Aortic Insufficiency and Levels of Excersise...What to do, Please Help????

[Oscar61]

Hi guys! Hope everyone is well. I took a break for a bit from the site. I was "winding my clock too tight" doing too much sitting in front of the PC investigating and driving myself crazy. so i took a break. but now i'm back .

Getting to my issue/question: I'm wondering what sort of advice ( or even better the sharing of info from what other ppl have been told by their cardios/surgeon) in direct regards to Aortic Insufficiency and the amount of torrerable excercise that one can do. First, I understand that it depends on the individual and their current conditon. as a refresher, my LVVED is at 5.4 and my cardio has suggested surgery at 6.0. Sounds worse than it is. i am asymptamatic.

The real issue that i'm having is that i have been told one thing by my main cardio and something "slightly" different from another. my main cardio told me to "go live my life" her qoute obviously. dont change anything. work out, run, etc. if i begin to experience problems, ie: chest pain, SOB (which she doesnt think that i would at this point because she is keeping a close eye on me - an echo every 3 months and i was just diagnosed 6 months ago) to just let them know and we'll take it from their.

the other cardio (who is part of the same practice) indicated that i am fine with doing all of the cardio i want, but to NOT lift weights. i dont remember his exact terminology but his reasoning was that cardio "raises one thing (cant remem. what that thing was) and lowers another, and that weight training raises both things which is bad for my condition. sounded like it made sense whatever it was. i apologize for the lack of exact info their.

In any event, wondering if any of you had some REAL advice that i could use. i've put back on about ten pound and soften up from concern of my conditon (contrary to what the docs have said and even though i feel fine) since this whole thing started 6 months ago and have been wanting to get back into both weights and running.

Any responses would be greatly appreciated,

J.

 

[Gemma]

Hi there Jay! Nice to see you back again .
Jim was also told not to lift any heavy weights (mind you, his LVEDD was 7.0 when first diagnosed so a fair bit bigger than yours - and he was getting symptomatic). But he wasn't given any other restrictions.
I think the thing with weights is that you shouldn't be lifting anything so heavy you have to hold your breath and your veins start bulging out the side of your neck - that's when ANYONE can do themselves injury, valve issue or not. It's something to do with a combination of increasing your blood pressure and the strain on your heart as it struggles to get enough power to your muscles to lift the weight. Whereas aerobic exercise (swimming, running, walking, cycling, etc) and lifting smaller weights and BREATHING as you lift, don't have that effect.
Plus of course, it's really not that attractive watching grown men turn purple and grunting in the corner of the gym just to prove they can lift 5 lbs more than their friends!!!

 

[Oscar61]

Hi again Gemma! Thanks for the reply. Seems like you might of answered the issue of the doctor telling me "this goes up and so does this when you work out with weights" question. I could always make the phone call but sometimes its better to see what other ppl are doing or have been told also.

where are the rest or your responses though?!? do we have a bunch of couch potatoes out there ??????

 

[bethanne]

My cardio gave clear instructions regarding exercise. Cardio okay, but no weights!! Sorry no explanation was given..

 

[Oscar61]

thanks for the input bethann! no other reponses to this? i thought this might actually be a hot topic?????

 

[fdegranville]

aortic insufficiency

aortic insufficiency

Hi Oscar,
I'm surprised your doc said surgery at LV 6.0. I've had 3+ AI (with LV @6.0)for a long, long time, combined with moderate mitral stenosis. I've never been told what measurement would prompt surgery, but I have read indications closer to 7.0. Not knowly all the details of your particular case, there may be other contributing factors.

As far as exercise, I've always been told, do what you can tolerate without too much effort.

~fdeg
ps. I see you are in New York, where are you treated?

 

[francie12]

Hi, Jay-- Nice to see you back! Matt (whose LV is 5.4 like yours, moderate aortic insufficiency) was also told no restrictions on excercise, except weight lifting. I just wanted to say, you should see him on the basketball court, running flat out for almost an hour, sweat streaming--no sob, no dizziness, no symptoms. It has done me a world of good to watch these games. All the best, Jane

 

[Bryan B]

Oscar,

I had moderate AI for 25 years before my surgery last March. I was never given any restrictions on activity, although given my physique my doctors probably didn't think they needed to warn me about weight lifting. Basically my body gave me it's own restrictions in the last few years before my surgery as my AI progressed from moderate to severe regurg.

 

[francie12]

I forgot to mention our cardio's explanation of why cardiovascular exercise is actually beneficial, at least at Matt's level of AI. He said that when the heart rate goes up the is pushed out of the LV more quickly, the isn't allowed to pool there, LV isn't dialated. He actually explained it more clearly than that--hope I got it close to right!

 

[Oscar61]

im back everyone!,

was out of town for a few days. jane, seems that matt is doing great....so glad to hear from you and to hear that he seems to be doing great also. also. fdegran, the 6.0 was given to me as a "guideline" where my cardiologist would begin to "suggest" surgery. thereby avoiding any real damage done, and at my age (30) letting the heart completely heal. she had mentioned the guidelines as set forth by the American Heart Ass. as to being 7.5 for surgery, but she seemed to think that her as well as "the majority" of other cards. out there would feel that surgery would be best advised before that much damage is done (whether asymptimatic or not). i'll be looking for other opinions as i get closer to that point.

i apprecaite the input that you guys have given so far. am still wondering what some other ppl out there might be thinking?? hope all is well with everyone.

J.

 

[Raverlaw]

Cardio raises your pulse, but results in lower blood pressure if you exercise regularly. Heavy weight lifting can raise your pulse (from the exertion) and also your blood pressure, at the same time, which is dangerous for an enlarged heart or an insufficient valve.

That's what I was told *after* surgery.

If I were you, I'd get on a good cardio program to tone up and drop the extra weight while you're waiting for surgery.

 

[Hansolo]

Oscar,

I think more directly related to your exercise question and what your cardiologist meant to say is that the normal BP response to endurance or cardio type exercise is that systolic (pressure when your heart contracts) increases with increasing intensity but your diastolic (pressure when your heart relaxes) remains basically at its resting pressure. In fact, an abnormal blood pressure response and reason to terminate a typical exercise stress test is evidence of increase in diastolic BP.

Most weightlifting type exercises increase not only the systolic but also the diastolic pressure (in this case normal). This is due to increasing peripheral vascular resistance from the relatively slow contraction and relatively greater recruitment of muscle fibers per muscle bed. Systolic BP has been measured in weight lifters during a lift as high as 600% of resting pressure. By comparison endurance exercise results in only ~130% increase in systolic BP over resting. If you have a regurgitant AV, blood flow is more compromised by greater diastolic pressure because when the LV should be filling with oxygenated blood during diastole it is in fact filling more quickly from the AV side making each beat very inefficient. Ejection fraction becomes extremely compromised decreasing stroke volume and increasing HR. This increases myocardial oxygen demand increasing risk of significant arrhythmia when the demand is not met. Another potential risk is that once you stop the lift (set) to rest, there can be a steep crash in systolic pressure because of the pooling of blood in the working muscle which can result in blackouts. Basically the heart has lost return blood flow because it is filling an endless pool with a leaking hose. To minimize this occurrence you should keep moving (legs and arms) following a set which will keep what is termed the muscle pump active and aid venous return to the heart.

Obviously there are techniques you can use with light/moderate weights to minimize the increase in both systolic and diastolic BP if you feel you must keep a weight training program. Probably the best way is by doing exercises that are more isolation oriented (one limb exercises) and not bearing down with the reps. This means you do not involve many muscle groups in the exercise which will have less impact on peripheral vascular resistance and thus less impact on diastolic pressure. Also you do not hold your breath which reduces inter-thoracic pressure (another factor in increasing peripheral vascular resistance). For example, single arm dumbbell curls in stead of barbell curls and single leg extensions and curls instead of both. Also, restrict limb exercises in a way that reduces postural muscle contractions such as the abdominal and back muscles. You can target the abs in different exercises; the point is to limit peripheral vascular resistance for any one lifting exercise.

This of course makes the lifting routine intolerably long if you think you are going to get through a full body routine. Reasonable goals must be set by understanding that in your condition. This goes for after valve surgery as well depending on your valve choice and outcome.

As you alluded to this has to be tempered by individual differences and circumstances.

I have not been overly impressed with most cardiologists with respect to exercise guidance and even less with surgeons. However, to their defense there are few well designed studies in valve patients.

Wish you the best... ;-)

 

[epstns]

I can only speak from my own, slightly different, perspective. I have moderate aortic stenosis, not insufficiency. I'm also a bit older (57 -- ugh!). My cardio said that I should continue my cardio routine, running (really jogging) my 20 miles/week as I have been doing for years. He then said that if I want to do weights I should limit the weight to 40 lbs., but that I can do as many reps as I can comfortably tolerate -- as long as I do not hold my breath.

At my age, I'm OK with this. I am no longer planning to gain bulk, in fact I just want to control it!