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Heart Disease  (Expert Forum)
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Aeortic Valve Insufficiency and Exercise
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Aeortic Valve Insufficiency and Exercise

by dave, Nov 18, 1999 12:00AM
I am 56 year old male 6'4" tall, weight is 245lbs. I was diagnosed as having aortic insufficiency 7 1/2 years ago with an echograph. At that time I was told that it was not a problem. Due to my profession I take a physical every 6 mo. None of the doctors said anything about it until 1 1/2 years, at that time I was requested to do another Echograph again I was told no problem but we should look at it again in 1 year, which was 6 months ago. This time we did another Echograph the results came back that my heart had increased in size and the regurgitation had increased. The cardiologist ordered an angiogram which revealed no blockage and the regurgitation was not as bad as the echo indicated. The cardiologist recommended based on the Echo that I get an aortic Valve Replacement. I was not comfortable with this decision and went to another cardiologist for second opinion.
The second cardiologist did a TEE which revealed a bicuspid aortic valve with moderate regurgitation and my heart size within limits. Up until 6 months ago I had been exercising 3 times a week on a tread mill keeping my heart rate between 130 and 140 for 45 minutes. During the last 6 months I have not done any strenuous exercise other than walking 2 or 3 miles a week. I just did another TEE yesterday which indicated that my heart size and regurgitation had decreased. My blood pressure is 130/80 and pulse rate 65.
My question is how acurate is the Echograph? Could the technician not have done it correctly? Should an aortic valve replacement be ordered only on the bases of an echograph? Could I have been execising too much to cause the heart to enlarge? I have been told that exercise would not cause the heart to enlarge, if this is true what would cause my heart to get smaller other than lack of exercise? Do you have any suggestions on how to avoid having an aortic replacement?
Thanks for your help
Dave

by CCF CARDIO MD JMF, Nov 18, 1999 12:00AM
Dear Dave,

The natural history of a bicuspid aortic valve such as yours is that they will leak and need to be replaced before they cause permanent damage to your heart.

It is important to follow serial echos to assess your heart function and size.  At the first signs of a decline in heart function, serious consideration should be given to having the valve replaced.

As far as echos, they are subject to day to day variation and may have slightly different results.  Exercise will not cause this change, however, if you had more or less to drink it may have caused a decrease in the leak.

If you require a second opinion, i would highly recommend Drs. Hammer and Lytle at CCF.
Member Comments (2)

by CCF CARDIO MD JMF, Nov 18, 1999 12:00AM
Dear Dave,

The natural history of a bicuspid aortic valve such as yours is that they will leak and need to be replaced before they cause permanent damage to your heart.

It is important to follow serial echos to assess your heart function and size.  At the first signs of a decline in heart function, serious consideration should be given to having the valve replaced.

As far as echos, they are subject to day to day variation and may have slightly different results.  Exercise will not cause this change, however, if you had more or less to drink it may have caused a decrease in the leak.

If you require a second opinion, i would highly recommend Drs. Hammer and Lytle at CCF.
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