The exact cause of aortic enlargement in patients is not known. If Im trying to do 10 it will be harder to get those 2 up but it wasnt that hard before. Normally, your aortic valve has three cusps that regulate blood flow from your heart to your aorta. I have ramped up my walking to 30 minutes, keeping my heart rate under 100 bpm. I know they really should get checked, and they will. Thanks, Zdenko . 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.. coarctation of aorta. If youre questioning the recommendations youve received, perhaps a second opinion might be helpful. Now I take brisk walks and run on the treadmill only occasionally. Common symptoms include chest pain, shortness of breath, dizziness and fainting. 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). Miley Cyrus - Singer & Actress - Tachycardia. No thrombus, vegetation were noted I want to continue weightlifting .. what is your opinion about this ? Learn more about Baldwin Publishing Inc.editorial policy,privacy policy, ADA compliance andsponsorship policy. We live at 6,500 ft (elevation) so Im not sure if its affecting my blood pressure when doing normal things. Last week I visited a doctor and here are the changes for the last year (before|after): 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. Prescriptions for safe exercise will need to be carefully tailored to your particulars. Questions about Bicuspid Aortic Valve!! 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. But, while doing my cardio stress test they discovered that I have a Bicuspid Aortic Valve. The doctor looked at the results and told me to limit physical activity (running), because it can lead to heart failure in future. My son is desperate to be able to play sports without any restrictions. that suffer from heart valve disease along with a link to the reference story about heart valve disease and their Twitter handle to tweet on and promote the Valve Disease Day. One young man's complications from a bicuspid aortic valve were life-threatening, but perseverance and expert care helped him make it through. 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. Barb. This is the way I can help. Eventually I will need valve replacement. It was a shock to the system to Hear that we need to consider a repair considering we didntt think this was happened until hey was an adult. Over the past 3 years, my endurance has declined significantly, and now I cannot run a lap on the treadmill without some walking; however, my numbers from the semi-annual utrasound have not changed much. While I no longer due very strenuous activities, I still play softball, golf, kayak, ski, and do play hockey every now and again. I am followed every 2 years. Do you think the jiu-jitsu (e.g. Dietz?) I am a 48yo competitive cyclist who is very concerned with being able to return to my former ability to hit high effort levels following open heart surgery. Can you clarify what may not be true please? I do not do any kind of sport and I want to have healthy life at make sure my situation not getting worse and I weight 90 kg. Many patients with surgery for BAV, even if it involves aortic root replacement, lead rather normal lives afterwards. Ive done the Philly a Marathon a coup,e times and know that its a terrific event. ", Braxton is a survivor of pericarditis, an inflammation of the sac surrounding the heart. Considering the results of my stress test and TOE, do you think it could be my heart and should I seek 2nd opinion. No changes in regurgitation status (aortic regurgitation LVOT 19%); The echo in Jan asc aorta Diam 4.2 cm z-score 6.4. Obviously, mild to moderate would be somewhere in between. Unfortunatly that`s pretty much all the advice i`ve been given so far, so little out there on what i can actively do and what i can`t. I cant imagine life without CrossFit, but I wont be able to continue will I? I believe that many Cardiologist are not as experienced regarding how to advise high-performing athletes (even older ones like us). His cardiologist said, i am sure he can play a full game with new issues but I have to go with new guidelines and indirectly left it up to me to make the decision which moved him to mild /moderate and put right at the Borderline. Nwankwo Kanu (@papilokanu), the Olympic Gold Medalist (Soccer) suffered from Aortic Valve Defect. I think its reasonable to think of things this way. Bicuspid Aortic Valve: Symptoms, Diagnosis & Treatment, Biological Tissue Valves: Pig, Cow, Horse & Human, The Patient's Guide To Heart Valve Surgery. Think to report back to let us know how things go for you, personally. We have got two completely different opinions from our cardiologists: All aorta is normal, valvula normal funkcion only sinus valsava 35-37mm. I wouldnt be happy just running I want to be the best that I can be at it. 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). Specifically, Im wondering about inversions like forearm stand, head stand, and hand stand. I am an having trouble seeing the difference in the ross procedure and the bioprospthetic valve replacement as far as benefits go? I had it replaced in 2014 and am now 16. I had a Type A aortic dissection of the ascending aorta that extended into the descending aorta terminating near the femoral arteries. Im 39 also diagnosed with BAV when I was 31. Something they suspect is also from birth but never previously picked up. Get on with it. My resting pulse is 55 and BP 115/82. Thanks very much. He/she can talk with you about the generalities of operation in your circumstance. 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. Danny. I get sporatic tingling in my left hand and footand every so often in my left cheek bone. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window). 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. Dear Dr. Creswell, I have also been advised that running intervals at over 80% max heart rate would not be sensible. 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 Is Bicuspid Aortic Valve Disease? 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. Your web site and the links have much good information. Instead, even with continued sports participation, the progression of both valvular and aortic disease is no different from that in the general population. 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. BAV is the most common cause of heart disease present at birth and affects approximately 1.3% of adults. Arnold Schwarzenegger Test Drives New Aortic Valve on Cleveland This gives a chance for the sternum, which was split during the operation, to heal completely. 2 Such features need to be considered before surgical intervention. However, my most recent scan in October revealed all Stenosis and LV thickening had gone completely (Doctor said this was a very positive result perhaps due to excercise and medication). I eat relatively well, but sometimes having those pizzas and burgers late at night I had to change that.. My son is a very active and healthy 14 year old. Many endurance athletes are able to return to their sports after operation for BAV. lessons) In this case, would it be an overwhelming pain? 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. Hi Larry, I have question about your opinion about aortic valve regurgitation (no BAV) Im not a nurse or anyone who can help in any real way, she told PEOPLE, fighting back tears. 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. Substitute valves. There is not much scientific evidence about what to expect. My questions are: can my root dilation remain stable? "Until then, stay close.. Okay, thats greatbut I left feeling uncomfortable with the diagnosis. She said it could still be 6 months to a year just depending on if there are any more changes to this next echo. It sounds like youre off to a good start with your recovery. The doctor said it wasnt serious, but that I should keep watch on it every year. 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. Most patients spend about a week in the hospital after operation and then are able to go home. Please refer to this article if not: https://academic.oup.com/ejcts/article/50/3/400/2197426. This was 7 months ago. Hey was born with BAV and moderate regurgitation and stenosis, and dilatation of his ascending aorta. Valve replacement with either a tissue (bioprosthetic) valve or a mechanical valve is, by far, more common. Does the BAV with aortic dilatation and small leakage prevent the blood to flow less efficiently? I was wondering if you could give your opinion on my scenario. These differences of opinion may be legitimate. Its not around incision, its mainly middle of left side. And lastly, the degree of healing in the remaining (unoperated) aorta probably has a big impact on the potential risk. Thank you for the follow-up! 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. which seems to suggest that he has returned successfully to the sport. Im 33 and I do jiu-jitsu. I appreciate your response, thank you for taking the time to write me back. My last CT scan in November showed a change from 4.3 (May) to 4.5 (November) however I was only given these results yesterday. 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. You would never know meeting these celebrities that they had a CHD. The singer co-founded the Womens Heart Alliance, which works to raise awareness and funds research to fight womens heart disease. Options for operation In March 2018 he underwent emergency surgery to have this replacement valve replaced. We dont have a crystal ball, though. I met an old guy once after a run and he described me very well his running experience; he said when I accelerate, Im the only one to know. Bicuspid aortic value ppg 24 mmhg Apparently this can work better than Losartan? What should I do ? 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. My biggest concern is whether I will be able to return to my previous level of physical activity and level of fitness. Keep us posted! View HelpingHeartsCharitys profile on Facebook, View @HelpingHeartsMDs profile on Twitter, View HelpingHeartsCharityMDs profile on Instagram. Brave Dublin teen Sinead fights back from heart surgery to make beloved Max Page - Child Actor (Darth Vader in VW Superbowl ad) - Tetralogy of Fallot. I was disappointed [when I was diagnosed]. The procedure has the potential to bring the aorta to 4.3/4.4 and avoid further enlargement. Probably a bicuspid aortic valve but there are many other possibilities Reply Lack of breath? Either way I often think my cardiologist looks at me as if Im nuts and that my current 175 miles a week training should be thought of as beyond expectations post open heart surgery. I was hoping that if the ultrasound numbers dont change much, the endurance will not decrease significantly. I found a cardiologist with whom Im quite happy with. Ive been affected by heart disease practically my whole life, she said. 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. Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. Normal pericardium, no pericardia effusion A bicuspid aortic valve only has two of these leaflets. Replacement? 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]. Center for Bicuspid Aortic Valve Diseases | Penn Medicine "The 1997 heart valve replacement was never meant to be permanent," stated Daniel Ketchell, a spokesman for Arnold. A 2019 report suggests that bicuspid aortic valve disease is the most common congenital heart valve problem, affecting between 0.5 and 2 percent of the general population. I am 51 and leaning towards a tissue valve because of my activities and that I am a firefighter. He had a mild BAV and was told that he can play with no restriction. Glad to hear that youre recovering, Zdenko. And during the years, this remained pretty stable. To no surprise, people are worried about me running tomorrow. I think hes amazed by what I have described for my workouts of 65+ mile rides several times a week. If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. This award-winning website has helped over 10 million people fight heart valve disease. Bicuspid aortic valve with Marfan and other HTAD when the ascending aorta is dilated >45 mm. mod-severe regurgitation Since my initial post i decided to call another pediatric cardiology hospital in our state, University of Michigan Pediatric Cardiology. This makes the aortic valve a tricuspid valve. Bicuspid aortic valve (BAV) disease does not usually cause symptoms. When we go back to re-replace a patients prosthetic valve, for some reason, it usually has to be chiseled out from the heart. Hi all, Answers to your questions. Bicuspid aortic valve (BAV) is the most common form of congenital aortic valve disease, in which the valve has only two leaflets instead of the usual three; it affects up to 2% of the population. 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? Bicuspid aortic valves are more common in men, but also affect women. Benefits: no blood thinning (with attendant risks) needed. The surgery was a full success, and the valve is closing really well now. when I discussed this with my Dr. he reassured me that its not my heart causing it. Bobbie. My 25 year old son was just diagnosed with BAV AR (3+). Schwarzenegger's Aortic Valve Replacement | MedPage Today To make matters worse, I had a bout of AFIB, about 6 months ago. Call 911. I know I will need it replaced. Any person in my family there was no problem with the heart. Bicuspid Aortic Valve: Diagnosis, Treatment, and Outlook - Healthline I have just one thing bothering me, and that is healing of tissue surrounding heart and also chest muscles, nerves and so on. Finally, many patients are able to return to their sports after successful operation. 2k erg test. Yes, as the patient grows, so will the aorta.and eventually you get to the traditional >40 mm cutoff where activity restrictions are advised. is my lack of top end performance indicative of someone with BAV & aortic coarctation? I dont know why this formed as I have had the problem valve replaced many years ago. He is very athletic. Compared to our own native valve, all of the available prosthetic substitutes have a small degree of aortic stenosis built in, unfortunately. She partnered with the American Heart Association to encourage others to get CPR training that could potentially be life-saving. 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. At issue are the potential long-term effects of repeated episodes of high heart rate and high blood pressure that accompany intense exercise. They may also disrupt the normal flow of blood through the heart. Bicuspid Aortic Valve and Congenital Aortic Stenosis in Children This can lead to stretching apart of the valve leaflets and leakage at the valve, known as regurgitation. 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? Consensus guidelines are developed to be broadly applicable, but the guidelines may not be applicable in a given athlete patients circumstance. Very much appreciate this site, thanks Larry for giving people like us a place to voice our concerns ! The potential downside relates to durability. Stress echo revealed hypercontractile with normal response in all LV segments, no LV cavitary dialiation. He has been restricted from playing contact sports since hey was 10. my age is 20 right now We dont know what to do. These Famous People Survived Congenital Heart IssuesYou Can, Too, On-Site CLIA Certified Laboratory Services, Click here for COVID-19 & Vaccine Information, Actor, body builder and former California Governor, After winning three Super Bowls with the New England Patriots, linebacker. All Rights Reserved. I am 31 years old and had my BAV repaired at The Cleveland Clinic in 1999 when I was 15. Dr. Creswell It will also be necessary to keep a close eye on the size of the aorta over time, using echocardiography and CT. Normal great vessel size Their experiences have been variable, and perhaps for a variety of reasons. Ive not found any programs for evaluating repaired athletes unless something exist with a physiologist research lab. How a Fitness Trainer Manages Bicuspid Aortic Valve Disease - Men's Health There are just so many causes of shortness of breath, lightheadedness, and chest pain.even besides the heart-related causes. Aortic valve replacement is recommended for nearly all patients with severe valve stenosis (valve opening less than 1.0 cm2), Aortic valve replacement is recommended for patients with severe valve regurgitation if there are symptoms due to the regurgitation (eg, shortness of breath with exertion) or evidence that the heart is suffering because of the regurgitation (enlargement of the left ventricle), Repair or replacement of the beginning portion of the aorta is recommended if there is enlargement of the aorta to greater than 5.0 cm. It sort of flutters open and shut. The guidelines do not address the frequency of surveillance for individuals with BAV and no enlargement of the aorta. My son is 15 years old, he was born with BAV /aortic stenosis. Etc? Several contemporary elite triathletes have BAV and Ive written about their stories in: Examples from other sports would include Arnold Schwarzenegger, among others. Congenital bicuspid aortic valve after age 20 - PubMed Im not sure theres enough information at hand to offer sound advice. 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. 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. He wasnt real worried about me and I have regurgitation (mild) and (mild) aortic root dilation.. Do u think it would be OK to lift weights and if so maybe u could give me a better understanding. From your standpoint (and your sons), it will be important to have that dialog to sort out whats safe. Website designed by Gatorworks. 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. OPTIMUM HEALTH, INC His exercise stress test on 8/5/16 was fine. Thank you for your assistance in this matter. No pulmonary hypertension The ST junction and ascending aorta are mildly dilated max 35mm. 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. 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. First, Id encourage you to follow your doctors advice. This visit we were told it could be a few years before anything needs to be done. I have recently had CT scan and MRI scan, following some chest pain experienced on track while doing marathon training. EKG and echocardiogram were done showing BAVD. Would you recommend taking beta-blockers at this stage? My questions are You already have a cardiologist looking after you. Regarding the PEARS, the main concern is about the possibility that the aorta dissects even in a controlled measure (lets say 4.5cm). Im aware that those days are past, but to abandon every activity seems like a prison sentence What is safe side threshold? 1) What kind of sports are recommend to me according to my situation? Thank you so much! My primary question relates to sports. From your reading, or even just here at the blog, youll know that its not an unusual story. 2012; 109:1632-1636. 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. Perhaps you could print out the diagram, take it with you to the cardiologist, and ask him/her to circle the forms of exercise that would be safe in your case. The data regarding the progression of disease in athlete patients with BAVare limited. Thanks so much for all this info! ANYTHING other than walking and golf? Yes, there are certainly individuals with BAV who go a lifetime without needing valve replacement or aortic surgery. . Bicuspid Aortic Valve Im 52 years old and had surgery 2.5 years ago to repair an ascending aortic aneurysm (5.8 cm) and aortic tissue valve replacement. 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. Like you, I have been frustrated by the lack of experience and information that the cardiology community has for folks like us, although it is encouraging to read everyones posts here and see that we are not alone. Do you opration? I am mostly a runner, 4 times a week, with 10 21 km races. Assuming that 2% of the US population has bicuspid aortic valve disease, that is 6,278,281 people. Check out Anthony DiLemmes blog, Anthonys Heart Valve Replacement Saga. To much info to much detail so much information and advice. How much exercise is too much for someone with a functional BAV? In addition to being patients, there are many celebrities who, like you, parent a child with CHD as well. What advise can you give to someone in my position? His whirlwind romance with Katherine Schwarzenegger has resulted in a rather large ring on her finger. Im am in stres ?! In the blog post, I talked about the circumstances when operation is needed.as well as when sports are generally safe. Keyhole just refers to the type of incision used for conventional valve replacement like you had.