Need a little advice.....

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photogman

I had my 2 year checkup with my new cardiologist (old one moved to California and opened up practice there) a month or so ago. Usual echocardiogram to check bicuspid stenotic aortic valve. He said he felt I was 10 or less years away from replacement. Anyway, I have been reading on the internet about weightlifting with a bicuspid valve/aortic stenois as I have lifted heavy my whole adult life and later teenage years. I'm 50 years young now and up until 4 months ago, I was still bench pressing slightly over 300#. Anyway, I call my cardio's nurse this morning and have her ask him if I should scale my weighting way back to an appreciate level with the valve and everything. She called me back and she said the dr. said to forget weightlifting entirely. I really want to do what is medically prudent and won't cause any damage to my valve (doming, etc.) and myself (sudden fatal cardiac event). I feel like my body will just atrophy away like the witch on the wizard of oz when dorothy threw the bucket of water on her. I'm not playing dr. here just wondering if I can maintain it and at a sensible level....like a 100# or so with high repititions instead of low reps heavy weight. I was wondering if any of you can lend any advice and jump in here? Thanks
 
Same here....

Same here....

According to my cardio I'll need AVR in the very near future. I'm 44 and started back lifting weights regularly almost 9 years ago. I made good progress and was in the best shape of my life. About a year ago I was told to only lift light weights (less than 100 lbs.). Then three months ago the cardio said no lifting at all. The doc said lifting puts too much strain on an already bad valve. I guess it makes sense, but it is very frustrating. Now when I go to the gym I can only walk on the treadmill or ride the stationary bike.
 
It's unfortunate, but weight lifting puts tremendous stress on a heart that has to pump its entire output through a tiny hole. Your brain and muscles scream for extra oxygen and nutrients during lifting, but the pipelines are constricted at the valve. It puts you at risk for your heart to go arrhythmic from the stress, a potentially fatal problem while under that kind of load. And if you have any coronary blockage at all, you are at an even higher risk.

As you know, you can't tell whether you have any coronary blockage without someone actually looking, such as through a catheter angiogram or an MRA. Stress echoes (AKA stress tests, exercise stress tests, etc.), particularly for someone with AS, are highly unreliable in predicting coronary blockages. Not that thet're so accurate for people without AS, either. Former President Clinton had it done by some of the best in the nation at Columbia in NY, and was declared fit. Three weeks later he was in the hospital for chest pains due to clogged coronary arteries that required intervention. And he's far from alone in that result.

I'm not a medical professional or an exercise maven, but I might think a good scenario would be to start right now by greatly lowering the weight (to below 50lbs., e.g. going to hand weights) and working in shorter sessions to avoid stressing your heart. This is assuming you have no aortic aneurism tendencies, which would simply mean no lifting whatsoever, starting yesterday.

Basically, if the weight or the machine resistance is enough to make you grunt, you need to go still lighter. Absolutely, you must practice breathing through any lifting, including in regular life situations, and always avoiding holding your breath when pushing with your muscles. This is something you probably already practice, but rates mentioning.

The goal would be to rapidly and continuously work to scale down all lifting as your heart needs you to, while you set your body up to be able to deal with the worsening valve constriction. Because you are weight training, your body weight may well be somewhat higher than someone else your size. Even though you're fit, that does mean extra work for the heart. So, you probably want to reduce your overall bulk. If you can manage to lower your weight, you can avoid having that muscle go to fat on you in the meantime by reducing some bulk as you go along.

You will want to come to a complete stop by the time your valve opening reaches, say, 1.5 cm² or less, or if your left ventricle begins to approach the top of the normal size limit.

You might also consider moving to yoga or other stretching/movement-related body training to increase your limberness, although you will need to avoid the more rigorous or aerobic aspects of the training. Limberness may help with sternum recovery, and possibly reduce body pains, such as costochondritis attacks during recovery, and may allow you to longer maintain your base muscle tone.

You will likely be able to pick up moderate lifting and unrestricted aerobic body disciplines again later, after your heart and sternum are healed. Disappointing, I'm sure. But as you point out, the value of lifting would be lost on a corpse.

Just my thoughts. There are others who will probably come along here here who are very weight-training literate.

Best wishes,
 
Consider more "cardiovascular" types of exercise... With your doctor's approval of course.


I did very well for the time I was taking kung-fu. Mind you it was non-contact stuff, I never got the the level of sparring anyways and dropped it due to time limitations, not body limits.

In cardiac rehab they focus a lot on cardio exercise for obvious reasons, there's some VERY minimal weights involved but it's mostly for regaining range of motion/strength, not neccesarily building muscle tone. I did a lot of stationary rowing cycling, and treadmilling which I enjoyed a lot and miss.


Non-contact sports, maybe endurance stuff like running, team sports... it would be best to discuss it wiht yoru cardiologist.

You've been doing a lot of weight training over several years and have a certain amount of body mass that is muscle. Stopping all physical activity outright would do almost as much damage as continuing to push your damaged heart valves by lifting. I'm sure there is some compromise that would at least help to maintain some of your muscle mass while making life on your heart easier.
 
tobagotwo said:
It's unfortunate, but weight lifting puts tremendous stress on a heart that has to pump its entire output through a tiny hole. Your brain and muscles scream for extra oxygen and nutrients during lifting, but the pipelines are constricted at the valve. It puts you at risk for your heart to go arrhythmic from the stress, a potentially fatal problem while under that kind of load. And if you have any coronary blockage at all, you are at an even higher risk.

As you know, you can't tell whether you have any coronary blockage without someone actually looking, such as through a catheter angiogram or an MRA. Stress echoes (AKA stress tests, exercise stress tests, etc.), particularly for someone with AS, are highly unreliable in predicting coronary blockages. Not that thet're so accurate for people without AS, either. Former President Clinton had it done by some of the best in the nation at Columbia in NY, and was declared fit. Three weeks later he was in the hospital for chest pains due to clogged coronary arteries that required intervention. And he's far from alone in that result.

I'm not a medical professional or an exercise maven, but I might think a good scenario would be to start right now by greatly lowering the weight (to below 50lbs., e.g. going to hand weights) and working in shorter sessions to avoid stressing your heart. This is assuming you have no aortic aneurism tendencies, which would simply mean no lifting whatsoever, starting yesterday.

Basically, if the weight or the machine resistance is enough to make you grunt, you need to go still lighter. Absolutely, you must practice breathing through any lifting, including in regular life situations, and always avoiding holding your breath when pushing with your muscles. This is something you probably already practice, but rates mentioning.

The goal would be to rapidly and continuously work to scale down all lifting as your heart needs you to, while you set your body up to be able to deal with the worsening valve constriction. Because you are weight training, your body weight may well be somewhat higher than someone else your size. Even though you're fit, that does mean extra work for the heart. So, you probably want to reduce your overall bulk. If you can manage to lower your weight, you can avoid having that muscle go to fat on you in the meantime by reducing some bulk as you go along.

You will want to come to a complete stop by the time your valve opening reaches, say, 1.5 cm² or less, or if your left ventricle begins to approach the top of the normal size limit.

You might also consider moving to yoga or other stretching/movement-related body training to increase your limberness, although you will need to avoid the more rigorous or aerobic aspects of the training. Limberness may help with sternum recovery, and possibly reduce body pains, such as costochondritis attacks during recovery, and may allow you to longer maintain your base muscle tone.

You will likely be able to pick up moderate lifting and unrestricted aerobic body disciplines again later, after your heart and sternum are healed. Disappointing, I'm sure. But as you point out, the value of lifting would be lost on a corpse.

Just my thoughts. There are others who will probably come along here here who are very weight-training literate.

Best wishes,

This is a terrific discussion thread. I hit the wall at the six-seventh month recovery mark this month after making steady progress with the cardiovascular. Being the diligent scientist, I have concluded that it was reincorporating weights and that coupled with my aerobic caused me to plateau a bit. Good to luck to those awaiting surgery or having to step back. With my decision to go with a biological replacement, it's a journey that I will someday take as well. Happy New Year.
 
Hey! I was a competitive powerlifter for 20 years. I always knew I had a "heart problem" from birth, but imaging not being as sophisticated then as it is today;it was called an aotic insufficiency. When I was 36 a visit to the cardio revealed the bicuspid valve. My doctor initially told me no reistrictions until I explained to him what I did. He told me weight restrictions for valves were 50lbs and I laughed considering I curled 45 in each hand! Well, he told me as long as I never held my breath or did the valsalva maneuver during lifting, he felt comfortable scaling my weight back as I saw fit.
The reality: for lifters who are really strong,no one can give you an answer. Vanity is not a good reason to die or hasten a major surgery. I quit powerlifting and took up cycling and the (yuck) running. I still lifted. Honestly, I looked better with the addition of other exercises and I felt better too. Cycling (especially the hills) reminders me of the power necessary for squatting,so I really enjoy it.
Since surgery my weight lifting is fairly sad and I miss it more than I can tell you;but I will continue to work my way up to a much lower weight than I have done in the past and be happy I can still wrap my hands around that iron bar. We are uncharted territory,so let's live to make a map!
Laura
 
Weightlifting (heavy) at best will not help your valve condition and at worst could hasten your surgery or weaken your aortic wall. Its all to do with the sudden rise in blood pressure, the pump.

If you do not limit entitrly, I would suggest at a minimum scaling down drastically, more circuit training.

Another thing to keep an eye on is your ascending aorta as aneurysms are associated with bicuspid valves which i would be more concerned about with the heavy weightlifting.

When i first went to my cardio, i was surpised how many valve replacements he did on weightlifters, he said he would have advised me to not lift had I been diagnosed earlier. At that point, irrelevent, surgery in a month, dont lift a thing.

tobagotwo had a good point about focusing on limberness prior to surgery.
 
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