Now Id like to know your opinion about physical performance, before and after. Would this have any affect on any of the results of the tests I have done (Echo, EKG, Chest Xray)? 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. Could you express your opinion on this issue? We were to see them in 3 months. The issues of when, how, what sports are safe, etc. The heart has a difficult time coping with extra demands of exercise. Background: Transcatheter aortic valve implantation (TAVI) has achieved satisfactory outcomes in the selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%). I think we should have a choice??? Body contact sports may pose some danger to athlete patients who take blood thinners. Anything you can offer up here would be very much appreciated. I have found your article(s) very useful amongst what I see as so much mis-information out there. Replacement? Bobbie. I have recently had CT scan and MRI scan, following some chest pain experienced on track while doing marathon training. 1,3,4,15 It can lead to chronic heart failure and increase the risk of acute aor-tic syndromes and sudden cardiac death.15 Michelena et al16 studied 212 cases of asymp tomatic bicuspid . 2. 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. Stress echo revealed hypercontractile with normal response in all LV segments, no LV cavitary dialiation. Im really wondering at what point should I look into flying back to Thailand or Hong Kong to get re-checked. my son has BAV he was born with. The free weights are about 10kg and Im not doing any really heavy weights. Thank you for your ideas and I apologize for my gramma errors (English is not my first language). No LV chamber chamber dialiation, normal LV wall thickness, good LC systolic function, No regional LV wall motion abnormality. Key points about bicuspid aortic valve. We dont know what to do. I had AVR 3 years and 4 months ago. I realize that appointment availability for medical specialistsin your case, the pediatric cardiologistcan be tight. Anyway, I just wanted to say I found this article particularly informative. I look forward to hearing from you. Again, this is a topic that is not yet well-researched. He is now 15. Bicuspid aortic valve is the most common congenital cardiovascular anomaly, occurring in 1-2% of the population. Think to report back to let us know how things go for you, personally. As youve mentioned, sometimes it can be useful to visit a cardiologist who has an interest in athletes and their heart problems. 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. 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. Website designed by Gatorworks. Sadly, no crystal ball is available. Ad Choices, Blood molecules as they exit the left ventricle: I'll be back., The 42 Best Romantic Comedies of All Time, The 25 Best Shows on Netflix to Watch Right Now. Call 911. If untreated, it can lead to blocked blood flow. Would you recommend taking beta-blockers at this stage? I am wondering if you know anything about these drugs and how they can impact aortic growth? "I had to make lifestyle and diet changes, she said. Lynn. So for that first month, we usually advise no driving, lifting, pulling, pushing, reaching, etc. They ruled out Marfans syndrome because his aorta was dilating. Tachcardaia beetwen echo due that doctor couldent see clearly. At the USC Cardiovascular Thoracic Institute, we are dedicated to improving the statistics concerning cardiovascular and thoracic disease such as those once faced by the governor, said Starnes, who also serves as executive director of the Institute. Hey would like to continue to be active but is worried about which procedure would be best for him. Today, echocardiography (ultrasound) for screening or diagnostic purposes for some other heart problem is the most common way that BAV is detected. Sory but I dont speak very vell english. Yes, there are certainly individuals with BAV who go a lifetime without needing valve replacement or aortic surgery. 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. When there is narrowing (stenosis) or leakage (regurgitation) of the aortic valve, the heart must do extra work. And I took him for check up every year and nothing change and he never had any symptoms. Hi. Hey was born with BAV and moderate regurgitation and stenosis, and dilatation of his ascending aorta. 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). 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. No enlargement of aorta or any other problems. 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. Thanks in advance. Get on with it. I asked her about surgery. Im used to long runs up to 12 miles at an average 6 minute per mile pace as well as fast interval and farther training. Hi again Dr. Creswell, Thank you for this blog! I cant imagine life without activity, but Im not fool to risk my life, not any more anyway :). This is an area where second opinions may be helpful in sorting out whats safe. Im highly considering this option, after 4 months of research and appointments with doctors. I made appointment with my cardio, to clear that up, dont worry :). The congenital bicuspid aortic valve (BAV) condition is a valvulo-aortopathy with substantial heterogeneity in its clinical expressions, associated disorders, complications, and prognosis. 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. An early indicator of BAV is a heart murmur, which is an abnormal sound caused by the turbulent . Or, is it something that can wait until they get sports physicals in their teens? These operations can sometimes enjoy the benefits of each of the operations you mentioned.and avoid done of the down sides. I feel fantastic and have already been walking the streets of Cleveland enjoying your amazing statues. There have been reports of lingering effects (decreased function of the left or right ventricles) for several days after marathon runs. Hi Larry, thanks for doing this website, I wish there were more like it. It was her death that prompted me to get checked out. The value of CT/MRI comes when a millimeter or two makes a difference in treatment, restrictions, surgery, etc. It usually consists of three flaps of tissue what are called valve cusps. He also has minimal leakage at the valve aorta. What a great resource! People can live normal lives with Congenital Heart Defects. There are several variations of this procedure that are applicable in specific situations. EKG and echocardiogram were done showing BAVD. Bicuspid aortic valve (having only two leaflets rather than the normal three) happens in about 1% to 2% of the population and is more common among men. This year (her junior year) her Cardio doc is saying that she cant in good conscious clear her for basketball (the sport my daughter LOVES). It prevents the blood from flowing back from the aorta into the heart when the pumping chamber relaxes. I would really like for people to not have to experience what I had to experience, she continued. 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). Options for operation Its now 8 months after surgery and Im pretty much back in my every day life, was even granted to attend my pilot medical tests which are due in 2 weeks. They are located between the atria and corresponding ventricle. . In short, I consider myself to be a high level athlete. In January 2021, she underwent open heart surgery to install an aortic valve. Diagnosed last year while looking at something else. Currently, it is estimated that about 5% of those with bicuspid aortic valve disease will experience aortic dissection. Since he had to stop playing.. depression has set in. Historically, a heart murmur was the most common reason affected individuals were identified. Arnold Schwarzenegger was born with a bicuspid aortic valve, in which the aortic valve has only two leaflets, instead of the typical three. A CT scan made the diagnosis. Your advice is always invaluable and most appreciated. I am big for my age . So you know, this is not uncommon for heart valve surgery patients. 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. 3. Thank you,dr Creswell, Having a congenital heart defect means you are born with a problem with the hearts structure. For many patients, I recommend no heavy lifting (>10 pounds) for the first month after conventional heart surgery. (Yes, I have been going for regular check-up since in was about 7 years old. 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. He/she can talk with you about the generalities of operation in your circumstance. Having a congenital heart defect means you are born with a problem with the heart's structure. . Related posts: http://games.crossfit.com/athlete/39565 "I am lucky to be here.". On said it wont make a real difference, the other said oh yes, that was like a blockage, you will feel the difference. However, some people are born with an aortic valve with only two leaflets, known as a bicuspid aortic valve. But if you have a bicuspid aortic valve, you only have two cusps. Do we have a choice with him only being 15??? Thanks for the very insightful post, and for taking the time to reply to everyone here. Athletes will ask when they can return to their sports. I applaud your efforts to search out information to help you decide on a course of action. Good to hear that youre making a good recovery from your second operation. In addition to the European guidelines, there is also an American set of guidelines published in the Proceedings of the 36th Bethesda Conference. Holding breath during lifts valsalva). 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 . We want our patients to know that whatever the level of care they need, our team will design and implement the health plan that works best for them, Starnes said. Common symptoms include chest pain, shortness of breath, dizziness and fainting. Thank you very much for your thoughtful response. Any person in my family there was no problem with the heart. Finally some solid information about exercise and life post AVR, thank you very much for that. These differences of opinion may be legitimate. Reply. Beta blockers are frequently prescribed in the circumstance you describe, but in truth we dont know if they will be effective in delaying surgery for any given patient. However, I always performed poorly when it came to the top end fitness tests e.g. My son was just told he made the varsity basketball team as a freshman. with an efficiency of 69%, I have an appointment with a specilaist next week and am just wanting some, even if vague, answers. With so many similar stories, do you know why there is not more statistical data or studies done with regards to sports and BAV and changes in aortic diameter? By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. From afar, its hard to know what might be responsible for your symptoms. Am I crazy? The actress, 44, found out she had a leaky valve in 2002. California Governor and movie star of films including The Terminator and The Predator, Arnold Schwarzenegger marked the 10-year anniversary of his heart surgery at USCs Health Science Campus. Every 6 months it is getting larger. That is someones life.. He told me to carry on as normal and to take 300mg Irbesartan per day. 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. What should I do ? Perhaps that info will give you some basis for discussion with your cardiologist and surgeon regarding the type of valve that is used for your re-replacement. Moreover, there is a myriad of operations that such patients may have had, each with its on set of considerations. 2) He can lead a normal life & can continue his training with regular echocardiography control (once in a year). 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). 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. 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 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. I get sporatic tingling in my left hand and footand every so often in my left cheek bone. Medical therapy may be useful to slow or halt the progression of aortic valve disease and aortic enlargement by reducing the blood pressure and the blood pressure across the aortic valve. Since I started running, I lost about 8 kg, my blood pressure decreased from 140/90 to 120/80-70. While my surgeon said that I can do whatever normal healthy person would do my cardiologist gave me some restrictions basically not to raise my HR over 120. The lines are the edges of the valve leaflets that open and close to let blood through. Dr. Larry, very helpful content. Dear Doctor, 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. Okay to wait? 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! It doesnt help that I am a nurse. At 4.0 cm, its important to be thoughtful about activities. And he never had any symptoms and played competitive soccer since he was 6. Get your act together, Columbus! Its a lot harder in the UK to see your cardiologist so you cant get the answers quickly. Could I continue to train and just cut out the blood chokes? There can be issues with aches and pains even months after operation that still relate to healing. I would encourage you to have further discussion with your doctor(s) about EXACTLY what forms of exercise are safe. You can contact me on zdenkokosutic@yahoo.com. Now at 74, and after having AVR I am 10 weeks into the dont lift more than 10 pounds restriction. Consensus guidelines are developed to be broadly applicable, but the guidelines may not be applicable in a given athlete patients circumstance. To save nice heart the best would be doing nothing (! Schwarzenegger was born with a condition known as bicuspid aortic valve, in which the heart's main artery, the aorta, has only two cusps instead of three.If untreated, it can lead to blocked blood . Im a 51 year old male who had aortic repair (5.8 cm) and bovine valve replacement AVR surgery 2 years ago. A HR limit of 120 will be tough, I would guess. Anyway, talk to a surgeon who understands quality of life means. Aortic enlargement in patients whove had valve replacement for BAV can be a vexing problem. What are my chances of being able to go back to marathon running after surgery? Answers to your questions. Also I lift weights . There is recent interest and experience with aortic valve repairinstead of replacementfor patients with BAV. Negative Stress Echocardiography I think we would expect less enlargement over time with stopping strenuous exercise. The doctor looked at the results and told me to limit physical activity (running), because it can lead to heart failure in future. We live at 6,500 ft (elevation) so Im not sure if its affecting my blood pressure when doing normal things. This international evidence-based nomenclature and classification consensus document is intended for universal use by clinicians, imaging specialists . Chris Pratt to Marry into the Kennedy Family. Im 32 years old and didnt expect at all that my aorta would dilate. Aortic root is 4cm and currently waiting for a 6month check up to see how it`s going. Star Jones. My son is a baseball player, so that is good. To make matters worse, I had a bout of AFIB, about 6 months ago. 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. Arnold Schwarzenegger Helped Greta Thunberg Get a Tesla, Where to Watch the Biggest 2023 Awards Contenders. At the age of 12, she had a procedure to widen her valve as her heart condition continued to have an impact. I have question about your opinion about aortic valve regurgitation (no BAV) My son is devastated, depressed, and wanted to play ball in college. Looking through the reader comments here at the blog and reflecting on the athlete inquiries Ive received, I thought Id cover some of the major issues. Vanity Fair may earn a portion of sales from products that are purchased through our site as part of our Affiliate Partnerships with retailers. No other issues. It has served me well enabling me to live the vigorous, full, complete life you are all so familiar with. His doctor said his heart look very healthy and no other issues. The aortic valve lies between the heart and the aorta, the main artery . New guidelines from 2015 are in accord with your doctors recommendations about vigorous exercise as well as periodic imaging to measure the aorta. I had a David Tirone Operation a couple of weeks ago to repair a BAV with aortic dilatation (49mm), and a small leakage. what would your advice be for training & competing? 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. Or its the result of the cumulative effect of the aortic and mitral valve leakage? It is quite frustrating, Im running with some guys that have a hard time believing that I run a marathon. You have a good understanding of the issues. Defects can involve the walls or valves of the heart, or they may affect the arteries and veins near the heart. Thank you for answering these questions. 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. Can you direct us to ANY research on the effect of endurance sports on AVR patients? Looking forward to hearing your thoughts. If he is a candidate for valve replacement are these sports he could ever return to In the best case scenario? Obviously, I underwent emergency surgery to replace the aortic valve (Medtronic open pivot mechanical valve) and have the aneurysm repaired with a dacron graft. One situation that seems particularly ripe for differences of opinion is that of the athlete with BAV, no significant stenosis or regurgitation, but with an aortic diameter of 4.5 to 5.0 cm. Thats an issue to pursue with your sons doctor(s). 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. Ive been told by my cardiologist that they think I should probably avoid competitive rowing and weight lifting. To help correct the regurgitation, the cusps of the patients valve leaflets can be tailored, with the valve leaflets left in place. Bicuspid aortic valve (BAV) disease does not usually cause symptoms. ANYTHING other than walking and golf? I know they really should get checked, and they will. Thats important to keep in mind. If the valve does not close completely, blood can leak into the heart. In practice, the indications for aortic valve replacement for severe aortic stenosis or severe aortic regurgitation are straightforward and uncontroversial. Thank you for your assistance in this matter. This almost seems like an off the shelf answer and Id therefore be really keen to find out your thoughts? In fact, one young man died 5 years after operation (from other non related causes) and the study on his aorta tissue revealed that the device helped it to heal, presenting a healthy histology. I certainly know runners, cyclists, and triathletes in that circumstance who are active and doing well. Im afraid Ill end up like my Mom. First, Id encourage you to follow your doctors advice. Thank you very much for writing such a thorough and well informed article. I have found out I have a BAV last year. Before 2 years my aorta was 37mm . Ive done the Philly a Marathon a coup,e times and know that its a terrific event. My son is 12 years old. We also sign a school waiver every year. 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. It is believed that Schwarzenegger had a bicuspid aortic valve which led to a Ross Procedure operation performed in 1997. 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. Any words you have for us would be greatly appreciated. Patients with BAV who have a normal size aorta, with no stenosis or regurgitation of the aortic valve, can participate in sports without restriction. A total of 25,556 newborns (51% male; mean age, 12 days) underwent echocardiography. 2 Such features need to be considered before surgical intervention. I love running. 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. While i appreciate you are not my cardiologist and we`ve never met is there anything generic out there that i can look at to gain an idea. He is certainly expert in the area of drug therapy to reduce the rate of aortic enlargement. Post 2 years and Ive yet to get back to my high level of racing fitness and wanted to see what should be expected. Have completed an excercise stress test and signed off as ok on reaching level 13. Symptoms of bicuspid aortic valve disease most commonly develop in middle age in people with a history of a childhood heart murmur. A few hours after helping the woman, she began to experience chest aches, soreness in both arms, nausea and clammy skin. I had a Bentall with mechanical valve done in Feb 2017. I am a 60 yo female who has been active my whole life. The confusing thing I hear is some cardiologists telling BAV people not to life over x lbs. I asked my surgeon and also the echocardiographist about my sports performance after full recovery, about 6 months after the surgery. Only restrictions are no weights greater than 100 pounds or heavy contact sports. I see Im not alone. Bicuspid aortic valve with Marfan and other HTAD when the ascending aorta is dilated >45 mm. I otherwise feel very healthy, other than (I think) normal slowing down that comes with age. ), What do you think? It is very frustrating as my doctor would prefer to see me live the rest of my life with restrctions and have the aneurysm stabilized rather than take a chance on surgery and possibly returning to my normal lifestyle. James Cameron checks in from Pandora with a status report. I have a few questions because I was instructed not to lift more than 10 lbs and that I could resume surfing in a year. I dont know why this formed as I have had the problem valve replaced many years ago. Im 37 years old male, live in Croatia, 191 cm, 94 kg, very athletic, practicing various sports my whole lifetime. Im 39 also diagnosed with BAV when I was 31. "Until then, stay close.. Considering the results of my stress test and TOE, do you think it could be my heart and should I seek 2nd opinion. http://www.energystretch.com Thank you so much for your reply. 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. I am 6ft 3 . This makes the aortic valve a tricuspid valve. I didnt get it.". We go back in 3 months for another echo. Any guidelines? I am an having trouble seeing the difference in the ross procedure and the bioprospthetic valve replacement as far as benefits go? My son is 15 and has grown about 4-6 inches in the last year. Last week I visited a doctor and here are the changes for the last year (before|after): Now I take brisk walks and run on the treadmill only occasionally. I ran a 1/2 marathon 4 months after my surgery and have been since training for the Philly FULL marathon, which is tomorrow. 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.