Additional types of patients who should ask for a TAVR evaluation include: Bicuspid aortic valve patients who are experiencing symptoms. 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. 1. Normal pericardium, no pericardia effusion when I discussed this with my Dr. he reassured me that its not my heart causing it. The surgery was a full success, and the valve is closing really well now. 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. My son was also complaining of shortness of breath with stairs mild and feels tired more easily. Im a 33 yro female, diagnosed with BAV. My daughter has played two years of varsity basketball already. (bicuspid aortic valve), singer Bret Michaels (atrial septal defect), and even 'Survivor' contestant Whitney Duncan (ASD). Bicuspid aortic valve (BAV) and congenital aortic stenosis are two types of heart defects that may be present at birth. Questions about Bicuspid Aortic Valve!! 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. A normal aortic valve looks like the Mercedes logo, a circle broken up by three lines that meet in the middle. Individuals with BAV can develop progressive narrowing or obstruction of the valve, leaking of the valve, and . Want to get a head start on your Oscar predictions? 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. Hes gained 25 pds . The typical symptoms are fatigue or shortness of breath, particularly with exertion. Is a CT or MRI absolutely necessary for measuring the aortic diameter? thanks for sharing all this interesting info. 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. Periodic re-evaluation with echocardiogram and/or CT scanning is used for most patients in this circumstance. However, many people will develop complications from their BAV and may need surgery in their lifetimeeither to repair or replace the aortic valve, the thoracic aorta or both. 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. It also featured an extended chat with Schwarzenegger's old boss James Cameron, and, despite an attempt, not even the mighty Arnold could pry any Avatar 2 secrets loose. Something they suspect is also from birth but never previously picked up. Hi Larry I would think that, ordinarily, a homograft would heal up along a similar timeline to other types of valve/aortic root replacement. Abstract. Bicuspid aortic valves can accumulate calcium deposits more easily than tricuspid aortic valves. Would you recommend taking beta-blockers at this stage? There is recent interest and experience with aortic valve repairinstead of replacementfor patients with BAV. Depending upon the size of the prosthetic valve, there is so e built-in obstruction to blood flow that is e aggregated during exercise. Hannah Yona Fraint, M.D. It can also lead to aortic stenosis , and is more . Stress echo revealed hypercontractile with normal response in all LV segments, no LV cavitary dialiation. Apologies for my slow reply. Patients whove had aortic valve replacement and/or replacement of the aorta will require life-long monitoring by their doctor, with periodic echocardiogram and/or chest CT scanning. Business, Economics, and Finance. Finally some solid information about exercise and life post AVR, thank you very much for that. Many congenital heart defects cause few or no symptoms. While the defective valve may be easy to see, the defect also causes changes in the tissues of the aorta and the heart. I was just curious if there any way to know if my valve is affecting my times at all? Arnold Schwarzenegger was born with a bicuspid aortic valve, in which the aortic valve has only two leaflets, instead of the typical three. Tyler. 100 Black-Owned . The procedure was performed at the Cleveland Clinic. Ordinarily, race walking is considered to be in the same category of activity as long-distance running. 2. "I had been doing some work around the house working with a heavy ladder, he told PEOPLE of his activity in the days leading up to his heart attack. A lot of people have it, she told Access Hollywood in 2009. This is an area where second opinions may be helpful in sorting out whats safe. There is not much scientific evidence about what to expect. Also hypertension in both arms. I cant think like a nurse where hey is concerned. Bicuspid aortic valve: A bicuspid aortic valve only has two leaflets, increasing the risk of circulatory problems and heart conditions. Measurements of aortic diameter can be made with echocardiogram. However, my most recent scan in October revealed all Stenosis and LV thickening had gone completely (Doctor said this was a very positive result perhaps due to excercise and medication). Everyones symptoms are different but I felt compelled to share mine. I otherwise feel very healthy, other than (I think) normal slowing down that comes with age. Im really wondering at what point should I look into flying back to Thailand or Hong Kong to get re-checked. Miley Cyrus - Singer & Actress - Tachycardia. Current guidelines suggest no restrictions on activity for athletes with BAV who have no stenosis/regurgitation and who have a normal sized aorta. Last week I visited a doctor and here are the changes for the last year (before|after): My biggest concern is whether I will be able to return to my previous level of physical activity and level of fitness. March 15, 2023. After 5 years of amateur competitive rowing, I had no problems keeping up with my peers whilst training at lower intensities. He left it pretty vague. As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. Thank you so much for your explanations, Im 30 years old with BAV 2 instead of 3 leaflets since birth, doctors recommended me to have Echocardiography test each year and so. Hey has been physically active with restrictions of no contact sports, and no isometric exercise. Follow up for development of these functional lesions is indicated. (Have you heard of the studies by Dr. Im due to have an exercise tolerance test soon, but from my dealings so far Ive lost faith in the level of competence of my current cardiologist. I was diagnosed with BAV, with regurgitation, no stenosis, at age 63. Pathology. Moderately dilated aortic root (max 46mm), mild ascending aortic dilatation. They wont repair my aneurysm unless it was 55mm during surgery or 60mm before surgery. But neither of these procedures are durable for the long-term. Now Id like to know your opinion about physical performance, before and after. Perhaps a cardiac surgeon would be able to provide even more detailed information about things like various options for operation that might be applicable in your case as well as thoughts about when operation should be performed. Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. I am an amateur runner, I do not participate in competitions. This is such an interesting blog, I wish I had known of it sooner. I had an exercise tolerance test recently and they seemed happy with my results so fingers crossed thats a good indication I can carry on training hard! To list down the names of celebrities including entertainers, musicians, politicians, TV personalities, sports figures, etc. Im wondering if you can advise me. Its weird because sometimes when Im resting I can feel a little weird fluttering.. How are you? For patients with bioprosthetic valves after heart valve surgery, the valve itself is not usually affected by weight-lifting activities. 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. Hello Dr. Creswell, 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. I dont know anything about crossfit but I see his times are average on that page. Yesterday, for example, I spoke with a 71-year old patient who just had aortic valve replacement surgery due to this . Adam has been featured by the American Heart Association and Medical News Today. There are just so many causes of shortness of breath, lightheadedness, and chest pain.even besides the heart-related causes. They are located between the ventricles and their corresponding artery, and . My questions are: can my root dilation remain stable? I realize that appointment availability for medical specialistsin your case, the pediatric cardiologistcan be tight. I have some issues with a dull pain right below my left breast that seems to come more often with a poor dietbut just doesnt seem like it could me esophagus related? My cardiologist Said to not lift heavy weights. A bicuspid aortic valve (BAV) is an aortic valve that has only two leaflets instead of three. The more common form of bicuspid aortic valve occurs in a valve with three cusps with . I dont think theres a way to predict the future in this circumstance. Hello dear doctor. The reason I ask is my Cardiologist said it looked fine in the echo imaging, but (and correct me if Im wrong please) I got the impression from what you said in this article that a CT or MRI is necessary for aortic diameter measurement. 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. Youre right, though. Please help me . He also has minimal leakage at the valve aorta. Like you mention, one theory is related to the aortic blood flow. And, of course, aortic stenosis can affect ones native aortic valve or a prosthetic valve substitute. , Bicuspid Aortic Valve Disease, Acquired Valve Disease. Always best to heed the advice of your doctor(s) who will be in the best position to offer advice about safe forms of exercise. Ive been affected by heart disease practically my whole life, she said. Guidelines specifically for athletes come from the Proceedings of the 36th Bethesda Conference in 2005. First, a disclaimer.My practice is devoted to adult patients. Search for heart hospitals that specialize in heart valve treatment. (I am on a low dose beta blocker) Went through the process of antibiotic therapy and. Thanks very much. Bicuspid aortic valve is the most common congenital cardiovascular anomaly, occurring in 1-2% of the population. Mild aortic valve disease without symptoms may only require frequent health checkups. I didnt get it.". He has mild AS and AR and is otherwise asymptomatic. If 5% of them dissect, this means 313,914 people. Lack of breath? Benefits: no blood thinning (with attendant risks) needed. Hi, my name is Hector and I am 34 years old. 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. 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). I cant distinguish if its muscle pain or somewhere inside chest, its not sharp or dull, somewhere in between. Maybe thats not surprising, given that Im a heart surgeon and that many individuals with BAV need operation at some point. At my last evaluation, my aorta measured between 4.3-4.5 cm, depending on where the measurement was taken, and the regergitation was classified in the moderate range. 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. If labeling my fitness level I wouldnt use the term athlete, but I used to work out pretty vigorously 5 days a week until about 8 months ago (weights, medium endurance cardio, no longer distance running than 5 miles, interspersed with HIIT). Sadly, we dont have a crystal ball, though to know what the future holds for any particular individual. I would just like to share my experience of having a Aortic Valve replacement. In April of this year (2016), I discovered I had a BAV in the worst manner possible. Fast forward, he is now 13 and we went yesterday for his yearly. Related posts: About a year ago a pulmonologist discovered a grade 2/6 heart murmur during a workup for a sleep study. What does heavy weights mean? Although we still dont have very long term results tracked (15+ years), in the short term the results seem to be much superior to regular bentall de bono option (and its variations). Best to mention your participation in the marathon when you have the tests done. Almost half of BAV subjects develop different degrees of valvular dysfunction during their lifetime. Chris Pratt to Marry into the Kennedy Family. The doctor looked at the results and told me to limit physical activity (running), because it can lead to heart failure in future. This have affected my son psychologically since he loves playing soccer what should I do. Rose underwent the procedure last week, and said he would be going home to rest for a couple of weeks before returning in March. O'Donnell suffered a heart attack in 2012, and wrote about her experience on her blog. These techniques are most applicable to situations in which there is regurgitation, rather than stenosis, of the valve and when there is also enlargement of the aorta. I have: My son was just told he made the varsity basketball team as a freshman. Im 31 and 1 years ago i found im BAV with modrate AI. 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 current guidelines suggest that sports activities do not need to be restricted for patients with BAV who have no valve regurgitation/stenosis and who have no enlargement of the nearby aorta. Reply. Maybe a genewho knows. 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. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Dr. Larry Creswell on athletes and heart health. After an MRI, Ive been diagnosed with BAV and mild aortic coarctation. This is ridiculous. PS: I noticed that the option Notify me of follow-up comments by email doesnt seem to work. Interesting situation Sean Miller. I have a St. Judes Bovine valve now. That is to say, I did up until two months ago. I take bisoprolol (low dose) and my pressure is currently normal . It is believed that Schwarzenegger had a bicuspid aortic valve which led to a Ross Procedure operation performed in 1997. Did you run? Thank you sincerely for your time and information. We just dont know. I am 26 yera old , I have aortic aneurisem. Soccer is his only sport and his passion- he plays on his high school team and a travel team. Bethesda Conference reports), even though there is no certain link between sports and the aorta enlargement. Also suggested taking low dose of beta-blockers although I have been told the effectiveness has not been proven. 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 . We just saw the cardiologist in July and again same symptoms and no significant cardiac changes . What should I do ? Keep us posted! Not sure I have something specific to suggest for additional reading.and I dont know where to steer you about a knowledgeable trainer in the UK. 2020 Update: Arnold Gets An Aortic Valve Re-Replacement! I continued playing hockey routinely until I was in my late twenties. No thrombus, vegetation were noted I am 18 years old . I lifted weights for many years and spent almost all my life in physically demanding jobs. 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. But Ill check it as soon as possible. I have recently found out that I have aortic regurgitation will soon be needing surgery. They all underwent aortic valve replacement. I was shocked. When he was 7 we noticed his heart racing at age 11 his bicuspid aortic valve was diagnosed We have been told his valve is at the top of the normal size chart. 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. All Rights Reserved. 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. I currently lift reasonably heavy weights in the 8-12 rep range, including body weight excercises such as pull ups and push ups. The valve can gradually become harder to open or leakier . Also twice a week I try to do 40-minute workouts like planks, pushups and so on (with my bodyweight). Like I said, peoples experiences are all different. Rest pulse (70 bpm|50 bpm) O'Donell took the aspirin recommended for people who think they are suffering a heart attack just in case, but didnt call 911. My cardiologist tells me that I need to be monitored yearly and that I should exercise without limitation (for cardio) I have symptoms however that include chest pain and shortness of breath and palpitations. Flaps of tissue on the valve open and close with each heartbeat. since the last worsening ten years ago, the situation still stable and each year I went to the doctor to have the tests, they still tell me nothing has been changed since. Ive recently joined the gym to get fit an toned up but I cant get a clear answer from the cardiologist of what weights I cant actually do at the gym. However my Sinus of valsalva is dilated between 45-47mm (depending on the machine used). Could the changes in my LV be the result of the physiological, not the pathological change? triangle chokes, other blood chokes) could be putting pressure on my heart and cause my aorta diameter to increase? This can cause the valve to malfunction and prevent blood from flowing correctly from the . Will surgery mean I can do more or less training? I certainly know of athletes who return to all forms of endurance sport as well as weight-lifting after operations like yours. I see Im not alone. Thank you so much for your clear explanations. 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? that suffer from heart valve disease along with a link to the reference story about heart valve disease and their Twitter handle to tweet on and promote the Valve Disease Day. There are certainly individuals with BAV who never have trouble down the line. I am a cycling Masters racer (Cat 2) for last 25 years . Anyway, his aorta was growing at a rate of 2 mm per year (he was growing faster:).and they put him on 100 mg Losartan. My son is 16 years old and his story is very similar to many I read on your blog. I would really like to know if I can (or shouldnt) push myself as hard as I used to. Log in, September 26, 2013 By Larry Creswell, MD 155 Comments. 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. Thoracic aortic aneurysm, an abnormal bulge in the part of the aorta located in the . I had AVR 3 years and 4 months ago. A bicuspid aortic valve: Most people are born with an aortic valve that has three leaflets (a tricuspid aortic valve). An echocardiogram last June revealed a function BAV. I dont want to do any damage or compromise my homograft as the last surgery was a very difficult recovery. As a result, the valve doesn't function perfectly. 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. 2; Thanks for my previous response a few weeks ago. My son is 15 years old, he was born with BAV /aortic stenosis. Just a short info for whomever may read, I searched for Tims name and I found this page: My cardiologist has advised me to avoid high impact activities such as weight lifting and endurance training. Is strength training that involves only using ones own body weight ok with mild BAV issues, or is all strength training out? I think we would expect less enlargement over time with stopping strenuous exercise. The Jeopardy! Could you please give me an insight into what else could be causing these chronic episodes of shortness of breathe, lightheadedness and off-on chest pains. I think you understand the guidelines correctly. To help correct the regurgitation, the cusps of the patients valve leaflets can be tailored, with the valve leaflets left in place. If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. I am also in grey zone waiting for surgery. Surgery. John Fox, NFL coach, suffered from Aortic Valve Disease. It has served me well enabling me to live the vigorous, full, complete life you are all so familiar with. Sadly, no crystal ball is available. Like you point out, its always wise to be vigilant after surgery for things that might be amiss.and get checked out. I think its reasonable to think of things this way. Thanks for sharing your sons story with BAV. Many of us are not familiar with the many types and facets of the martial arts. The potential downside relates to durability. The doc says the big risk is due to the blood thinners. Its probably not possible to have too much information as you think about your situation. At this time, it is not known whether Arnold received the new valve using a surgical aortic . Congenital heart issues affect approximately 40,000 people born each year in the U.S. and are one of the most common types of birth defects. I cant lift over 40lbs and I cant continue my work as a tradesman as it requires lifting over the 40lb mark. She is afraid, I can understand that. He just turned 15 he is 511 203 lbs and has a heart of gold. Even if its one person I help. After a 6 month ramp up, will the Porcene valve take the stress of the 5 rep sets? Hi, Fantastic website, there is very little actual information on this on the web. We dont have a crystal ball, though. The valve may also become stiff due to calcium deposits on the leaflets over time. 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. That would include weightlifting. Im 32 years old and didnt expect at all that my aorta would dilate. My son is desperate to be able to play sports without any restrictions. Needless to say, the diagnosis was quite overwhelming. Great article! My primary question relates to sports. It doesnt help that I am a nurse. My exercise is limited to 30 minutes of moderate carido, with no weights. However, my surgeon told me that he could fit a tissue valve and so would not need to be on warfarin. How much exercise is too much for someone with a functional BAV? 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? Aortic stenosis, the narrowing of the aortic valve. Some people with bicuspid aortic valve will have symptoms in early childhood. To me, you know your own body and what you can manage whilst straining as little as possible. Robin Williams - Aortic Valve Replacement & Mitral Valve Repair. This almost seems like an off the shelf answer and Id therefore be really keen to find out your thoughts? my age is 20 right now Negative Stress Echocardiography I have also had a stress test, which showed no issues at all. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. There are certainly athletes whove returned to their sports after valve (and aorta) repair/replacement. 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.
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