My doctor says i use losartan for decrease my blood presure. I have moderate to severe regurgitation and the heart is enlarged as far as I understood. Hi again Dr. Creswell, Im in Philly today but Im from Central NY. Sadly, no crystal ball is available. Or its the result of the cumulative effect of the aortic and mitral valve leakage? 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? I am a marathoner with BAV and no other cardiac issues. Learn more about Baldwin Publishing Inc.editorial policy,privacy policy, ADA compliance andsponsorship policy. John Ritter - Actor - passed away due to undiagnosed CHD at age 55. However, my problem is that if I can train at this pace then I can still run but I certainly cant compete! Thanking you in advance, If echo shows a normal size, thats probably okay. Have you considered meeting with a heart surgeon to talk about the situation? Activities are not usually restricted for athlete patients with mild aortic stenosis. "I am lucky to be here.". 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 ? Search Heart Hospitals Please refer to this article if not: https://academic.oup.com/ejcts/article/50/3/400/2197426. Thank you for your assistance in this matter. Your email address will not be published. Routine endocarditis prophylaxis is . He wants to be normal. Im a 30 yr old male, training 5 times a week rowing and strength training. I cant distinguish if its muscle pain or somewhere inside chest, its not sharp or dull, somewhere in between. Is it right to declared someone having BAV unfit for the post of a chemist? Best to continue to work towards identifying cause(s) and getting any needed treatment. I found a cardiologist with whom Im quite happy with. Could I continue to train and just cut out the blood chokes? Most patients can resume all of these activities by 2-3 months after operation. If you havent yet seen a surgeon, perhaps a visit would all wan opportunity to talk about these issues, even if operation is not yet needed. I have severe aortic stenosis with no signs or symptoms. Probably a bicuspid aortic valve but there are many other possibilities Reply Enlarged lv 37/58 mm rf 65 fs 36 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. 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? So you know, this is not uncommon for heart valve surgery patients. 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. Hey would like to continue to be active but is worried about which procedure would be best for him. His BAV is causing very little back flow. Anyway, I will continue with running as much as I can, and now I have an excuse for my lousy performance. Additional types of patients who should ask for a TAVR evaluation include: Bicuspid aortic valve patients who are experiencing symptoms. 2023 Cond Nast. I have not had any issues since my surgery. "Thanks to the team at the Cleveland Clinic, I have a new aortic valve to go along with my new pulmonary valve from my last surgery," he wrote. It will probably take a visit with a surgeon (who has all of the pertinent details) to outline the possibilities for you. Heart disease and stroke are the number one killers of women, Streisand, 74, told PEOPLE about why she helped found the organization. I just thought it was muscle strain., My body cleared the blockage itself, said the game show host, who credited the aspirin he was taking for what he thought was simple muscle pain. Arrhythmias may sometimes manifest many years after surgical repair of congenital heart defects. Hes a 30-year-old 8th grade science teacher, a cyclist and outdoorsman, who is chronicling his story with BAVfrom diagnosis, to evaluation, to preparations for upcoming valve replacement surgery. Bicuspid valves are quite common (1-2 percent of the population). It usually consists of three flaps of tissue what are called valve cusps. Background: Transcatheter aortic valve implantation (TAVI) has achieved satisfactory outcomes in the selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%). This can cause the valve to malfunction and prevent blood from flowing correctly from the . 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. Im less certain about how BAV, coarctation, and history of VSD repair might impact ones current top-end performance. 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. The lines are the edges of the valve leaflets that open and close to let blood through. I know what theyre saying and after that I know that I have mixed feelings because I feel depressed about not being active like I used to be, but then I feel selfish as I am not being grateful. I was concerned about his cough last weekend so I was assessing his lungs with my stethoscope when I heard a very pronounced diastolic murmur at his 3rd ICS. Dear Dr. Creswell, In Jan 2016 My son was seen by the cardiologist and had some changes on his echo and the cardiologist said hey had mild progression of the aortic regurgitation( moderate to severe) with preserved LV function. My son is a baseball player, so that is good. This have affected my son psychologically since he loves playing soccer 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. Obviously, I underwent emergency surgery to replace the aortic valve (Medtronic open pivot mechanical valve) and have the aneurysm repaired with a dacron graft. The potential downside relates to durability. He is certainly expert in the area of drug therapy to reduce the rate of aortic enlargement. Star Jones. I have found out I have a BAV last year. Thank you for this blog! I have an OnX mechanical valve. I dont know about the relative effectiveness of various ARBs used for this purpose. Consensus guidelines from the Proceedings of the 36th Bethesda Conference recommend: The first recommendation does not include the endurance sports. They all underwent aortic valve replacement. Normal pericardium, no pericardia effusion Is that far fetched? Yoga is not included in the classification of sports that is commonly used, but I suspect that yoga would have low to moderate static and dynamic components. Is the biggest risk (from numbness) a over-calcified valve which would cause lack of blood flow? I inderstand that my resistance training will likely be severely curtailed from this point forward, but severe restrictions on my endurance training will be a very difficult pill to swallow. How much exercise is too much for someone with a functional BAV? To me, cardiologists are not sports people and air on being absolutely over cautious. Thank you for answering these questions. The flaps are called cusps. Advice here will be based on opinion rather than accumulated evidence in large numbers of children with BAV. 140 miles at race pace. Its not around incision, its mainly middle of left side. It makes the heart work harder than it should. If the valve does not close completely, blood can leak into the heart. However, my surgeon told me that he could fit a tissue valve and so would not need to be on warfarin. Flaps of tissue on the valve open and close with each heartbeat. Early after operation, and for perhaps the first month, we typically limit activities that place stress on the shoulders and sternum. Did the heart have to work harder to compensate? Perhaps that will provide so e reassurance. ), What do you think? This site complies with the HONcode standard for trustworthy health information. I was training for 11th marathon at the time (over the past 13 years). If so, youre far from alone. What advise can you give to someone in my position? Running it is important for me but if it has a problematic effect , I would opt for power walking 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. Im hoping you can help with some guidance. Unfortunately, I really cant point you to such studies. I otherwise feel very healthy, other than (I think) normal slowing down that comes with age. 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. I started experiencing palpitations last year along with several instances of light-headedness. I see Im not alone. You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. Stress echo revealed hypercontractile with normal response in all LV segments, no LV cavitary dialiation. 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). these conditions occur mostly during my exercises at the gym and Im left very lightheaded and shortness of breathe. Bicuspid aortic valves can accumulate calcium deposits more easily than tricuspid aortic valves. 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. The data regarding the progression of disease in athlete patients with BAVare limited. 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.. EKG and echocardiogram were done showing BAVD. No other issues. As I have aged I have upped the reps to 15 or more and two or three sets max, sometimes doing a set or two of 5 reps with heavier weights. This is an unfortunate situation for the athlete patient because the consensus guidelines do not yet recommend operation, yet advise against strenuous sports activities. No operation to replace/repair the aortic valve and yo replace the ascending aorta is minimally invasive. Thats just a marketing gimmick. I dont know what to do .. In addition, I will get a random bout of lightheadedness when standing or sitting in a awkard position. My personal approach to endurance athletes in this situation would be to offer operation if the patient wanted to continue to participate in endurance sports (after operation) and was willing to assume the risks of operation. SPORTS FIGURES/ATHLETES. The only prudent course is to have periodic follow-up imaging to keep track of size/growth. Depending upon the size of the prosthetic valve, there is so e built-in obstruction to blood flow that is e aggregated during exercise. Im 32 years old and back in 09 I discovered I have a BAV. Ive not found any programs for evaluating repaired athletes unless something exist with a physiologist research lab. 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. Options for operation Or usually lead a normal life? 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). Im 39 also diagnosed with BAV when I was 31. Defects can involve the walls or valves of the heart, or they may affect the arteries and veins near the heart. And during the years, this remained pretty stable. She partnered with the American Heart Association to encourage others to get CPR training that could potentially be life-saving. Best to mention your participation in the marathon when you have the tests done. For many patients, I recommend no heavy lifting (>10 pounds) for the first month after conventional heart surgery. Im not familiar with employment eligibility issues with BAV, even in this country. Contemporary reports suggest that life expectancy with BAV is no different from the general population. After finding out about her heart disease, Braxton stopped eating unhealthy foods at night. Barbara Walters - Aortic Valve Replacement. Another possibility that you havent mentioned deserves some discussion with your sons doctor(s) or surgeon. Latifah has taken on her mom's caregiving duties, along with relatives and a nurse, whenever she is on the east coast. When the aorta is enlarged in the setting of BAV, there are a couple possibilities: the valve needs to be replacedor it doesnt: Valve repair. The other theory is that there is a structural problem that leaves the aortic wall weak. Thank you sincerely for your time and information. 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. Now I wanted to start again (also due to the 8kg I accumulated in the meanwhile:( ) and I discovered that I can barely run 5K in 30 min and I generally find it very difficult to run. I had an echo because of a scuba diving accident and was discovered to have a BAV (no PFO). Your sons cardiologist would seem to be in the best position to offer specific advice. Bicuspid aortic valve can be found in 1% to 2% of the general population . May 11, 2010 -- Barbara Walters said on Monday that her upcoming heart surgery, a procedure known as an aortic valve replacement, will hopefully correct a problem of which . Im really wondering at what point should I look into flying back to Thailand or Hong Kong to get re-checked. 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]. Less than one month ago Schwarzenegger was (virtually) hosting the Austrian World Summit of the Schwarzenegger Climate Initiative, which introduced speakers like Prince Charles, Jane Goodall, and Pakistani Prime Minister Imran Khan. For the last 7-8 years I didnt do too much sport (kids, family). I do not know aorta measurements. This is thought to occur at a rate of about 0.1% per year in adults. In 1997, Schwarzenegger underwent heart valve surgery to correct his heart defect. Thanks for the infoI really appreciate what you,have to say. The numbness/tingling has me constantly worriedand the slight chest pains have me always thinking is that my BV or Aorta causing issues?. I would really like for people to not have to experience what I had to experience, she continued. I am an amateur runner, I do not participate in competitions. I wish you both all the best. I had multiple re-hospitalizations but seemed to recover. A few hours after helping the woman, she began to experience chest aches, soreness in both arms, nausea and clammy skin. And judgment would be needed. I think its reasonable to think of things this way. Thanks, For athletes with mechanical heart valves, the most important consideration is usually about potential bodily injury while taking blood thinning medications. Thank you so much for your clear explanations. They wont repair my aneurysm unless it was 55mm during surgery or 60mm before surgery. Just double checking. Alternatively, bicuspid aortic valve symptoms can appear during the first twenty years of life. We expect the current generation tissue valve to last at least 12-15 years before problems. This also assumes that there are no other cardiac issues or medical problems to consider. Monica Lewinsky: 25 Randoms on the 25th Anniversary of the Bill Clinton Calamity. ODonnell, now 54, said her heart attack began after she helped an enormous woman struggling to get out of her car in a parking lot. I know they really should get checked, and they will. As Schwarzenegger previously had two cardiac procedures, it is possible that Arnold may have received aTAVR using a Valve-in-Valve approach to replace his failing aortic tissue valve that was implanted in 1997. I am a competitive cyclist, neither the Cardio or my Doctor said I should not be racing bikes anymore, does that sound reasonable to you, my doc did say to monitor the aortic root size yearly. diagnosed wid BAV AND AS WITH AR In addition to being patients, there are many celebrities who, like you, parent a child with CHD as well. I know I will need it replaced. I probably get more inquiries from athletes with bicuspid aortic valve (BAV) than any other single heart problem. As a result, the valve doesn't function perfectly. Apologies for my slow reply. They are able to see my son this Friday, which i am much more comfortable with! The surgeon I used told me that he had performed keyhole surgery once but wasnt sure if it would be of much benefit to me. Hello dear doctor. When Ive had patients in your situation, Ive usually recommended getting the screening when its CONVENIENT. Hey was born with BAV and moderate regurgitation and stenosis, and dilatation of his ascending aorta. This might reasonably translate into some measurable improvement related to physical exercise. Could you express your opinion on this issue? Consensus guidelines suggest that athletes with mild aortic regurgitation and no other heart problems can participate fully in their sports. I was having chest pain and flew to Thailand to see what the issues were and they found I had GERD and Esophagitis. Bicuspid aortic valve: A bicuspid aortic valve only has two leaflets, increasing the risk of circulatory problems and heart conditions. Thanks so much 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. They dont know they have it [It] leaks blood. 5 months ago was diagnosed with severe AR and 5 cm long aneurism (root 3.0 cm, sinusi valsave 4.3cm, ST 3.6cm, ascending aorta 3.6cm) on regular yearly checkout, with no syptoms. My exercise is limited to 30 minutes of moderate carido, with no weights. Miley Cyrus - Singer & Actress - Tachycardia. The tragic event's silver lining was that it caused Latifah, 46, and her mother, 67, to bond. Adam has been featured by the American Heart Association and Medical News Today. Those figures are funny to me because before I was doing three or four times more intense training beside my job (air force pilot). 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 would defer to Dr. Dietz since youve already contacted him. Down side: must take blood thinners to prevent blood clots from forming on mechanical valve. Last week, the CBS This Morning anchor announced via his co-anchors Gayle King and Norah ODonnell that he would be taking a break from the show to undergo heart surgery. The Ross procedure borrows your sons pulmonary valve and uses it to replace his aortic valve and aorta. Also, again, no stenosis or regurgitation, 35 mm ascending aorta. 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. And, if so, how did things go? I was diagnosed age 4 and am now 35. Thank you so much. 1. Lynn. Last i took him for the check up and everything is still the same but they said now the guidelines has changed and he is on the borderline of Mild to Moderate which will move him to restricted activities. Then, Arnold's pulmonary valve was switched to the aortic position. First, a disclaimer.My practice is devoted to adult patients. "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. Do we have a choice with him only being 15??? Its a lot harder in the UK to see your cardiologist so you cant get the answers quickly. BAV only has mild regurgitation. Context Bicuspid aortic valve is the most common congenital cardiac anomaly in the adult population. Since you have the ready info about your aortic sizes over time, I will guess that you have a doctor or cardiologist that you are working with. Normal biventricular size and function, no scar. I have been doing this for the last 5-6 years now and am hopeful it can continue. Mild degrees of aortic regurgitation are usually well-tolerated and do not produce symptoms. 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. Any person in my family there was no problem with the heart. The timing is my choice.. Many thanks. This gives a chance for the sternum, which was split during the operation, to heal completely. Thank you for the blog that addresses the athletes point of view, and feelings. 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. Ive yet to feel like Im back to my previous racing fitness that I once had. His whirlwind romance with Katherine Schwarzenegger has resulted in a rather large ring on her finger. I have also been advised that running intervals at over 80% max heart rate would not be sensible. All Rights Reserved. The more common form of bicuspid aortic valve occurs in a valve with three cusps with . 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. These differences of opinion may be legitimate. Often times, especially for patients with tissue heart valve replacement devices, the valve simply wears out. Your doctor will be in the best position to know all of the relevant information and offer sound advice. I have recently found out that I have aortic regurgitation will soon be needing surgery. Maybe thats not surprising, given that Im a heart surgeon and that many individuals with BAV need operation at some point. I am big for my age . We are trying to work out a way for her to continue to play. However, there are few reports about the safety and efficacy of TAVI in type 0 BAV. This almost seems like an off the shelf answer and Id therefore be really keen to find out your thoughts? Other heart parameters are very good (no bigger chamber or aorta). 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). "I had to make lifestyle and diet changes, she said. 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 42 year old male and have been a highly competitive distance runner since high school. I dont want to do any damage or compromise my homograft as the last surgery was a very difficult recovery. 4.2cm dilated aortic root The issues of when, how, what sports are safe, etc. Doctors at the Frankel Cardiovascular Center's Comprehensive Aortic Program have . Aaron Boone (@AaronBoone), famous baseball player suffered from Bicuspid Aortic Valve. Last echo measurements LDid 6.3cm z-score 2.4, LVIDs 4.1 cm z-score 2.0, LVPWd 1.2cm z-score 1.9, asc aorta Diam 4.0 cm z-score 5.8. In practice, the indications for aortic valve replacement for severe aortic stenosis or severe aortic regurgitation are straightforward and uncontroversial. I feel as though Im recovering well and, having no other conditions or comorbidities, rapidly. My cardiologist has advised that while marathon running is out, shorter runs (up to 6-8 miles) and pilates are both fine for now. I have question about your opinion about aortic valve regurgitation (no BAV) 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. ps. No pulmonary hypertension To much info to much detail so much information and advice. Hi Dr Creswell, Use or viewing of any Baldwin Publishing, Inc. article signifies your understanding and agreement to the disclaimer and acceptance of these terms of use. Tachcardaia beetwen echo due that doctor couldent see clearly. The procedure was performed at the Cleveland Clinic. I then played football my last two years of high school as well as playing hockey and throwing shot put for the track team. If Im trying to do 10 it will be harder to get those 2 up but it wasnt that hard before. Finally, many patients are able to return to their sports after successful operation. The rest of the aorta is normal (visualized to just above the bifurcation in the abdomen). Like you mention, one theory is related to the aortic blood flow. I currently run 40 -50km a week and do two 2 hour intensive yoga sessions a week. It functions as a one-way valve, opening and closing with each heartbeat, which keeps the blood flowing in the correct direction. 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. This is an area where second opinions may be helpful in sorting out whats safe. In your case, though, the infection might well influence the healing process. Perhaps other readers will comment. All aorta is normal, valvula normal funkcion only sinus valsava 35-37mm. There was only a 0.2 cm increase in the previous 7 years (so from age 21 to 28). I had my BAV replaced in Feb. 2005 (porcine tissue) with a Dacron repair of the ascending aorta. Mild/moderate regurgitation. , Bicuspid Aortic Valve Disease, Acquired Valve Disease. To me, you know your own body and what you can manage whilst straining as little as possible. I was wondering if you could give your opinion on my scenario. We see his pediatric cardiologist every 6 months. Hi Larry, thanks for doing this website, I wish there were more like it. I would like to know more about your recovery timeline since you are so much further out from surgery than I amfor instance; how long before you could do long rides again; when could you do tempo efforts; start high heart rate intervals; and finally race again?