Aortic Stenosis I asked her about surgery. Or, is it something that can wait until they get sports physicals in their teens? Very likely an operation will be needed at some point in the future. What activities can I do? Probably wise to follow the advice of your doctors who know the details of your situation. Soccer is his only sport and his passion- he plays on his high school team and a travel team. Okay to wait? It seems to be a very interesting option for those who have aortic dilatation due to Marfan or BAV (which is my case). 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 Marfan's's syndrome. I ran a 1/2 marathon 4 months after my surgery and have been since training for the Philly FULL marathon, which is tomorrow. How are you? I have appointment with a cardiologist on Friday but in the meantime i would like to know weather in case of surgery a replacement of the valve is definitely necessary or my condition still allows some options for a surgery without replacement. In short, I consider myself to be a high level athlete. Should I increase amount of weight? What does heavy weights mean? 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. E. G. I could bench 50lbs with no need to strain and hold my breath, which wouldnt result in a massive spike in blood pressure, but if I tried to bicep curl 50lbs it would do. 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. I'm new to this group, so I'll be rather short. The congenital bicuspid aortic valve (BAV) condition is a valvulo-aortopathy with substantial heterogeneity in its clinical expressions, associated disorders, complications, and prognosis. We also sign a school waiver every year. Get on with it. What should I do ? I had a David Tirone Operation a couple of weeks ago to repair a BAV with aortic dilatation (49mm), and a small leakage. The singer co-founded the Womens Heart Alliance, which works to raise awareness and funds research to fight womens heart disease. Sounds like youre on the right track with your upcoming visit with a specialist. To no surprise, people are worried about me running tomorrow. Surgery. There is a readable section related to BAV. And during the years, this remained pretty stable. Lastly, a human donor valve was inserted into the pulmonary valve position. Together, you should be able to settle on what sports activities will be safe based on those facts. Im not surprised that youve received a conservative recommendation about exercise. I was diagnosed with BAV, with regurgitation, no stenosis, at age 63. 1) Son has to stop football training as well as any physical activity, even at school (P.E. A cadaver if valve is then used to replace his pulmonary valve. You could probably settle on a plan for return to exercise with your surgeon and cardiologist. What should i do? Want to get a head start on your Oscar predictions? However, there are few reports about the safety and efficacy of TAVI in type 0 BAV. He wants to be normal. Sometimes my cardiologist says there is minimal change and he thinks my aorta had slightly enlarged by 1-2mm. This is the only measurement that has gone down . In fact, in some people they can go undiagnosed for years. Thank you very much for your thoughtful response. Also suggested taking low dose of beta-blockers although I have been told the effectiveness has not been proven. On April 16, 1997, Arnold Schwarzenegger underwent elective heart surgery to replace a defective, congenital aortic heart valve. Thanks. Ive seen several cardiologist and they are divided in recommendations. Great to hear that youre doing cross country running. Details of my condition: For many patients, I recommend no heavy lifting (>10 pounds) for the first month after conventional heart surgery. Its weird because sometimes when Im resting I can feel a little weird fluttering.. I have only trivial aortic regurgitation. 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). Your sons doctors are undoubtedly experts at pediatric patients. This was caused by an aneurysm in the ascending aorta (root) that measured over 6 centimeters). An early indicator of BAV is a heart murmur, which is an abnormal sound caused by the turbulent . We are now seeing moderate stenosis, hence replacement in the not too far distant future. The incidence of bicuspid aortic valve and complications. Here is a link to a diagram that categorizes sports according to their dynamic and static components: http://www.athletesheart.org/wp-content/uploads/2013/12/Classification-of-Sports-300217.png. I have read that strength training is beneficial for heart health. Many thanks. 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. I like to practice MTB and running competitively in local races. The Cardiologist now suggesting taking beta blockers as a way to slow things down and has advised that anywhere from 4.5 to 5.0 is where he would consider intervening. Before that, I had never seen a cardiologist ever. I have normal aortic size, mildly dilated aortic sinus (39 cm), and trace aortic regurg. Before 2 years my aorta was 37mm . Ordinarily, we reserve operation for patients with severe aortic regurgitation who have some decrement in the LV function. I do think that this condition can weigh heavily on patients minds, though, and in your case perhaps particularly so because of the experience of your mother. 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. 1 year ago I gave up smoking and started endurance running. There can be issues with aches and pains even months after operation that still relate to healing. Will I need surgery? 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). A few hours after helping the woman, she began to experience chest aches, soreness in both arms, nausea and clammy skin. This blog helped me a lot in my panic days, it put me at ease when I was worrying to much, just to see and to know your enemy and to realize that you are not alone is great help. lifting a max bench of 150 lbs I was diagnosed age 4 and am now 35. Some people with bicuspid aortic valve will have symptoms in early childhood. They call this type of heart attack the Widow Maker," she wrote. I probably get more inquiries from athletes with bicuspid aortic valve (BAV) than any other single heart problem. As of Monday, my BP at the echo appointment read 115/66. And my doctor do not give me responsive and exact answer to my questions regarding sports. Since Im very active in sports, Id like to have your opinion on it. I have been checked by echo/CT every year for the last 7 years to monitor the progress of my valve regergitation and aortic aneurism. Although bicuspid . John Fox, NFL coach, suffered from Aortic Valve Disease. Best to continue to work towards identifying cause(s) and getting any needed treatment. This almost seems like an off the shelf answer and Id therefore be really keen to find out your thoughts? Seven months ago I had emergency AVR due to a BAV that was severely compromised by endocarditis. You should discuss this possibility with your doctor(s). (Yes, I have been going for regular check-up since in was about 7 years old. Many heart conditions can be controlled or repaired once theyre diagnosed. Again, thank you and bless you for taking the time to talk with us here! "The 1997 heart valve replacement was never meant to be permanent," stated Daniel Ketchell, a spokesman for Arnold. My cardiologist said that sometimes it remains stable and never grows anymore. Im 31 and 1 years ago i found im BAV with modrate AI. Mild/moderate regurgitation. Ive been told by my cardiologist that they think I should probably avoid competitive rowing and weight lifting. Thanks for the infoI really appreciate what you,have to say. 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. I have moderate to severe regurgitation and the heart is enlarged as far as I understood. I am riding my 3 rd anual Belgian Waffle Ride today. 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. My heart seems to heal, so that speaks well for my future.. Consult your doctor to see if there are any restrictions that would be specific to your case. Weve known the risks and my daughter has done well to avoid scrapping for the ball etc. I have an OnX mechanical valve. The procedure was performed at the Cleveland Clinic. Sheer brutality and trauma caused Myasthenia Gravis. Thank you for your time Dr.! 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). I realize that appointment availability for medical specialistsin your case, the pediatric cardiologistcan be tight. Bicuspid aortic valve. I am a 36 yo male who was first diagnosed with BAV at the age of 17. Thats the main reason for choosing a tissue valve in my case. Advice here will be based on opinion rather than accumulated evidence in large numbers of children with BAV. I dont know anything about crossfit but I see his times are average on that page. 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 . Down side: must take blood thinners to prevent blood clots from forming on mechanical valve. There are a multitude of patient-specific circumstances that must be considered when deciding if and when operation is needed. For these individuals, provided there is no other relevant heart disease, it may be appropriate to have follow-up echocardiogram and/or CT scanning every 2 years. is my lack of top end performance indicative of someone with BAV & aortic coarctation? Thank you for your ideas and I apologize for my gramma errors (English is not my first language). 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. Do you have a congenital heart defect? I am a 23 year old male, have BAV with mild AR. Im a 29yo CrossFit addicted man who just found out I have BAV while applying for the defence force here in Australia. I am young with many years ahead, I dont want to accept this just yet when I know theyre is possibilty of repair. We briefly talked about the Ross procedure vs mechanical valve replacement. A repaired valve may not be as efficient as the native, healthy valve. Therefore, people . But Bob, you confirm that it does for you; and unfortunately I see same for me although 25 years younger. Be specific. The abnormal anatomy of the bicuspid aortic valve is complex, and a classification schema of 3 anatomical types has been proposed by Sievers and Schmidtke. Everyones symptoms are different but I felt compelled to share mine. Could the changes in my LV be the result of the physiological, not the pathological change? I realise that I will eventually need the valve replaced again and just hope that things go as well next time. Not sure I have something specific to suggest for additional reading.and I dont know where to steer you about a knowledgeable trainer in the UK. 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. An echocardiogram last June revealed a function BAV. Finding this site is such a relief / source of hope for me thanks so much Dr. Larry!. Barb. I wouldnt hesitate to register your concern with your sons doctor about waiting a few weeks. In March 2018 he underwent emergency surgery to have this replacement valve replaced. First, a disclaimer.My practice is devoted to adult patients. My son is 15 years old, he was born with BAV /aortic stenosis. Can BAV cause sudden death incidents in otherwise healthy 40 year old males? You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. 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. 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. Have you considered meeting with a heart surgeon to talk about the situation? 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. Although we still dont have very long term results tracked (15+ years), in the short term the results seem to be much superior to regular bentall de bono option (and its variations). Replacement of the aortic valve with either a cryopreserved human homograft (the aortic valve from a human cadaver) or with the patients own pulmonary valve results in the least obstruction to blood flow. I have also been advised that running intervals at over 80% max heart rate would not be sensible. After the scans, ultrasounds, stress tests and TOE, I was diagnosed with BAV with no Stenosis, no Aortopathy and no evidence of Coarct and normal LV size and function. However, is there any advantage to having them screen in their first decade of life, if they are not showing any symptoms? swimming? Many patients with surgery for BAV, even if it involves aortic root replacement, lead rather normal lives afterwards. mod-severe regurgitation ", Braxton is a survivor of pericarditis, an inflammation of the sac surrounding the heart. Thank you to every doc and nurse on my team!". 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. The typical symptoms are fatigue or shortness of breath, particularly with exertion. Thanks, To help correct the regurgitation, the cusps of the patients valve leaflets can be tailored, with the valve leaflets left in place. The mechanical valve conduit replaces the valve with a mechanical valve and the aorta with a Dacron fabric tube. Do you think I should slow down a little bit? 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. The aortic valve prevents blood from flowing back into the left ventricle of the heart. Ive done so much research and there are lots of young people who have went on to play sports and lead normal lifes. Aortic valve stenosis: Your aortic valve narrows, reducing blood flow through it. My consultant informed me that, because of my age, I would have a mechanical valve fitted which meant that I would be on warfarin for life and therefor not be able to play football. Shes quite the athlete. Theres no reason to not be CPR certified.. Dr. Creswell, I am a 55 years old male and have BAV. BAV is the most common cause of heart disease present at birth and affects approximately 1.3% of adults. For example, his spurt in enlargement happens to coincide with his spurt in growth. These operations can sometimes enjoy the benefits of each of the operations you mentioned.and avoid done of the down sides. Cardiac outcomes in a contemporary population of adults with bicuspid aortic valve have not been systematically determined.Objective To determine the frequency and predictors of cardiac outcomes in a. I would really like for people to not have to experience what I had to experience, she continued. Hey is a frustrated guy. On said it wont make a real difference, the other said oh yes, that was like a blockage, you will feel the difference. Most patients can resume all of these activities by 2-3 months after operation. Hi Larry, I have no proof this may be causing my less than stellar performance or if perhaps I should have more patience. 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. There was only a 0.2 cm increase in the previous 7 years (so from age 21 to 28). Please refer to this article if not: https://academic.oup.com/ejcts/article/50/3/400/2197426. Given my age and activity level, do you think it would be beneficial, or even prudent, to explore a valve repair surgery as you described above? Im not sure how you should best sort out the differing recommendations from your doctors. I didnt get it.". Some cardiologists tell me that I can run up to 130 beats per minute ; others say theyd prefer I do power walking because pressure always rises while running. Im less certain about how BAV, coarctation, and history of VSD repair might impact ones current top-end performance. Glad to hear that youre recovering, Zdenko. "Weve gotten a lot closer and weve learned each other on a whole different, deeper level, she told PEOPLE in 2015. Bicuspid aortic valve (BAV) is a heart problem present at birth and the most common congenital cardiac anomaly, with an estimated incidence of 0.5 percent to percent in the general population. Thank you! I am mostly a runner, 4 times a week, with 10 21 km races. Thoracic aortic aneurysm, an abnormal bulge in the part of the aorta located in the . Thats important to keep in mind. Think to report back to let us know how things go for you, personally. My son at 11 months was diagnosed with BAV. He had a mild BAV and was told that he can play with no restriction. Kimberly has experienced heart valve disease firsthand. Consensus guidelines suggest restricting activities in athletes with BAV and aortic diameter >4.0 cm. my son has BAV he was born with. And now my aortic root is 42 mm. Thank you for this blog! You are a very good man. Its a hard thing to describe to my cardiologist that my legs and HR are not cooperating when the pace picks up. Athletes with BAV who have no stenosis or regurgitation of the aortic valve AND have no enlargement of the nearby aorta may participate fully in their sports. My family is pressuring me to quit strenuous cycling but I am thinking that switching to longer rides at lower heart rates would not accelerate valve wear or otherwise be bad for me. Sometimes patients with mechanical aortic valves report that they lose a bit of their top-end athletic performance. That means it is a congenital heart defect. This can be very frustrating to athletes who are used to being more active. I can imagine it might be difficult to make arrangements when you live in one country and your doctor(s) work in another. Again, there are ACC/AHA guidelines for when operation is needed: Sometimes more than one indication for operation may be present, so there is the additional guideline for patients who need operation for aortic stenosis or regurgitation: I know from discussion with athletes over the past few years that there are differences of opinion among cardiologists and heart surgeons about these guidelines. Follow up for development of these functional lesions is indicated. Here are some celebrities that experienced severe heart valve defects and had to have either heart valve replacement and heart valve repair surgery. In practice, the indications for aortic valve replacement for severe aortic stenosis or severe aortic regurgitation are straightforward and uncontroversial. Thanks for sharing the article about the PEARS technique. Ive been affected by heart disease practically my whole life, she said. If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. You already have a cardiologist looking after you. Bicuspid Aortic Valve: Symptoms, Diagnosis & Treatment, Biological Tissue Valves: Pig, Cow, Horse & Human, The Patient's Guide To Heart Valve Surgery. But, while doing my cardio stress test they discovered that I have a Bicuspid Aortic Valve. In April of this year (2016), I discovered I had a BAV in the worst manner possible. Unfortunately, I really cant point you to such studies. Hi Larry, thanks for doing this website, I wish there were more like it. We were to see them in 3 months. Considering the results of my stress test and TOE, do you think it could be my heart and should I seek 2nd opinion. "Until then, stay close.. (bicuspid aortic valve), singer Bret Michaels (atrial septal defect), and even 'Survivor' contestant Whitney Duncan (ASD). In addition to being patients, there are many celebrities who, like you, parent a child with CHD as well. I was hoping that if the ultrasound numbers dont change much, the endurance will not decrease significantly. I dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. Hi Dr Creswell, Hi Dr. Creswell. The confusing thing I hear is some cardiologists telling BAV people not to life over x lbs. After that, most patients can gradually return to activities that put stress on the sternum and upper extremities. Dear Doctor, Im a 44 year old male. Regards will need careful consideration by your physicians who know all of the pertinent details. Hector V. Ive never heard about a mechanical aortic valve becoming loose because of high HR. Vanity Fair may earn a portion of sales from products that are purchased through our site as part of our Affiliate Partnerships with retailers. It sounds like youve gotten conventional advice regarding sports where there is a risk of bodily injury. Use or viewing of any Baldwin Publishing, Inc. article signifies your understanding and agreement to the disclaimer and acceptance of these terms of use. There is a risk of sudden death in individuals with BAV, probably related most to aortic stenosis or aortic dissection/rupture. My son was diagnosed with BAV, by chance, when he was 7. I have recently found out that I have aortic regurgitation will soon be needing surgery. Im not familiar with employment eligibility issues with BAV, even in this country. I made appointment with my cardio, to clear that up, dont worry :). Because it was just a cardiologist, not a sports cardiologist or physiotherapist. His doctor said his heart look very healthy and no other issues. This is the way I can help. I had a Bentall with mechanical valve done in Feb 2017. 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. I have almost everyday all day shortness of breath which follows with chest pain and discomfort. I had AVR 3 years and 4 months ago. My cardiologist has advised that while marathon running is out, shorter runs (up to 6-8 miles) and pilates are both fine for now. I cant lift over 40lbs and I cant continue my work as a tradesman as it requires lifting over the 40lb mark. At 4.0 cm, its important to be thoughtful about activities. Dont see why HIIT should be excluded. Very much appreciate this site, thanks Larry for giving people like us a place to voice our concerns ! SPORTS FIGURES/ATHLETES. I was also advised that it is really the static weight-lifting that could pose a problem. There is recent interest and experience with aortic valve repairinstead of replacementfor patients with BAV. Perhaps the best course of action might be to start off very conservative with exercise, as you are doing, with periodic assessment of the aortic valve and aorta with echo and CT. You might then gradually increase the activity and monitor for any bad signs with the periodic echos and CTs. 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. I have been feeling better than before the surgery and I feel with better condition on the trails. There are simply no reports that describe the experience of athletes returning to ECer ise (or training) after aortic dissection. Hi Larry, 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. "I had many of them, but I thought, 'Nah.' Anything you can offer up here would be very much appreciated. Perhaps the doctor could contact the specialist and request an earlier appointment, if that made sense. The surgery involved a replacement heart valve made from a transplanted tissue sourced from his pulmonic valve. Great article! 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.. In fact, like most people, the 25-year-old had never heard the term before. Will surgery mean I can do more or less training? 24 HOUR GYM To revist this article, visit My Profile, then View saved stories. No aneurysm. There are certainly athletes whove returned to their sports after valve (and aorta) repair/replacement. Ive yet to feel like Im back to my previous racing fitness that I once had. I was training for a marathon when I was 62 years old and diagnosed with BAV with severe regurgitation. As youve mentioned, sometimes it can be useful to visit a cardiologist who has an interest in athletes and their heart problems. The doctor allows me to do moderate sport defined by her like not 20k each day; 20k per week should be fine. 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? In 1997, Schwarzenegger underwent heart valve surgery to correct his heart defect. Very often, follow-up CT scans and echocardiograms are needed every 6-12 months to keep track. Aortic stenosis and bicuspid aortic valve (BAV) During that first month we recommend ample walking as the best form of exercise. This has caused a Thoracic aortic aneurysm that is 4.3 cm. I do think that aspects of the martial arts are strength-related. Questions about Bicuspid Aortic Valve!! How much exercise is too much for someone with a functional BAV? 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. Dwayne E. Russell Its conceivable that an echocardiogram a week afterwards could be abnormal simply because of the race. A bicuspid aortic valve only has two of these leaflets. Your doctors will be in the best position to offer advice because they will be most familiar with your case. Is the biggest risk (from numbness) a over-calcified valve which would cause lack of blood flow? Would you recommend taking beta-blockers at this stage? No information provided by Baldwin Publishing, Inc. in any article is a substitute for medical advice or treatment for any medical condition.