Im not sure how you should best sort out the differing recommendations from your doctors. When first diagnosed with BAV I just nodded and smiled it was only the following day that reality hit home and I thought of all of the questions that I would have liked to have asked the cardiologist! I have read that strength training is beneficial for heart health. "I had to make lifestyle and diet changes, she said. 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. Post 2 years and Ive yet to get back to my high level of racing fitness and wanted to see what should be expected. The valve will become healed (scarred) into the surrounding heart tissues with the passage of time. No LV chamber chamber dialiation, normal LV wall thickness, good LC systolic function, No regional LV wall motion abnormality. Be specific. I dont know why this formed as I have had the problem valve replaced many years ago. Hi Sean, Thanks for sharing your sons story. My problem is a perpetual fear and worry about having this diagnosis and having to someday undergo open heart surgery. 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. I didnt get it.". 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. Hannah Yona Fraint, M.D. Ordinarily, race walking is considered to be in the same category of activity as long-distance running. Does the BAV with aortic dilatation and small leakage prevent the blood to flow less efficiently? Running it is important for me but if it has a problematic effect , I would opt for power walking Is operation needed? Zdenko . Also, due to a bout of DVT and elevated d-dimers Im on Warfarin for life. ), What do you think? 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). I am followed every 2 years. No changes in regurgitation status (aortic regurgitation LVOT 19%); Many thanks again for answering this. Valve replacement with either a tissue (bioprosthetic) valve or a mechanical valve is, by far, more common. I would pose these questions to your doctor(s) since they are most familiar with the details of your situation. 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 ? Thats an issue to pursue with your sons doctor(s). The surgery involved a replacement heart valve made from a transplanted tissue sourced from his pulmonic valve. In addition, the Left ventrical has slowly increased over this same time period from 5.87 to 6.6 cm. Four necropsy series5, 6, 8, 20 provide the only basis we have for estimating the incidence of bicuspid aortic valve in the adult population, as diagnosis by auscultation is insufficiently accurate and no relevant echocardiographic study has been published. Eventually I will need valve replacement. Aortic stenosis has been reported to occur in as many as 72 percent of adults with a congenital bicuspid aortic valve, with peak incidence occurring in the 5th and 6th decades of life. Consult your doctor to see if there are any restrictions that would be specific to your case. Finding this site is such a relief / source of hope for me thanks so much Dr. Larry!. It is two to three times more common in males than in females. 3. Barb. Advertisement. Compared to our own native valve, all of the available prosthetic substitutes have a small degree of aortic stenosis built in, unfortunately. We saw cardio in April again and my sons symptoms are the same and no progression on the aortic regurgitation. Many endurance athletes are able to return to their sports after operation for BAV. I have been doing as much research as possible on what are the advantages/disadvantages of each replacement. 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. All Rights Reserved. In your case, though, the infection might well influence the healing process. Starnes implanted a healthy human tissue valve and said at the time, This will not limit Arnold Schwarzenegger in any way when he recovers.. 1) What kind of sports are recommend to me according to my situation? I agree that its somewhat surprising that more detailed information isnt available. I am 46 years old today, 22x marathoner, 4x Ultra (50 miles) and 5x natural fitness competitor. Contemporary reports suggest that life expectancy with BAV is no different from the general population. I seen my cardiologist yesterday and this is the first year in 4 years that the aneurysm hasnt grown a mm. (Or do I just need to train even harder??). Glad Ive found this website! I am a marathoner with BAV and no other cardiac issues. thanks for sharing all this interesting info. The confusing thing I hear is some cardiologists telling BAV people not to life over x lbs. He is very athletic. And, of course, its important to monitor over time the function of the prosthetic aortic valve and the size of the aorta. Also suggested taking low dose of beta-blockers although I have been told the effectiveness has not been proven. Is it right to declared someone having BAV unfit for the post of a chemist? Are there any things I can do now to help minimize my risk? Do you recommend any particular diet, exercise, vitamins,etc.? However, randomized, controlled trials have excluded bicuspid aortic valve (BAV), which is the most frequent congenital heart disease occurring in 1% to 2% of the total population and representing at least 25% of patients 80 years of age or older referred for aortic valve replacement. However, I always performed poorly when it came to the top end fitness tests e.g. My exercise is limited to 30 minutes of moderate carido, with no weights. I know that there can be complication with Dacron graft or even aorta aneurysm building up but Ill stay on positive side since I have no tissue disorder and its highly unlikely that with properly working aortic valve I would develop another one in that short period of time. They are also predisposed to enlargement of the ascending aorta, the large blood vessel that carries blood flow away from the heart. Anyway, it has slowed to 1 mm per year, and, via email, Dr. Dietz has suggested we may consider a switch to 300 mg Libersartan? Currently complete in 5-a-side football and have done for life. Common symptoms include chest pain, shortness of breath, dizziness and fainting. Your site has been helpful in provided a sense of peacebut an extra insight would be super encouraging. I was diagnosed with BAV about four years ago now by fluke whilst looking into my high blood pressure (I was only 24 at the time so I underwent a lot of testing due to my age and HBP the conclusion was it is hereditary, with many members of my family with HBP). 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. I have regular checks, 12 to 18 months, and until about 3 years ago was told that it was hard to tell that Id had a replacement valve, it now shows slight stiffening. We briefly talked about the Ross procedure vs mechanical valve replacement. Assuming that 2% of the US population has bicuspid aortic valve disease, that is 6,278,281 people. He just turned 15 he is 511 203 lbs and has a heart of gold. Athletes should have detailed discussion with their doctors about any prudent limitations to exercise after operation and settle on a mutually agreeable plan. http://games.crossfit.com/athlete/39565 An article at Endurance Corner about Normann Stadler, A blog post about elite triathletes and heart problems, Aortic stenosis and bicuspid aortic valve (BAV), http://www.athletesheart.org/wp-content/uploads/2013/12/Classification-of-Sports-300217.png, https://academic.oup.com/ejcts/article/50/3/400/2197426, If there is enlargement of the beginning portion of the aorta to greater than 4.0 cm, the individual should have a. Thank you for the follow-up! BAV is one of the most common congenital heart conditions, occurring in about 2% of individuals. Im not sure theres enough information at hand to offer sound advice. Stress echo revealed hypercontractile with normal response in all LV segments, no LV cavitary dialiation. But Bob, you confirm that it does for you; and unfortunately I see same for me although 25 years younger. Holding breath during lifts valsalva). I hadnt heard about the technique previously. Contact Editor. The risk of BAV in children of parents with BAV is probably about 10%. Who Qualifies for TAVR. What activities can I do? If you suspect you have a heart issue, either because you have symptoms or a family history of heart problems, see a doctor. My son was diagnosed with BAV, by chance, when he was 7. 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. Your sons cardiologist would seem to be in the best position to offer specific advice. This was during a 12 week intense training block where my resting heart rate got as low as 42 bpm. But I recognize that not all cardiologists or heart surgeons would agree. Context Bicuspid aortic valve is the most common congenital cardiac anomaly in the adult population. I certainly know of athletes who return to all forms of endurance sport as well as weight-lifting after operations like yours. 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. Thanks for sharing an update. Bicuspid aortic valves can accumulate calcium deposits more easily than tricuspid aortic valves. And my doctor do not give me responsive and exact answer to my questions regarding sports. I am mostly a runner, 4 times a week, with 10 21 km races. Hi, Fantastic website, there is very little actual information on this on the web. Great article! mod-severe regurgitation And now my aortic root is 42 mm. Flaps of tissue on the valve open and close with each heartbeat. These differences of opinion may be legitimate. coarctation of aorta. The doctor looked at the results and told me to limit physical activity (running), because it can lead to heart failure in future. Pop Medicine > Celebrity Diagnosis . Im a 51 year old male who had aortic repair (5.8 cm) and bovine valve replacement AVR surgery 2 years ago. 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. Dr. Larry, I do appreciate your insightful article very much. I wouldnt be happy just running I want to be the best that I can be at it. Bicuspid Aortic Valve This content can also be viewed on the site it originates from. 2) He can lead a normal life & can continue his training with regular echocardiography control (once in a year). It has allowed me to do the thing I enjoy doing in life. Yes, there are certainly patients with BAV who never need operation. The increased stroke volume and cardiac output may cause . Please refer to this article if not: https://academic.oup.com/ejcts/article/50/3/400/2197426. 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. Athletes will ask when they can return to their sports. Down side: must take blood thinners to prevent blood clots from forming on mechanical valve. Im 53. His only complaint or change is shortness of breath with stairs. I was hoping that if the ultrasound numbers dont change much, the endurance will not decrease significantly. I feel as though Im recovering well and, having no other conditions or comorbidities, rapidly. Perhaps you could organize such a visit for a 2nd opinion regarding safe levels of exercise? I had a cardio version to correct the AFIB. Surgery. http://www.energystretch.com He had a mild BAV and was told that he can play with no restriction. Do you think the jiu-jitsu (e.g. 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. It is quite frustrating, Im running with some guys that have a hard time believing that I run a marathon. (liver cysts noted). After his procedure, Arnold posted the picture above with the following statement, "Thanks to the team at Cleveland Clinic, I have a new aortic valve to go along with my new pulmonary valve from my last surgery. , Bicuspid Aortic Valve Disease, Acquired Valve Disease. Glad to hear that youre recovering, Zdenko. I certainly know runners, cyclists, and triathletes in that circumstance who are active and doing well. Im not sure how those two problems would be related. Adam has been featured by the American Heart Association and Medical News Today. I got checked out by my GP who detected a murmur then had all the other heart related tests and was diagnosed with BAV with stenosis and regurgitation. Palace Insiders Say Prince William Is Already Furious About Prince Harrys Memoir Leaks, Prince Harry alleges Prince William attacked him over Meghan Markle in a new excerpt from, Scene Stealer: The True Lies of Elisabeth Finch, Part 1, Rupert Murdoch Knees Trump in the Balls While Hes Doubled Over Coughing Up Blood, By BG017/Bauer-Griffin/GC Images/Getty Images. From afar, its hard to know what might be responsible for your symptoms. Here are some celebrities that experienced severe heart valve defects and had to have either heart valve replacement and heart valve repair surgery. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Cond Nast. no symptoms yet please help. Since I started running, I lost about 8 kg, my blood pressure decreased from 140/90 to 120/80-70. Functionally bicuspid aortic valve (type 1). In the blog post, I talked about the circumstances when operation is needed.as well as when sports are generally safe. Celebrities With Heart Disease - Celebrity Heart Health Survivors. 100 Black-Owned . She was originally under the impression she felt the way she did simply because she was exhausted. Aaron Boone (@AaronBoone), famous baseball player suffered from Bicuspid Aortic Valve. If youre uncertain about any advice youve received about exercise, you might try to seek a second opinion that may provide some extra confidence about exercise. Advice here will be based on opinion rather than accumulated evidence in large numbers of children with BAV. Well, as it happens, the Cleveland Clinic has been recently rated the top heart hospital in the nation, and the number two hospital overall. Dr. Larry, very helpful content. So it is very possible to continue athletic activities after surgery. 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 . Hi Dr Creswell, Is it possible that the valve will get loose? Is there anything we can do? Your doctor will be in the best position to know all of the relevant information and offer sound advice. 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. Thank you so much for your clear explanations. Apparently this can work better than Losartan? This was 7 months ago. His last MRI showed a dilation of 4.4cm at his aorta root but his BAV is fine with very little leakage. 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. I am a 36 yo male who was first diagnosed with BAV at the age of 17. Congrats! Stories of Bicuspid Aortic Valve. No aneurysm. "I am lucky to be here.". Do you have a congenital heart defect? 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. I first wrote about BAV in a short post here at the blog back in 2009. Enjoy! Thanks very much. I am 38 and very active (running, cycling, strength training etc). Do you have any info or recommendations about this? Hi Dr Creswell, I see my cardiologist the end of May. We are now seeing moderate stenosis, hence replacement in the not too far distant future. An early indicator of BAV is a heart murmur, which is an abnormal sound caused by the turbulent . After that, most patients can gradually return to activities that put stress on the sternum and upper extremities. Normal function of cardiac valves Background: Transcatheter aortic valve implantation (TAVI) has achieved satisfactory outcomes in the selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%). Bicuspid aortic valve refers to a spectrum of deformed aortic valves with two functional leaflets or cusps which are often unequal in size. In addition to running, I also perform moderate to high intensity resistance (weight) training 5-6 times per week. Im 31 and 1 years ago i found im BAV with modrate AI. Hi Larry, Rose underwent the procedure last week, and said he would be going home to rest for a couple of weeks before returning in March. Im 32 years old and didnt expect at all that my aorta would dilate. Your situation is complicated.and it wont be possible to give a complete answer here without additional information. What signs should I look out for? 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. Although bicuspid aortic valves can occur . On Aug 30, 2017 I passed out at the gym and subsequently airlifted due a large abscess and valve dehisence and underwent another operation and now have a homograft. I am big for my age . lifting a max bench of 150 lbs Doing nothing wont be great for my heart and wont extend my life neither probably.. My cardiologist gave me green light for everything except strenuous exercise (used to train for ironman and similar challenges). Ive thought that the next visit to the pediatrician would be a good opportunity to discuss the issue. We were to see them in 3 months. Do you think the weights Im doing at the moment seem OK with those results ? eventually was told everything was ok. Im not familiar with employment eligibility issues with BAV, even in this country. Throughout the years he has played football and basketball. 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. My Echo Stress Test is normal but when I finish obviously the pressure is higher (190-80 at the end) . Thanks, I will do whatever I can to make sure my mom is comfortable and has whatever she needs, she said. That post is a starting point for todays discussion. 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. 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)? I have 5 children, so I dont want to drop dead and leave my poor wife with them all to look after on her own. A bicuspid aortic valve only has two of these leaflets. 2 Such features need to be considered before surgical intervention. The potential downside relates to durability. I am playing basketball I am doing 100m and 200m and swimming . I have 4 children and a great wife. In this case, would it be an overwhelming pain? My son is desperate to be able to play sports without any restrictions. no tiredness, no dizziness, etc. If untreated, it can lead to blocked blood flow. 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. Additional types of patients who should ask for a TAVR evaluation include: Bicuspid aortic valve patients who are experiencing symptoms. Dont see why HIIT should be excluded. You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. I am considered elite in my age division. I have also been advised that running intervals at over 80% max heart rate would not be sensible. The plasma volume and the heart rate increase, while the systemic vascular resistance decreases throughout the first trimester and plateau about halfway through pregnancy [10]. Im keeping my heart rate below 150, 160 at most but just for short period of time. Its really not strenuous, maybe 10 km/h and not more that 10 push ups at once. To make matters worse, I had a bout of AFIB, about 6 months ago. Before 2 years my aorta was 37mm . Yes, as the patient grows, so will the aorta.and eventually you get to the traditional >40 mm cutoff where activity restrictions are advised. 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. You should discuss this possibility with your doctor(s). Thank you for your ideas and I apologize for my gramma errors (English is not my first language). I know that heart surgery can be scary.but I also know that for the vast majority of patients with these conditions, surgery goes well and the outcomes are good. It would be great to know what happens to groups of patients after AVR and aortic replacement that have returned to their various sports. On Monday the 13th, I had my annual echo. On March 30, 2018, we learned that Arnold Schwarzengger required a second heart surgery. Push for earlier date? This has caused a Thoracic aortic aneurysm that is 4.3 cm. Ive yet to feel like Im back to my previous racing fitness that I once had. Is it like keyhole surgery? The lines are the edges of the valve leaflets that open and close to let blood through. 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. Hi Larry, with valve area of 1.4 cm2 and aorta of 4.1 cms I have been given no restriction to date in any physical exercise as my valve is in decent condition. 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. Specifically, Im wondering about inversions like forearm stand, head stand, and hand stand. Anyway, I will continue with running as much as I can, and now I have an excuse for my lousy performance. Thanks for sharing your sons story with BAV. enlarged LV = 350ml Thanks! Very often, follow-up CT scans and echocardiograms are needed every 6-12 months to keep track. My biggest concern is whether I will be able to return to my previous level of physical activity and level of fitness. Interestingly, bicuspid valves are one of the most common forms of heart valve disease. Is this true that you wont be symptomatic with only mild AR?