Ive got my results from my recent echo and a lot of normals on there but main things were regurgitation and stenosis were mild with the aorta measuring about 33mm. 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). I found myself in emergency surgery 12 months ago with 50% leakage, an enlarged heart and an ejection fraction of 30. Ever since undergoing open heart surgery in 2010 for her surprise diagnosis of heart disease, Jones has worked as a national ambassador for the American Heart Association to raise awareness. Reply. This is amplified when I sit with my feet up (male cross-legged) because of the tingling/numbness in feet. Athletes in this circumstance should collect opinions from their doctor(s) and make very careful considerations before returning to exercise. I have been feeling better than before the surgery and I feel with better condition on the trails. Its a hard thing to describe to my cardiologist that my legs and HR are not cooperating when the pace picks up. Normal LV diastolic function. I have read that strength training is beneficial for heart health. I was hoping that if the ultrasound numbers dont change much, the endurance will not decrease significantly. 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. I had a Type A aortic dissection of the ascending aorta that extended into the descending aorta terminating near the femoral arteries. These leaflets open and close to regulate blood flow from the heart into the aorta, and prevent blood from flowing back into the heart. Baton Rouge, Louisiana 70808. these conditions occur mostly during my exercises at the gym and Im left very lightheaded and shortness of breathe. Schwarzenegger visited USC on April 16, 2007 and saluted the new Cardiovascular Thoracic Institute (CVTI), according to a press release issued by The Keck School Of Medicine at USC. My performance as a cyclistgiven my ageputs me in the elite category, although with the stenosis I am experiencing a definite decline in performance. What should i do? 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I started experiencing palpitations last year along with several instances of light-headedness. I have completed two marathons. Between one and two percent of all people have this defect, and it affects more men than women. I would pose these questions to your doctor(s) since they are most familiar with the details of your situation. Catch up on the years best movies, whether in theaters or now streaming at home. Fast forward, he is now 13 and we went yesterday for his yearly. Now, fully healed thanks to two stents in her arteries, Lucci is spreading the word. Bicuspid aortic valve is a type of abnormality of the aortic valve. Exercise and sports are usually safe if there is mild aortic root enlargement but no other heart or vascular problems. There are many causes of light-headedness and chest discomfort that are not related to the heart. Now Id like to know your opinion about physical performance, before and after. The more common form of bicuspid aortic valve occurs in a valve with three cusps with . Im not a nurse or anyone who can help in any real way, she told PEOPLE, fighting back tears. In both echocardiographic cohorts and surgical series, pure aortic regurgitation is significantly less common than stenosis. No information provided by Baldwin Publishing, Inc. in any article is a substitute for medical advice or treatment for any medical condition. The cardiologist told us at that appointment that we needed to start considering surgery to repair his valve. You are a very good man. Nonetheless, I think theres considerable confusion about this condition, in terms of diagnosis, implications for the athlete, and its treatment. In addition to running, I also perform moderate to high intensity resistance (weight) training 5-6 times per week. Some good points there, Craig. He was very talented at football. The issue of how much (& what types of) exercise after surgery is difficult because we dont have good studies (& evidence) upon which to base recommendations. Functionally bicuspid aortic valve (type 1). Log in, September 26, 2013 By Larry Creswell, MD 155 Comments. 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 inderstand that my resistance training will likely be severely curtailed from this point forward, but severe restrictions on my endurance training will be a very difficult pill to swallow. Lastly, a human donor valve was inserted into the pulmonary valve position. Almost half of BAV subjects develop different degrees of valvular dysfunction during their lifetime. Key points about bicuspid aortic valve. 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 . Etc? I am now down to seeing my doctors every 3 years or so and have been doing very well. He just turned 15 he is 511 203 lbs and has a heart of gold. Have you considered meeting with a heart surgeon to talk about the situation? Would you recommend taking beta-blockers at this stage? Miley Cyrus - Singer & Actress - Tachycardia. Hi, Fantastic website, there is very little actual information on this on the web. Activities are not usually restricted for athlete patients with mild aortic stenosis. Dear Dr Creswell you seem to be such a kind cardiac surgeon to make yourself available in answering questions. Because BAV may be an inherited condition, Athletes with BAV, no significant valve stenosis or regurgitation, and an aortic diameterless than 4.0 cm can participate fully in their sport(s), Athletes with BAV and enlargement of the aorta to between 4.0 and 4.5 cm can participate safely in only low and moderate intensity sports (this would. In addition, I will get a random bout of lightheadedness when standing or sitting in a awkard position. So it is very possible to continue athletic activities after surgery. Patients whove had aortic valve replacement and/or replacement of the aorta will require life-long monitoring by their doctor, with periodic echocardiogram and/or chest CT scanning. Celebrity. Check out Anthony DiLemmes blog, Anthonys Heart Valve Replacement Saga. 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). 6 weeks later Im still experiencing symptoms that (in the back of my mind) have me thinking about the BV issue. I do think that aspects of the martial arts are strength-related. I have no symptoms that I would notice, e.g. Ordinarily, we reserve operation for patients with severe aortic regurgitation who have some decrement in the LV function. Im 37 years old male, live in Croatia, 191 cm, 94 kg, very athletic, practicing various sports my whole lifetime. No enlargement of aorta or any other problems. For the last 7-8 years I didnt do too much sport (kids, family). I have bav with mild dilation of aorta 39mm. I used to run a lot. I certainly know runners, cyclists, and triathletes in that circumstance who are active and doing well. Kimberly was born with an abnormal valve, but didn't begin to develop symptoms until her 40s. Health eCooking is a registered trademark of Baldwin Publishing, Inc. Cook eKitchen is a designated trademark of Baldwin Publishing, Inc. Any duplication or distribution of the information contained herein without the express approval of Baldwin Publishing, Inc. is strictly prohibited. Bicuspid aortic valve (BAV) disease is the most common congenital heart defect, as it affects 1.3% of the adult general population . Arnold Schwarzenegger was born with a bicuspid aortic valve, in which the aortic valve has only two leaflets, instead of the typical three. If I ever need surgery to replace my root , I understand that there is an element of complexity for such surgery, but after surgery, is life expectancy for individuals assumed to be shortened at all ? My heart seems to heal, so that speaks well for my future.. My 28, got a BAV with mild stenosis and a aortic root measuring 40mm. It is very difficult to find information regarding the athlete and BAV. Diagnosed at 5 with BAV, checked yearly, and okayed to play soccer. Most probably not pericarditis cause I had it once so I know that pain type, but again, maybe its some other type. when I discussed this with my Dr. he reassured me that its not my heart causing it. I was training for 11th marathon at the time (over the past 13 years). I see my cardiologist the end of May. Your responses mean a lot to myself and no doubt others on this forum. She is afraid, I can understand that. I was running 9 to 10 minute miles. My son at 11 months was diagnosed with BAV. Compared to our own native valve, all of the available prosthetic substitutes have a small degree of aortic stenosis built in, unfortunately. As I mentioned in previous comment my recovery is going great. Thank you for what you do and for your responsiveness. Im 32 years old and back in 09 I discovered I have a BAV. 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. Im a 29yo CrossFit addicted man who just found out I have BAV while applying for the defence force here in Australia. Search Heart Hospitals Okay, thats greatbut I left feeling uncomfortable with the diagnosis. The valve can gradually become harder to open or leakier . Join Vanity Fair to receive full access to VF.com and the complete online archive now. Use of this site constitutes acceptance of our User Agreement and Privacy Policy and Cookie Statement and Your California Privacy Rights. 3. Thanks for the very insightful post, and for taking the time to reply to everyone here. Hello dear doctor. Could I continue to train and just cut out the blood chokes? O'Donell took the aspirin recommended for people who think they are suffering a heart attack just in case, but didnt call 911. We live at 6,500 ft (elevation) so Im not sure if its affecting my blood pressure when doing normal things. Therefore, in the current study, we aimed to compare procedural and 30-day outcomes after TAVI between type 0 and type 1 BAV . The first pic showed the action and comedy legend in a supine position with a thumbs-up, while the next three featured a lovely autumn walk, taking in the sights. My mom [and aunt] passed away [in their 60s from heart disease], and my dad had a heart attack when I was around 10 and he had a triple bypass, the actress told PEOPLE. Can you advise and or recommend a specialist? I was disappointed [when I was diagnosed]. I dont think theres a way to predict the future in this circumstance. Do you opration? In fact, in some people they can go undiagnosed for years. Look forward to your reply and thanks for your time. 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. He is now 15. Hi . Again, this is a topic that is not yet well-researched. I have been given no restriction to date in any physical exercise as my valve is in decent condition. 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. I had it replaced in 2014 and am now 16. In some cases, bicuspid aortic valve causes another condition called aortic valve stenosis. After the first month, patients are generally allowed to return gradually to all of their previous activities. While it was anticipated that a minimally invasive, transcather device would be used during the procedure, a surgical valve was ultimately used during an open-heart procedure using a median sternotomy. Several famous people were reported to have had bicuspid valves: former first Lady Barbara Bush, the comedian Robin Williams, and California Governator Arnold Schwarzenegger. Im guessing that my muscles are building up again and since everything was messed up, especially on left side, maybe some scar tissue or damaged nerves are coming up. 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. I cant thank you enough for your responses to all the above questions. . http://www.energystretch.com We are trying to work out a way for her to continue to play. Parenthetically, it may be time for an update. Hi again Dr. Creswell, The lines are the edges of the valve leaflets that open and close to let blood through. He was forced to stop playing football at 11. So you know, this is not uncommon for heart valve surgery patients. I would prefer not to stop. I understand its strenuous activity but if Im for example bench pressing it will get harder for me to put it up at the 8th rep.. Im not sure how those two problems would be related. In addition to the European guidelines, there is also an American set of guidelines published in the Proceedings of the 36th Bethesda Conference. and my valve is working quite well (mild aortic regurgitation). Now I take brisk walks and run on the treadmill only occasionally. 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. As I train triathlon I check my heart every year and there is small back flow (the same last 5 years). The doctor said it wasnt serious, but that I should keep watch on it every year. I have: September 13, 2017 1:00 PM. 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. There are a multitude of patient-specific circumstances that must be considered when deciding if and when operation is needed. Perhaps you could organize such a visit for a 2nd opinion regarding safe levels of exercise? He loves sports and is wanting to do more and more. The aortic valve prevents blood from flowing back into the left ventricle of the heart. The doc states that basketball is a contact sport in her medical books and we would need to consult with another doctor to possibly get approval. But, three heart valve surgeries! 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. Im aware that those days are past, but to abandon every activity seems like a prison sentence What is safe side threshold? It usually consists of three flaps of tissue what are called valve cusps. I have an OnX mechanical valve. I suspect it had been leaking for a long time, as I felt no different; however, my recovery from long runs took longer than in the past (old age?). My biggest concern is whether I will be able to return to my previous level of physical activity and level of fitness. 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 have repeatedly asked each follow up, if continued marathon training is OK. Im always told it is fine with the old adage of listening to your body. 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? Went through the process of antibiotic therapy and. Bicuspid valve stenosis treatment involves surgery to replace the valve. It was her death that prompted me to get checked out. My doctor says i use losartan for decrease my blood presure. 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? He sees his cardiologist every year. Contact Editor. Or is the real risk related to further deterioration of the heart in the longer term that would be picked up by 6 monthly monitoring, which may indicate the need for surgery but not an immediate risk of dying suddenly? John Fox, NFL coach, suffered from Aortic Valve Disease. Could he be over-cautious? Dont see why HIIT should be excluded. My problem is a perpetual fear and worry about having this diagnosis and having to someday undergo open heart surgery. All Rights Reserved. Bicuspid aortic valve with Marfan and other HTAD when the ascending aorta is dilated >45 mm. Please refer to this article if not: https://academic.oup.com/ejcts/article/50/3/400/2197426. Do you have any info or recommendations about this? Hi Larry I would really like for people to not have to experience what I had to experience, she continued. While I do not work out regularly, my job as a construction worker is somewhat strenuous. Kimberly has experienced heart valve disease firsthand. This can be a life-threatening problem and is more apt to occur with progressive enlargement of the aorta and with uncontrolled high blood pressure. His cardiologist said he cant play. Im 53. Bicuspid valves are quite common (1-2 percent of the population). I cant think like a nurse where hey is concerned. Most patients can resume all of these activities by 2-3 months after operation. . If untreated, it can lead to blocked blood flow. Typically, the aortic valve has three cusps (tricuspid aortic valve), but some people are born with an aortic valve that has two cusps (bicuspid aortic valve). We have got two completely different opinions from our cardiologists: I am big for my age . I see in this blog that Dr. C noted: Compared to our own native valve, all of the available prosthetic substitutes have a small degree of aortic stenosis built in, unfortunately. I have only trivial aortic regurgitation. 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. Normally, your aortic valve has three cusps that regulate blood flow from your heart to your aorta. There are certainly athletes whove returned to their sports after valve (and aorta) repair/replacement. Would this constitute as too much in your opinion ? Benefits: long-term durability. I applaud your efforts to search out information to help you decide on a course of action. A bicuspid aortic valve: Most people are born with an aortic valve that has three leaflets (a tricuspid aortic valve). However, there are few reports about the safety and efficacy of TAVI in type 0 BAV. Contemporary reports suggest that life expectancy with BAV is no different from the general population. Flaps of tissue on the valve open and close with each heartbeat. 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. with an efficiency of 69%, I have an appointment with a specilaist next week and am just wanting some, even if vague, answers. This would be a major operation.and would certainly be invasive regardless of the particulars. Apparently I also have a mildly enlarged IVC as well as mildly enlarged left and right atria. 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. Last i took him for the check up and everything is still the same but they said now the guidelines has changed and he is on the borderline of Mild to Moderate which will move him to restricted activities. I dont believe this has been well studied. It sort of flutters open and shut. My son will seek a repair when his conditions deteriorate. My son was diagnosed with BAV, by chance, when he was 7. Normal function of cardiac valves On Monday the 13th, I had my annual echo. Its not around incision, its mainly middle of left side. after surgery and was playing football again by September. Im wondering if you can advise me. 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. "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. Easy bicycling might work, but I suspect that running wont be workable with that cap. Thanks. 2. My questions are Ascending aorta is normal and so the rest. Many thanks. However, I always performed poorly when it came to the top end fitness tests e.g. Apologies for my slow reply. My questions are: can my root dilation remain stable? If you havent yet seen a surgeon, perhaps a visit would all wan opportunity to talk about these issues, even if operation is not yet needed. transcatheter aortic valve replacement (TAVR), Mick Jagger's Heart Valve Surgery: Top 5 Facts. Looking through the reader comments here at the blog and reflecting on the athlete inquiries Ive received, I thought Id cover some of the major issues. Thanks so much Hi Sean, He is certainly expert in the area of drug therapy to reduce the rate of aortic enlargement. Is there anything we can do? I dont have any ayptoms. However, my problem is that if I can train at this pace then I can still run but I certainly cant compete! Advances in treatment have allowed many babies with known congenital heart disease to survive well into adulthoodand many people who have congenital heart disease go on to live long, productive lives. First, youre not alone! PS: I noticed that the option Notify me of follow-up comments by email doesnt seem to work. enlarged LV = 350ml To the extent that any operation fixes the stenosis or regurgitation, we might expect better efficiency from the heart. 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. I have wife and two small boys, I wanna live to see my grandchildren. Lastly, Id say that BAV alonewithout leakage or narrowing of the aortic valve, and without enlargement of the nearby aortawould not preclude sports activities of any sort. The CVTI is waging war against the leading cause of death among American men and women - heart disease. i.e. I can tell my story. I dont know all of the important details. The doctor looked at the results and told me to limit physical activity (running), because it can lead to heart failure in future. . 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. Yes, as the patient grows, so will the aorta.and eventually you get to the traditional >40 mm cutoff where activity restrictions are advised. I was also advised that it is really the static weight-lifting that could pose a problem. Will I need meds? This gives a chance for the sternum, which was split during the operation, to heal completely. "Listen to the voice inside, the one we all so easily ignore. Your sons cardiologist would seem to be in the best position to offer specific advice. We briefly talked about the Ross procedure vs mechanical valve replacement. 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. My aortic root is 4.06 cms. Options for operation I got Edwards magna perimount 25mm bovine AV and Valsava graft for aortic root replacement. Thanks very much. Bicuspid aortic valve. His doctor said his heart look very healthy and no other issues. 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. Hamilton mother of twins, Cherie was diagnosed with bicuspid aortic valve disease (BAVD), a disease where the valve has only two leaflets. Based on the information Ive provided, I would greatly appreciate your advice and opinion on the matter. Some information about myself: Im 28, 186 cm, 77 kg, max pulse 194, rest 50 bpm, live in Russia. They wont repair my aneurysm unless it was 55mm during surgery or 60mm before surgery. You have a good understanding of the issues. At the USC Cardiovascular Thoracic Institute, we are dedicated to improving the statistics concerning cardiovascular and thoracic disease such as those once faced by the governor, said Starnes, who also serves as executive director of the Institute. His doctor recommended he see a pediatric cardiologist within 1-2 weeks but when I called they cant get him in until April 14th. It will also be necessary to keep a close eye on the size of the aorta over time, using echocardiography and CT. I was only diagnosed with BAV after a routine examination and only because my company has increased in size above a threshold at which all employees are supposed to be subjected to this examination (weird law in Belgium). Advice in this area must be individualized with your doctor(s). ANYTHING other than walking and golf? I had a Medtronic Freestyle valve fitted in May 2002, did exactly as directed regarding exercise etc. Okay to wait? While i appreciate you are not my cardiologist and we`ve never met is there anything generic out there that i can look at to gain an idea. Early after operation, and for perhaps the first month, we typically limit activities that place stress on the shoulders and sternum. Hi dr. Aortic valve regurgitation: Blood leaks back into your left ventricle instead of only flowing into your aorta. What he did say is there are no signs of stenosis, and my heart looks very strong. The valve may also become stiff due to calcium deposits on the leaflets over time. I dont believe there is any evidence that would help us know if some forms are safer than others. Oh, plenty. While I recovered from surgery just fine, my return to my normal activity levels has been hampered by recurring arrhythmias, muscle atrophy during recovery, medication,and general inability to exert myself like I could prior to surgery. Im doing cardio as they said thats fine and I was lifting free weights tonight of 10kg. 4.2cm dilated aortic root That said I have a resting HR of ~40 (always have). 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. Anything you can offer up here would be very much appreciated. 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. Zdenko . Some people with bicuspid aortic valve will have symptoms in early childhood. Stress echo revealed hypercontractile with normal response in all LV segments, no LV cavitary dialiation. BAV is present at birth (congenital). Thank you very much for the answer! I can imagine it might be difficult to make arrangements when you live in one country and your doctor(s) work in another. Guidelines suggest that athletes with BAV, normal size aorta, and no more than mild aortic regurgitation or stenosis can participate in all sports, without restriction.provided that they do not have an inherited connective tissue disorder like Marfanss syndrome. Im used to long runs up to 12 miles at an average 6 minute per mile pace as well as fast interval and farther training. We also sign a school waiver every year. When we go back to re-replace a patients prosthetic valve, for some reason, it usually has to be chiseled out from the heart. Thank you so much. 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. I dont train a lot, like 2k bike, 500k run and 100k swim yearly and few competitions sprints and one half IM in a year (32 years old). 2; But I recognize that not all cardiologists or heart surgeons would agree. At approximately three months I became very ill and was diagnosed with prosthetic valve endocarditis. I was to the understanding that the aneurysms caused in bav patients was due to the problematic bav valve causing uneven blood flow to cause uneven pressure on the aorta. I say this based on the fact different exercises will allow for differrent weight tolerances than others, in addition, stronger people can handle more weight than others. However my Sinus of valsalva is dilated between 45-47mm (depending on the machine used).
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