The different opinions coming from different patients and doctors about how much exercise is appropriate for someone with BAV can be a little frustrating. There are various camps out there on this matter, and I will attempt to break it down here. Keep in mind that recommendations can vary depending on severity of regurgitation & stenosis, and the presence/ size of an associated thoracic aortic aneurysm. My current status is Bicuspid Aortic Valve with mild-severe regurgitation and 4.6cm ascending aortic aneurysm. Here we go:
1. Doctors and patients who see the potential of dissection and rupture, even though it might be a small risk. If there is a possibility, then why risk a catastrophic event with the stress of exercise? These opinions stem from the recommendations made at the 36th Bethesda Conference in 2005. Walking, bowling and golf are ok.
2. Doctors and patients who take a cautious yet more liberal approach. This is where I’ve been hanging out for the past few months. I continue my normal forms of exercise, yet I do not push myself. Keep BPM under 140, avoid the Valsalva Maneuver while exercising, and listen to your body.
3. Patients who say, “Screw what anyone else says, I’m doing what I want!” I seriously considered this for a while. Not the smartest move, but potentially liberating. Potentially liberating from life as well.
I just recently had a cool email correspondence with Dr. Larry Creswell, from a blog that I’ve been following called athletesheart.blogspot.com. His blog is exactly the resource that I need. He is a Cardiologist who cares enough about people like me to make his knowledge available to the public. He also responded to an email of mine in full detail. I asked Dr. Creswell about what he thought I should be doing in regards to exercise right now, and he definitely falls under category #1. His response was, and I quote:
“…You ask about my thoughts about exercise between now and 11/25. I’d be very cautious. Guidelines developed by an expert panel can be found online in the Proceedings of the 36th Bethesda Conference. Athletes with BAV and aortic diameter >4.5 cm should participate in only low-intensity sports (eg, golf, bowling). I know that’s not what you’d like to hear. On the brighter side, once you’ve recovered from operation you should be good to go. I’m aware of a bunch of young athletes who’ve returned to their sports after operations like yours. You might check out Ironheart Racing online; their founder, Dave Watkins, had your operation and is back at triathlon. Climbing El Capitan would be awesome.”
Dr. Creswell is right. That IS NOT what I wanted to hear, though it is important for me to hear these second opinions. His thoughts will definitely help me shape the next couple of months. Maybe I should scale back a bit. More yoga. Less climbing. Less hills while cycling. More patience.