It is believed that Schwarzenegger had a bicuspid aortic valve which led to a Ross Procedure operation performed in 1997. That said, the recommendations dont address WHEN that screening should occur. 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. ANYTHING other than walking and golf? 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). I was having chest pain and flew to Thailand to see what the issues were and they found I had GERD and Esophagitis. Im not looking forward competitions nor marathons. Also I lift weights . PS I am really interested to know if HIIT is too intense a system of exercise for people with BAV. Bicuspid aortic valve is a heart problem present at birth. The guidelines were developed by an expert panel based on the scientific information available at that time: The issue has not been studied very well, but one recent study suggests that continued participation in sports for periods of up to 5 years does not change the natural history and progression of BAV. To revist this article, visit My Profile, then View saved stories. As of Monday, my BP at the echo appointment read 115/66. Apologies for my slow reply. Hi again Dr. Creswell, I am considered elite in my age division. Its conceivable that an echocardiogram a week afterwards could be abnormal simply because of the race. 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. Dr. Larry, very helpful content. However, my problem is that if I can train at this pace then I can still run but I certainly cant compete! Bicuspid aortic valve is a common congenital anomaly but does not cause functional problems unless aortic valve stenosis, aortic valve regurgitation, aortic root dilatation, or dissection or infective endocarditis occurs. 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. In general, the larger (in diameter) the substitute valve is, the less aortic stenosis it will produce. I cant think like a nurse where hey is concerned. I understand that we are only beginning to learn about the use of ARBs in patients who DO NOT have connective tissue disorders like Marfans syndrome. Get on with it. With the blood thinning needed for a mechanical valve, serious bleeding may occur with injuries. I guess my marathon training is officially over, but i hope that i still keep doing some sport and i dont mean bowling, no offense for who practice it ;). The cardiologist told us at that appointment that we needed to start considering surgery to repair his valve. thanks for sharing all this interesting info. 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). Mild/moderate regurgitation. Very much appreciate this site, thanks Larry for giving people like us a place to voice our concerns ! Thank you so much. Im obviously quite anxious that Ill drop death! The star's mother, Rita Owens, was diagnosed with heart failure after passing out while teaching art at a New Jersey high school in 2004. So you know, this is not uncommon for heart valve surgery patients. But, while doing my cardio stress test they discovered that I have a Bicuspid Aortic Valve. 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. Reply. Seven months ago I had emergency AVR due to a BAV that was severely compromised by endocarditis. 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. 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. The doctor said she would see if she could talk about his case with the surgical panel but she said even if he did have surgery he couldnt have a career in sports??? No changes in regurgitation status (aortic regurgitation LVOT 19%); Should I be doing push-ups/pull-ups? The procedure was performed at the Cleveland Clinic. They all cause a small bit of obstruction to blood flow as it leaves the heart. 1. We use surveillance (you mention every 6 months) because usually problems with progressive enlargement of the aorta or with the valve itself can be picked up before there is any lasting harm. Im a 30 yr old male, training 5 times a week rowing and strength training. Thats the main reason for choosing a tissue valve in my case. I first wrote about BAV in a short post here at the blog back in 2009. I feel like 95% of other people my doc sees are just happy to get back to their normal life which doesnt include pushing their bodies to extreme limits. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. I wouldnt hesitate to register your concern with your sons doctor about waiting a few weeks. I am an having trouble seeing the difference in the ross procedure and the bioprospthetic valve replacement as far as benefits go? 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. We have decided to wait and watch. Your situation is complicated.and it wont be possible to give a complete answer here without additional information. I started experiencing palpitations last year along with several instances of light-headedness. I used to be very muscular prior surgery and 3 mounts ago I started with 5 km runs, push ups and pull ups 3 days a week, slowly progressing. Save yourself.. Want to get a head start on your Oscar predictions? Aortic stenosis and bicuspid aortic valve (BAV) At this time, it is not known whether Arnold received the new valve using a surgical aortic . This is true at rest and may be even more so during exercise. 2. Elite triathletes and heart problems Best Valentine's Day Restaurant Specials 2023. That post is a starting point for todays discussion. I cant distinguish if its muscle pain or somewhere inside chest, its not sharp or dull, somewhere in between. But if you have a bicuspid aortic valve, you only have two cusps. Aortic replacement. My surgeon says that the aneurism and bav go together. Its always good that investigators are looking for new solutions to old problems. 140 miles at race pace. We just saw the cardiologist in July and again same symptoms and no significant cardiac changes . As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. There has been a slight increase in the measurements over the last several years, but I am still below the threshold which would require surgical intervention. My aortic root is 4.06 cms. He is on meds to slow it down. First, Id encourage you to follow your doctors advice. Thank you,dr Creswell, Like I said, peoples experiences are all different. What is your opinion about dissection in low/controlled messures? This has caused me a great deal of anxiety because I feel like I am being told to act like an old man before my time. Consensus guidelines suggest that (athlete) patients with BAV and moderate enlargement of the ascending aorta should curtail their strenuous static (eg, weight-lifting) and endurance sporting activities because of the risk of aortic rupture or dissection. Think to report back to let us know how things go for you, personally. after surgery and was playing football again by September. My son will be 16 next month. No stenosis, no calcification. The average lifespan for a cow valve or pig valve is about 10 to 15 years, according to the Cleveland Clinic. The pitfall, though, is that our native aortic valve is itself very efficient. 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. BAV is one of the most common congenital heart conditions, occurring in about 2% of individuals. Can you please shed some light on this is the sport performance supposed to gradually diminish (seems to go to zero for me) before the operation is needed? What should I do ? Defects can involve the walls or valves of the heart, or they may affect the arteries and veins near the heart. In March 2019, media outlets hailed two new studies on transcatheter aortic valve replacement (TAVR) as potentially signaling the beginning of the end of open heart surgery for aortic stenosis. I am perfectly happy to stick to the 10km max distance for races, but my key concern is that if I do run some faster training sessions then I might have a sudden death. 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. 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. Thank you for this blog! Log in, September 26, 2013 By Larry Creswell, MD 155 Comments. I wonder if there is also a psychological factor involved. Hey is almost looking forward to getting it fixed. You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Dr. Larry Creswell on athletes and heart health. ps. Apparently this can work better than Losartan? It has served me well enabling me to live the vigorous, full, complete life you are all so familiar with. Like you point out, its always wise to be vigilant after surgery for things that might be amiss.and get checked out. Thanks for sharing. . In 2017, there were 3,046 deaths due to rheumatic valvular heart disease and 24,811 deaths due to non-rheumatic valvular heart disease in the United States. 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 now take diltiazem daily. "I have heart disease, and I found out about five or four years ago, the singer, now 49, told PEOPLE in 2008. We live at 6,500 ft (elevation) so Im not sure if its affecting my blood pressure when doing normal things. But like a lot of women, I thought that heart disease was an old white guys disease," the former talk show, 56, host tells PEOPLE. I can tell my story. I had a Bentall with mechanical valve done in Feb 2017. My average weekly training plan includes 50k of running (5 days) with 80% done on pulse below 154-152 and only 20% done at pulse about 175-179 bpm. Regarding activity restrictions, you would do best to rely on the advice of your sons doctor(s) who will be in the best position to know the relevant specifics. I too am looking for information on effects to performance since I am a Masters racing cyclist with 25 years of racing/riding long events. Im 33 from UK and have known about my BAV since I was around 18. Great to hear that youre doing cross country running. CT or MRI may be more accurate. He will be rechecked with an echo, BNP blood test & MRI every 6 months. Bicuspid aortic valves can accumulate calcium deposits more easily than tricuspid aortic valves. What should i do? I feel as though Im recovering well and, having no other conditions or comorbidities, rapidly. My cardiologist is not concerned. The aortic valve prevents blood from flowing back into the left ventricle of the heart. This is the only measurement that has gone down . My son was just told he made the varsity basketball team as a freshman. Its a lot harder in the UK to see your cardiologist so you cant get the answers quickly. 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.. 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. I lifted weights for many years and spent almost all my life in physically demanding jobs. And my doctor do not give me responsive and exact answer to my questions regarding sports. Ive been affected by heart disease practically my whole life, she said. And judgment would be needed. (I am on a low dose beta blocker) I have a 15 year old son with a BAV, Aortic stenosis, Noderate regurgitation and dilatation of his ascending aorta. Currently, it is estimated that about 5% of those with bicuspid aortic valve disease will experience aortic dissection. As I mentioned in previous comment my recovery is going great. Very often, the specialists office will make note of the patients problem and make appropriate decisions about whether routine or urgent appointment scheduling is needed. O'Donell took the aspirin recommended for people who think they are suffering a heart attack just in case, but didnt call 911. I asked my surgeon and also the echocardiographist about my sports performance after full recovery, about 6 months after the surgery. Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. This was 7 months ago. Questions about Bicuspid Aortic Valve!! My daughter has played two years of varsity basketball already. Hope to hear back soon. The CVTI was created under the leadership of Dr. Vaughn Starnes, chair of the Department of Cardiothoracic Surgery and surgeon-in-chief at the Keck Medicine of USC. To the extent that any operation fixes the stenosis or regurgitation, we might expect better efficiency from the heart. I got Edwards magna perimount 25mm bovine AV and Valsava graft for aortic root replacement. They call this type of heart attack the Widow Maker," she wrote. The only prudent course is to have periodic follow-up imaging to keep track of size/growth. To no surprise, people are worried about me running tomorrow. John Fox, NFL coach, suffered from Aortic Valve Disease. 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. I had my BAV replaced in Feb. 2005 (porcine tissue) with a Dacron repair of the ascending aorta. Im 32 years old and back in 09 I discovered I have a BAV. Keep us posted! Your doctors will be in the best position to offer advice because they will be most familiar with your case. All they said is dont really do weight where you can feel the strain in your neck ?!? 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. Several contemporary elite triathletes have BAV and Ive written about their stories in: Examples from other sports would include Arnold Schwarzenegger, among others. This content can also be viewed on the site it originates from. Together, you should be able to settle on what sports activities will be safe based on those facts. I can imagine it might be difficult to make arrangements when you live in one country and your doctor(s) work in another. He was just diagnosed with functional BAV due to partial stuck together of two leaflets (out of three, as far as I understand, they are equal). 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. Yes, moderate aortic root dilation can remain stable. 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. Options for operation I was born with a BAV and but I didnt notice performance issues until the Summer of 2016, so I brought myself to the doctor. Im not familiar with employment eligibility issues with BAV, even in this country. I was shocked. Could the changes in my LV be the result of the physiological, not the pathological change? I have had scans and echos for as long as I can remember and have never been on medication nor has this condition stopped me from doing anything I have wanted. I would like to get back into it, but obviously I have been having some concerns. If he is a candidate for valve replacement are these sports he could ever return to In the best case scenario? The pertinent questions for your cardiologist is whether there is any stenosis (narrowing) or regurgitation (leakage) of the aortic valve and whether the size (diameter) of the nearby aorta is normal. My Echo Stress Test is normal but when I finish obviously the pressure is higher (190-80 at the end) . 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? I agree that its somewhat surprising that more detailed information isnt available. And he never had any symptoms and played competitive soccer since he was 6. This valve repair option is one that might best be pursued at a center that specializes in this problem.
