unless something exist with a physiologist research lab. But if you have a bicuspid aortic valve, you only have two cusps. Catch up on the years best movies, whether in theaters or now streaming at home. Their experiences have been variable, and perhaps for a variety of reasons. Aortic dissection, a tear in the wall of the aorta. Im not looking forward competitions nor marathons. If the valve is smaller than needed, there can be a limit to the ability of the heart to do extra workand that can show up as less speed. 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. Heart failure, where the heart weakens from working too hard to pump blood. 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. A bicuspid aortic valve is a congenital heart defect that affects the one-way valve between your heart and your aorta, known as the aortic valve. http://www.energystretch.com Hannah Yona Fraint, M.D. Thank you very much for the answer! Youll need to rely on your doctors for advice about your condition. If youre questioning the recommendations youve received, perhaps a second opinion might be helpful. (Have you heard of the studies by Dr. diagnosed wid BAV AND AS WITH AR there was a tiny strand of tissue on the septal aspect of the muscular LOVT (LCOT Vmax 2.1m/sec;20mmHg peak gradient. If echo shows a normal size, thats probably okay. Its awesome to see you are diligent at responding to people also. My Dr is almost certain that these symptoms are caused by issues that are not cardiac related, and that with at the stage my BAVD is at, it would not produce symptoms. Before 2 years my aorta was 37mm . The congenital bicuspid aortic valve (BAV) condition is a valvulo-aortopathy with substantial heterogeneity in its clinical expressions, associated disorders, complications, and prognosis. Symptoms of bicuspid aortic valve disease most commonly develop in middle age in people with a history of a childhood heart murmur. What activities can I do? 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. Other heart parameters are very good (no bigger chamber or aorta). Functionally bicuspid aortic valve (type 1). Glad to hear that youre recovering, Zdenko. I applaud your efforts to search out information to help you decide on a course of action. I currently run 40 -50km a week and do two 2 hour intensive yoga sessions a week. Thank you so much for all of this insightful information. Most probably not pericarditis cause I had it once so I know that pain type, but again, maybe its some other type. I can imagine it might be difficult to make arrangements when you live in one country and your doctor(s) work in another. The procedure has the potential to bring the aorta to 4.3/4.4 and avoid further enlargement. BAV was diagnosed in 196 newborns (prevalence, 0.77%), with a male-female ratio of 2.1:1. Hi. Great article! I was hoping that if the ultrasound numbers dont change much, the endurance will not decrease significantly. PS: I noticed that the option Notify me of follow-up comments by email doesnt seem to work. At issue are the potential long-term effects of repeated episodes of high heart rate and high blood pressure that accompany intense exercise. However, this is not always the case. Ive been told by my cardiologist that they think I should probably avoid competitive rowing and weight lifting. This is thought to occur at a rate of about 0.1% per year in adults. And now my aortic root is 42 mm. Ascending aorta is normal and so the rest. I agree that your doctor(s) are in the best position to offer advice regarding safe exercise based upon your particular circumstances. It is very frustrating as my doctor would prefer to see me live the rest of my life with restrctions and have the aneurysm stabilized rather than take a chance on surgery and possibly returning to my normal lifestyle. It prevents the blood from flowing back from the aorta into the heart when the pumping chamber relaxes. Arrhythmias may sometimes manifest many years after surgical repair of congenital heart defects. To revist this article, visit My Profile, then View saved stories. Thanks! The value of CT/MRI comes when a millimeter or two makes a difference in treatment, restrictions, surgery, etc. ps. They wont repair my aneurysm unless it was 55mm during surgery or 60mm before surgery. Probably wise to follow the advice of your doctors who know the details of your situation. Bicuspid aortic valve (having only two leaflets rather than the normal three) happens in about 1% to 2% of the population and is more common among men. I am mostly a runner, 4 times a week, with 10 21 km races. He posed next to statues of Thomas Jefferson, Jesse Owens (whose family moved to Cleveland when he was nine, and who later attended The Ohio State University), and Abraham Lincoln. We have decided to wait and watch. If he is a candidate for valve replacement are these sports he could ever return to In the best case scenario? However my Sinus of valsalva is dilated between 45-47mm (depending on the machine used). Do medications like beta-blockers limit any potential harm? Oh, plenty. All aorta is normal, valvula normal funkcion only sinus valsava 35-37mm. I am 18 years old . since the last worsening ten years ago, the situation still stable and each year I went to the doctor to have the tests, they still tell me nothing has been changed since. I lifted weights for many years and spent almost all my life in physically demanding jobs. "Heart disease is the number one killer of all Americans, the number one killer of African-Americans and the number one killer of women, so I shouldve been put on notice since Im three-for-three. 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. Normal function of cardiac valves Me, i`m nearly 43, male and have BAV. Some good points there, Craig. Anyway, talk to a surgeon who understands quality of life means. There are certainly athletes whove returned to their sports after valve (and aorta) repair/replacement. A repaired valve may not be as efficient as the native, healthy valve. To quickly review, individuals with BAV have an aortic valve with 2 unequalinstead of the usual 3 equal sizedleaflets. 27yr old male. May 10, 2010, 4:50 PM. Are there any things I can do now to help minimize my risk? This might reasonably translate into some measurable improvement related to physical exercise. And, of course, aortic stenosis can affect ones native aortic valve or a prosthetic valve substitute. Advertisement. Bicuspid Aortic Valve I realise that I will eventually need the valve replaced again and just hope that things go as well next time. The American College of Cardiology (ACC) in conjunction with the American Heart Association (AHA) has issued guidelines for the evaluation, monitoring, and treatment of individuals with BAV: In my opinion, these are useful guidelines for athletes and non-athletes, alike. It doesnt help that I am a nurse. Thanks for the infoI really appreciate what you,have to say. His doctor recommended he see a pediatric cardiologist within 1-2 weeks but when I called they cant get him in until April 14th. This site complies with the HONcode standard for trustworthy health information. Currently complete in 5-a-side football and have done for life. 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. Should I increase amount of weight? I have also been advised that running intervals at over 80% max heart rate would not be sensible. You can see my post above, from 26th of april. Since you have the ready info about your aortic sizes over time, I will guess that you have a doctor or cardiologist that you are working with. In your experience, can patients with BAV go a lifetime without having AVR? I am an having trouble seeing the difference in the ross procedure and the bioprospthetic valve replacement as far as benefits go? 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. And lastly, the degree of healing in the remaining (unoperated) aorta probably has a big impact on the potential risk. Im afraid Ill end up like my Mom. Ordinarily, we reserve operation for patients with severe aortic regurgitation who have some decrement in the LV function. A CT scan made the diagnosis. Sometimes it comes even when not exercising. Benefits: long-term durability. Consensus guidelines are developed to be broadly applicable, but the guidelines may not be applicable in a given athlete patients circumstance.

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