Mild/Moderate regurg activity levels

[chrisgreen500]

Hi,

I was diagnosed 8 years ago with aortic regurg. It remains at a mild/moderate level, and may hopefully never require an op.

I was wondering what other people's experience of exercise at this level of regurg was. What advice did you receive?

I have been told not to exercise anaerobically, and after initially being allowed to run a half marathon, a different doc subsequently changed my advice.

Thanks in advance for any feedback.

All the best
Chris

PS: it may appear I'm new to this, but my old account has disappeared, so I've made a new one!

 

[Wise]

I'm in similar condition as you. I haven't been given any restrictions. One thing I have noticed that sometimes I get lightheaded if I do anaerobic exercise.

 

[PJmomrunner]

Hi Chris! Welcome back. I have mild/moderate BAV regurg as well as an ascending aortic aneurysm and I too have been given conflicting advice relative to activity levels. All have told me not to lift, push, pull over 20-30 pounds, but the cardiologists (four!) have said running is okay in moderation. (no marathon training-- ~3 or 4 miles 3X/week) The surgeon (in whom I put the most trust) however, says I am not to run or otherwise raise my heartrate out of the low hundreds. The surgeon makes this recommendation based not on the dysfunction of the valve, but rather because of the fragility of the aorta.

Personally, in your situation I would want to know the second doc's rationale. "if you run, you'll be fine the first 999 times and then your aorta will dissect" is a pretty compelling argument for me, as one with a 4.5cm aorta, to give up something I love (however grudgingly ). Absent the aneurysm, I'm not sure I could comply.

 

[MrP]

I was diagnosed at age 9 with a bicuspid aortic valve and was always very active in athletics growing up (football, baseball, basketball, skiing); however, I seemed to get out of breath more quickly than others when running distances. At age 49 an echo test showed regurgitation at 2 -3+ on a scale of 1-4, AND I learned I had an ascending aortic aneursym as well. About 5 years earlier I started doing some heavy weight lifting and am convinced this increased considerably my aortic dilation....weight lifting (such as curls) increases the pressure on the aortic wall. I've read there's quite alot of anecdotal evidence weight lifting can make the situation worse. Post surgery, my cardiologist recommended anaerobic exercise and light lifting, and my surgeon recommended moderate lifting but no curls or strenuous lifting.

 

[mntbiker]

I still mountain bike at least 3 days a week and most weeks 5 times. I have been told that I have severe regurg and an ascending aortic aneurysm of 4.8cm. BAV by the way. I have been given no restrictions. A different cardio told me I was at +3 regurg for the BAV and +2 for the mitral valve and no restrictions. The only doctor that has given me any restrictions thus far was my GP. I defer to the cardioligist.

I have been at moderate regurg since the early nineties again with no restrictions.

I do see limitations in my activity from a year ago, for example - I can no longer run and my rides are much shorter then they had been but I do push myself to the limit all the time with other activities. (trampolines are a blast )

Good luck.

 

[chrisgreen500]

Hi,

Thanks for your replies. It seems there has been a variety of advice. But then I guess no two persons conditions are exactly alike.

Having been sporty all my life, I am quite aware of the feedback my body gives me, and I know not to push it too much.

I find my limitations - which are not profound - frustrating, as I am sure you all do. Sometimes I just want to go and have an enormous blowout down the gym, but if I went too hard I'd be blown out in approx 3 minutes

On another subject, I'd be interested to know how you have all adapted to life in the waiting room. I clearly remember the day, when as a very fit 32year old (8 years ago), I was told the news that I would need a new valve in the next 10 years (they have adjusted this upwards since). I got dizzy and had to lie down for half an hour.

It took me a good year or two to get used to living with this, and I am fortunate in that it has no noticeable effect on my daily life as yet. Now it is just an everyday thing, and even the thought of the surgeons knife (or hopefully some microbiotic machine if I can hold out long enough) does not bother me. It is going to happen some time.

Regards
Chris

 

[mntbiker]

Hi Chris,
Apparently you are just a bit older then me. I have also been very active my entire life. Not into sports or weightlifing but I am an avid biker, was a trail runner for a while and I had also been a Jiu Jitsiu instructor for many years. I had always ignored my condition thinking I would never need anything done until about a year ago when I started feeling like crap all the time and saw a serious decrease in my stamina. I have not adjusted well being in the waiting room. I would prefer to just get it over with at this point. Of course other days I dream that they tell me it was a mistake and there is nothing wrong with me. I think P.J. is probably one of the active lifers that has adjusted to the changes better then others. I am still kicking and screaming and refuse to adjust my lifestyle. I am going out for a 12 mile MTB ride in the morning and am planning a solo backpacking trip in April and have signed up to do a 12 hour MTB race in May.
I hope you find your way of adjusting.

 

[MarkU]

I was diagnosed at age 9 with a bicuspid aortic valve and was always very active in athletics growing up (football, baseball, basketball, skiing); however, I seemed to get out of breath more quickly than others when running distances. At age 49 an echo test showed regurgitation at 2 -3+ on a scale of 1-4, AND I learned I had an ascending aortic aneursym as well. About 5 years earlier I started doing some heavy weight lifting and am convinced this increased considerably my aortic dilation....weight lifting (such as curls) increases the pressure on the aortic wall. I've read there's quite alot of anecdotal evidence weight lifting can make the situation worse. Post surgery, my cardiologist recommended anaerobic exercise and light lifting, and my surgeon recommended moderate lifting but no curls or strenuous lifting.

My story is similar: bicuspid valve diagnosed at 5, first catherization at 15, AVR at age 47.
I was not given any restrictions growing up and played football, wrestled, ran track, etc. I didn't do much long-distance running in my youth, primarily due to physique issues rather than cardiac reasons. I always did a lot of weightlifting, starting around age 13.
Exhibited no symptoms until age 47, when I had the onset of shortness of breath, chronic fatique, etc. due to calcification of my valve. During my surgery they found some left ventrcular hypertrophy, which fortunately reversed itself within a year post-op.
Since my AVR five years ago I still lift light weights, but now mostly do high-endurance aerobic training for triathons (with the blessing of my PCP and cardiologist). I wear a heart monitor (except when swimming) and do most of my training at 75% (zone 2) of my maximum HR. Everything's working out well so far - in the last two years my resting heart rate has dropped into the low 40's and my blood pressure was 120/80 last time it was checked.
Mark

 

[msiwik]

75% Maximum HR

75% Maximum HR

My story is similar: bicuspid valve diagnosed at 5, first catherization at 15, AVR at age 47.
I was not given any restrictions growing up and played football, wrestled, ran track, etc. I didn't do much long-distance running in my youth, primarily due to physique issues rather than cardiac reasons. I always did a lot of weightlifting, starting around age 13.
Exhibited no symptoms until age 47, when I had the onset of shortness of breath, chronic fatique, etc. due to calcification of my valve. During my surgery they found some left ventrcular hypertrophy, which fortunately reversed itself within a year post-op.
Since my AVR five years ago I still lift light weights, but now mostly do high-endurance aerobic training for triathons (with the blessing of my PCP and cardiologist). I wear a heart monitor (except when swimming) and do most of my training at 75% (zone 2) of my maximum HR. Everything's working out well so far - in the last two years my resting heart rate has dropped into the low 40's and my blood pressure was 120/80 last time it was checked.
Mark

This is an excellent thread! Mark U - I want to talk you at the Indy Half Marathon about the 75% MH rule of thumb. My physiologist wanted me to use that as well in my recovery (now almost 10 mos.) for a couple of reasons: (i) going slow in the recovery; and (ii) longetivity of my biological valve. It's been a long slow climb back - starting with 12:00 min. miles at 4 months to 9:40 miles now. I am patient with it but can see myself wanting to do one anerobic workout a week (80 to 90% MHR) next year as I work back toward pre-surgery competition form. Much to compare and learn from each other!

 

[msiwik]

Don't be a stranger Chris

Don't be a stranger Chris

Hi,

Thanks for your replies. It seems there has been a variety of advice. But then I guess no two persons conditions are exactly alike.

Having been sporty all my life, I am quite aware of the feedback my body gives me, and I know not to push it too much.

I find my limitations - which are not profound - frustrating, as I am sure you all do. Sometimes I just want to go and have an enormous blowout down the gym, but if I went too hard I'd be blown out in approx 3 minutes

On another subject, I'd be interested to know how you have all adapted to life in the waiting room. I clearly remember the day, when as a very fit 32year old (8 years ago), I was told the news that I would need a new valve in the next 10 years (they have adjusted this upwards since). I got dizzy and had to lie down for half an hour.

It took me a good year or two to get used to living with this, and I am fortunate in that it has no noticeable effect on my daily life as yet. Now it is just an everyday thing, and even the thought of the surgeons knife (or hopefully some microbiotic machine if I can hold out long enough) does not bother me. It is going to happen some time.

Regards
Chris

I have tremendous empathy for you and the others like Mtbiker and PJ... I literally went from a half marathon (where I finished very well) to the operating room. I will live through this next time around (as will other athletes here) because I opted for a biological valves to some degree thinking it might help me with competition etc. Hang in there and stay connected with the group and help us learn from your experience.

 

[Philip]

I was also given conflicting information at mild/moderate. I was told to keep my max heart rate below 120 but that I was not yet in the window of appropriateness for surgery. As a very active person this was not acceptable, either fix me NOW or let me play. Others told me that I was little more likely to have a cardiac event than the "normal" population and that I just would fatigue rapidly. After much complaining and several stress test later all involved that the latter was true. My only limitations now are no heavy lifting.
As my condition deteriorated and before I completely got over the denial phase I would push to the point of stop or fall from dizziness. It took me a while to realize that this was my body's way of telling me "this is not a good idea, slow down" After running injury free for many years at both distance and intensity because I listened to my body rather than being a slave to a schedule I don't know why it took so long for this to sink in. So thats my advice..listen to your body, it will tell you when to back off. (I have no other problems other than aortic insufficiency)
I have not adapted well to life in the waiting room; waiting sucks! can I say that? Read some of the self advocacy pep talks I received from many here under my post: "waiting *!+*%" It was great advice.
What style of karate do you practice? I am also a martial artist. (Taekwondo)
Philip

 

[PJmomrunner]

I thnk P.J. is probably one of the active lifers that has adjusted to the changes better then others

Wow! Really? Me, adjusted? I'd say "resigned" is more like it, or perhaps "defeated," maybe even "less maladjusted."

 

[mntbiker]

Wow! Really? Me, adjusted? I'd say "resigned" is more like it, or perhaps "defeated," maybe even "less maladjusted."

Perhaps I should have said resigned?

You just come across as so adjusted and accepting I thought you were a good example.

Sorry!

 

[chrisgreen500]

Blimey, there's a coincidence!!

Blimey, there's a coincidence!!

That makes three martial artists in this one thread alone!

I practice Wado Ryu karate, and I am taking my 3rd kyu on April 1st. Did Shotokan for a couple of years 20 years ago.

Recently sparred with the 2004 World Karate Federation openweight kumite champion. That was a lesson!

This raises another question. If I were to go artificial valve, I assume the warfarin regime would mean no contact. I would imagine most active people like me think "I'll take the biological so I can stay involved, and hope things improve before the second surgery".

Chris

 

[PJmomrunner]

You just come across as so adjusted and accepting I thought you were a good example.

I'll take that as a compliment. BTW, I'm starting a new work-out program with my kids. I'm going to take it real easy, but I'm going work-out again. It's not exactly running, but it's something!