Thanks for the infoI really appreciate what you,have to say. (I'm a 17 year old female)After a heart echocardiogram yesterday we found out I have a bicuspid aortic valve, I originally went in to the cardiologist for extreme fatigue, constant racing heart (avg around 130bpm resting), palpitations, spells where I almost faint, feet swelling and turning purple, etc . Average STS score was 1.7%. I have 4 children and a great wife. Would you recommend taking beta-blockers at this stage? In April of this year (2016), I discovered I had a BAV in the worst manner possible. Im not sure how you should best sort out the differing recommendations from your doctors. The rest of the aorta is normal (visualized to just above the bifurcation in the abdomen). This can lead to stretching apart of the valve leaflets and leakage at the valve, known as regurgitation. My son was just told he made the varsity basketball team as a freshman. They are located between the atria and corresponding ventricle. (Or do I just need to train even harder??). In some cases a particular arrhythmia that is responsible for your feelings of palpitations or light-headedness could be identified.and options for treatment could be presented. Males are affected 3:1 compared to females. Make no mistake, though. For example, his spurt in enlargement happens to coincide with his spurt in growth. While I do expect to have a replacement done later in life, the repair was the best decision I could have made. March 6, 2023, Erin Feaker March 7, 2023, Rob Riley The best source of recommendations about safety of various forms of exercise will come from your doctor(s) who are familiar with all the particulars of your circumstance. Very much appreciate this site, thanks Larry for giving people like us a place to voice our concerns ! The actress, 44, found out she had a leaky valve in 2002. BAV is one of the most common congenital heart conditions, occurring in about 2% of individuals. BAVD is a malformation of the aortic valve present at birth that leaves you with two flaps instead of three, tripping up blood flow to the aorta. 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. Aortic dissection, a tear in the wall of the aorta. I dont know why this formed as I have had the problem valve replaced many years ago. From afar, its hard to know what might be responsible for your symptoms. An echocardiogram last June revealed a function BAV. Sbp. 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? Ten years ago (2006), doctors said that there was a worsening of the BAV but still no need to have Aortic replacement. It will also be necessary to keep a close eye on the size of the aorta over time, using echocardiography and CT. 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. It would be great to know what happens to groups of patients after AVR and aortic replacement that have returned to their various sports. Athletes will ask when they can return to their sports. Shes quite the athlete. The more common form of bicuspid aortic valve occurs in a valve with three cusps with . Use of this site constitutes acceptance of our User Agreement and Privacy Policy and Cookie Statement and Your California Privacy Rights. Dear Dr Creswell you seem to be such a kind cardiac surgeon to make yourself available in answering questions. Am I crazy? We are now seeing moderate stenosis, hence replacement in the not too far distant future. Best for athletes like you to have a discussion with their doctor(s) and settle on a defined, mutually acceptable course of action about which sports activities are safe. I would think that, ordinarily, a homograft would heal up along a similar timeline to other types of valve/aortic root replacement. Can you advise and or recommend a specialist? Jones' goal with the AHA is to help women "actively put themselves on the track to heart health." I see Im not alone. That said, guidelines from the 36th Bethesda Conference suggest that BAV, without enlargement of the nearby aorta or problems with the aortic valve, shouldnt preclude any sports activities.including weight lifting. Im am in stres ?! "Heart disease is the number one killer of all Americans, the number one killer of African-Americans and the number one killer of women, so I shouldve been put on notice since Im three-for-three. 3. 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. We all appreciate it. Mild to moderate ai If the valve does not close completely, blood can leak into the heart. 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. To continue to live this amazing life so full of challenges and friends, including so many of you in the audience, I have chosen to replace the valve with a new one. 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. Males are about twice as . Arnold Schwarzenegger opted against a mechanical valve replacement and chose a tissue valve because he felt a mechanical valve might limit his physical activity and capacity to exercise. My exercise is limited to 30 minutes of moderate carido, with no weights. Great to hear that youre doing cross country running. Only two cusps, commissures and sinuses are seen in the less common "pure" bicuspid aortic valve subtype. I love running. Thus far shes had only minor bruising (shes 6ft and has a solid build). The cardiologist doesnt do the surgery we have to go to another province to have surgery. The only prudent course is to have periodic follow-up imaging to keep track of size/growth. So my question: does there appear to be any performance advantage of tissue valves over mechanical or does the fact that Im on the anticoagulant anyway make the mechanical valve sort of a no brainer choice? You would never know meeting these celebrities that they had a CHD. This is an area where second opinions may be helpful in sorting out whats safe. 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. Normal function of cardiac valves Many athletes with bicuspid aortic valve (BAV) may continue to participate in their sports.provided there are no other problems, either with the aortic valve or nearby aorta. Miley Cyrus - Singer & Actress - Tachycardia. No LV chamber chamber dialiation, normal LV wall thickness, good LC systolic function, No regional LV wall motion abnormality. We just saw them in January. After 5 years of amateur competitive rowing, I had no problems keeping up with my peers whilst training at lower intensities. The value of CT/MRI comes when a millimeter or two makes a difference in treatment, restrictions, surgery, etc. A week after he made the varsity team as a freshman he was told by the doctor he couldnt play. And, if so, how did things go? I have also been advised that running intervals at over 80% max heart rate would not be sensible. Would this constitute as too much in your opinion ? Interestingly, bicuspid valves are one of the most common forms of heart valve disease. Normal great vessel size Thats important to keep in mind. ANYTHING other than walking and golf? The fusion (sticking together) of the valve leaflets causes abnormal valve opening and closing. Sadly, we dont have a crystal ball, though to know what the future holds for any particular individual. Aortic dilatation is a common feature of BAV with a prevalence ranging from 20 to 84% , due to differences in assessment techniques, study population, aortic size thresholds, and heterogeneous nature of the . On the bright side, there is ample evidence that, in the modern era, life-expectancy is not shortened for individuals with BAV compared to the general population. There are four valves of the heart, which are divided into two categories: Atrioventricular valves: The tricuspid valve and mitral (bicuspid) valve. 2 Such features need to be considered before surgical intervention. At issue are the potential long-term effects of repeated episodes of high heart rate and high blood pressure that accompany intense exercise. Still it puzzles me that for you as for me it seems to degrade more after the diagnosis for a condition we have since birth. September 13, 2017 1:00 PM. I had a Type A aortic dissection of the ascending aorta that extended into the descending aorta terminating near the femoral arteries. In addition to being patients, there are many celebrities who, like you, parent a child with CHD as well. My daughter (16 y/o) has a St Jude mechanical mitral valve (adult size valve even though she has had it for 7 years). And I took him for check up every year and nothing change and he never had any symptoms. 2. On Ocotber 23, 2020, we learned that Arnold Schwarzenegger had a third heart valve procedure, a re-replacement of his aortic valve replacement. "I have heart disease, and I found out about five or four years ago, the singer, now 49, told PEOPLE in 2008. For athletes who return to sport after AVR and aortic replacement, its important to settle on whats safe with your doctor(s) ahead of time. I used to do HIIT and moderate to heavy weight 5 days a week before my physical complications. 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. Thank you for best websit. Can you tell me what is to much, are push ups or pull ups heavy lifting, is 3 time per week 5 km running with 10-12 km/h pace to much? BAV was diagnosed in 196 newborns (prevalence, 0.77%), with a male-female ratio of 2.1:1. My son is desperate to be able to play sports without any restrictions. There is very little scientific evidence to guide us here. In 1997, he underwent surgery for a replacement valve made of his own pulmonic valve, which itself was replaced with a donor's. Bicuspid aortic valve refers to a spectrum of deformed aortic valves with two functional leaflets or cusps which are often unequal in size. I dont believe this has been well studied. I have no symptoms that I would notice, e.g. I am a marathoner with BAV and no other cardiac issues. We have contacted the Cleveland Clinic to learn more and will report back soon. Its really not strenuous, maybe 10 km/h and not more that 10 push ups at once. Maybe you can help me with some questions. Lastly, a human donor valve was inserted into the pulmonary valve position. Im a 30 year old male who is currently living in Asia with family. For those with moderate aortic stenosis, the guidelines suggest restricting activities. 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. No pulmonary hypertension Bicuspid aortic valve with Marfan and other HTAD when the ascending aorta is dilated >45 mm. Sadly, no crystal ball is available. In 1997, Schwarzenegger underwent heart valve surgery to correct his heart defect. I am 38 and very active (running, cycling, strength training etc). Only restrictions are no weights greater than 100 pounds or heavy contact sports. There are certainly individuals with BAV who never have trouble down the line. Apparently this can work better than Losartan? 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. You didnt mention your age, but obviously youd hope that whatever operation is performed.lasts a lifetime. The aortic valve is between the left lower heart chamber and the body's main artery, called the aorta. Rest pulse (70 bpm|50 bpm) I then played football my last two years of high school as well as playing hockey and throwing shot put for the track team. In patients needing valve replacement because of stenosis or regurgitation, the aorta should be repaired or replaced if the aortic diameter exceeds 4.5 cm. In some cases, bicuspid aortic valve causes another condition called aortic valve stenosis. Approximately 1%-2% of the population are born with an aortic valve that only has two cusps. The confusing thing I hear is some cardiologists telling BAV people not to life over x lbs. To me, cardiologists are not sports people and air on being absolutely over cautious. 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. There were some procedural differences between the bicuspid and tricuspid groups. Kim Kardashian Doja Cat Iggy Azalea Anya Taylor-Joy Jamie Lee Curtis Natalie Portman Henry Cavill Millie Bobby Brown Tom Hiddleston Keanu Reeves. Good to hear that youre doing well. "Women are the natural caregivers; we take care of everyone else under the sun," she says. My mom [and aunt] passed away [in their 60s from heart disease], and my dad had a heart attack when I was around 10 and he had a triple bypass, the actress told PEOPLE. Because it was just a cardiologist, not a sports cardiologist or physiotherapist. The aortic root is moderately dilated (max 46mm sinus to opposite commissure but you can measure 48off axis). If untreated, it can lead to blocked blood flow. Diagnosed at 5 with BAV, checked yearly, and okayed to play soccer. I am 18 years old . Im a 30 yr old male, training 5 times a week rowing and strength training. Susp. 3. There is a readable section related to BAV. I have not had any issues since my surgery. The other theory is that there is a structural problem that leaves the aortic wall weak. Normal pericardium, no pericardia effusion While I do not work out regularly, my job as a construction worker is somewhat strenuous. Do you think the weights Im doing at the moment seem OK with those results ? ), Your email address will not be published. My son will seek a repair when his conditions deteriorate. A bicuspid aortic valve (BAV) is the most common congenital heart defect, occurring in approximately 1%-2% of the general population. Even if its one person I help. I would like nothing more than to have this repaired so I can return to my lifestyle, I cant understand why I cant have it fixed as it is my choice to have surgery. Im afraid Ill end up like my Mom. I want to continue weightlifting .. what is your opinion about this ? The numbness/tingling has me constantly worriedand the slight chest pains have me always thinking is that my BV or Aorta causing issues?. 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. Many congenital heart defects cause few or no symptoms. Thank you to every doc and nurse on my team!". Aortic Stenosis She says now it is stable and I dont have to see her for 2 years. (I am on a low dose beta blocker) I know I will need it replaced. Log in, September 26, 2013 By Larry Creswell, MD 155 Comments. I would encourage you to have further discussion with your doctor(s) about EXACTLY what forms of exercise are safe. It was her death that prompted me to get checked out. Background: Transcatheter aortic valve implantation (TAVI) has achieved satisfactory outcomes in the selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%). In addition to this public search, we scanned our proprietary research database of over 1 million sources and were unable to find any specific research reports that address your goals. thanks for sharing all this interesting info. It is believed that Schwarzenegger had a bicuspid aortic valve which led to a Ross Procedure operation performed in 1997. Since my initial post i decided to call another pediatric cardiology hospital in our state, University of Michigan Pediatric Cardiology. Advertisement. I dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. New guidelines from the American College of Cardiology (ACC) were published just this week. My Echo Stress Test is normal but when I finish obviously the pressure is higher (190-80 at the end) . I was physically examined by a medical board at new Delhi for the post of a chemist in geological servey of India but they declared me unfit as I have BAV . "Weve gotten a lot closer and weve learned each other on a whole different, deeper level, she told PEOPLE in 2015. If a large enough valve is implanted, there may be no noticeable impact on the ability of the heart to do extra work that comes with running (or any exercise). Its conceivable that an echocardiogram a week afterwards could be abnormal simply because of the race. 4.2cm dilated aortic root I have been feeling better than before the surgery and I feel with better condition on the trails. , Bicuspid Aortic Valve Disease, Acquired Valve Disease. However, I always performed poorly when it came to the top end fitness tests e.g. 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 for that first month, we usually advise no driving, lifting, pulling, pushing, reaching, etc. Robin Williams - Aortic Valve Replacement & Mitral Valve Repair. I know it can be frustrating when you get conflicting opinions regarding the safety of exercise. 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. Although bicuspid aortic valve is typically asymp tomatic at fi rst, it is commonly associ-ated with progressive valvulopathy and tho-racic aortic disease. Heart disease and stroke are the number one killers of women, Streisand, 74, told PEOPLE about why she helped found the organization. I am now in no mans land of not needing immediate surgery (per the pressure number in left ventricle) and not being able to run more than 30 min. Again, this is a topic that is not yet well-researched. Since I started running, I lost about 8 kg, my blood pressure decreased from 140/90 to 120/80-70. In addition, I will get a random bout of lightheadedness when standing or sitting in a awkard position. The idea of somehow restricting the HR may be attractive as a means of curtailing strenuous activity. No enlargement of aorta or any other problems. Left ventricle (LV diastolic diameter 54mm|58mm, LV diastolic volume 142ml|167ml, LV systolic volume 39ml|57ml, Ejection fraction 72%|65%); He loves sports and is wanting to do more and more. The valve will become healed (scarred) into the surrounding heart tissues with the passage of time. The recovery from heart surgery can be hard to predict for any given patient, but we know that young otherwise healthy patients tend to do well. The Institute is a unique collaboration of cardiothoracic and vascular surgeons, cardiologists, pulmonologists and basic scientists all working together without the boundaries of departments or specialties. In my early 40s I thought that I was getting out of breath more than I should and eventually began to feel weak or nervous during a game, but only on Sunday. Enlargement of the left ventricle can be an indication that the heart suffers from the aortic regurgitation, even if the regurgitation doesnt produce symptoms like shortness of breath. This is true at rest and may be even more so during exercise. I wouldnt hesitate to register your concern with your sons doctor about waiting a few weeks. No operation to replace/repair the aortic valve and yo replace the ascending aorta is minimally invasive. Thats just a marketing gimmick. They ruled out Marfans syndrome because his aorta was dilating. I dont think theres a way to predict the future in this circumstance. 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. Thank you,dr Creswell, Instead, even with continued sports participation, the progression of both valvular and aortic disease is no different from that in the general population. I get the fact that lifting excessively can cause a spike in blood pressure, but only under certain conditions (i.e. Semilunar valves: The pulmonary valve and aortic valve. I dont know about the relative effectiveness of various ARBs used for this purpose. Hi, Fantastic website, there is very little actual information on this on the web. It will probably take a visit with a surgeon (who has all of the pertinent details) to outline the possibilities for you. Is the biggest risk (from numbness) a over-calcified valve which would cause lack of blood flow? Im less certain about how BAV, coarctation, and history of VSD repair might impact ones current top-end performance. I am a keen weightlifter, which is the basis of this post. Details of my condition: I dont know all of the important details. His whirlwind romance with Katherine Schwarzenegger has resulted in a rather large ring on her finger. The doctor looked at the results and told me to limit physical activity (running), because it can lead to heart failure in future. At the age of 12, she had a procedure to widen her valve as her heart condition continued to have an impact. Currently, it is estimated that about 5% of those with bicuspid aortic valve disease will experience aortic dissection.
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