Triathlon training intensity and Mitral regurgitation

[Armoca]

I am a male,54 years.Since 2000(after an active sports life) I have been training for triathlon (distances: 3800 mts swim, 180 Km bike and 42 km run ) and participated in 2001 and 2002 in Ironman competitions ( time : close to 12 hours:1 hour swim, 6 hours biking and close to 5 hours run).My training is 15-20 hours a week .
After an anual medical examination ( 2003 )I was diagnosed with a heart murmur and sent to a Cardiologist .I had a doppler color eco and I was found to have reumathoid valvular cardiopathy type mitral insufficiency mild to moderate (Regurgitation flow/Left atria =35 %).
Left ventricule : normal diameter ( vn-3,20 cm/m2)
Mitral valve:augmented density trough the borders, nomal amplitude. Papilar muscles  and ch.Tendin. normal.There is not systolic prolapse of the anterior and/or posterior valves-. Normal septum.Aorta/Pulmonar arthery/Right ventricule/Right atria : Normal
Intraventricular septum not augmented.
My doctor said that I can continue doing my training but AVOIDING HIGH STRESS  but he did not said what value would be a safe value (%HR maximun ) . My maximum HR is 178 after stress test.
My training is made at what is named Aerobic treshold ( 133 bpm:75% max HR )but some times i need to do some speed sessions at a higher heart rate(156-163 bpm :87-91 %max HR).
what should be my maximun training HR ? (and duration ?)Is any risk that my condition get worse if I continue with my training ?
Also, I have a broken teeth and got an apical absess treated with antibiotics.It could affect my condition ?
I appreciate your answers.Many thanks
Armoca

[rddablack]

A related discussion, Update - please was started.

[Nutty]

I know this may be a little off topic, but, do echocardiogram readings (visual observations) vary based on individual interpretation (say from one cardiologist versus another)?

I ask because I had an echo 4 years ago that said "borderline" LVH and current echo done by another cardiologist that noted "moderate to severe" LVH.  And yet the numbers on both were very similiar.

Tina Boyd

[Armoca]

Thanks a lot for your valuable info. How many times a year do I need to have a medical check in order to know  if my condition is mantained stable or it can be getting worse ?. Is it possible that  with lower weight, and exercising regularly my condition improve ?
Thanks again
Armoca

[CCF-M.D.-RCJ]

A tooth abscess should not affect your cardiac performance provided you don't suffer from the relatively rare occurence of endocarditis.

RCJ

[Armoca]

Sorry, I meant I had an absess at the root of the teeth.
Many thanks in advance
Armoca

[CCF-M.D.-RCJ]

Armoca,

Thanks for the post.

Q:"what should be my maximun training HR ? (and duration ?)"

This question cannot be answered "a priori".  One method of determining how much is too much would be to perform a symptom-limited stress echo.  If you push yourself to exhaustion, and immediately have an echo, then the effects of the exercise can be assessed by interrogation of the valve.

Q:"Is any risk that my condition get worse if I continue with my training ?"

Yes, although the risk would be small (and I can't define small).

Q:"I have a broken teeth and got an apical absess treated with antibiotics.It could affect my condition ?"

Apical abscess?  Do you mean in your heart?  If so, then the regurgitant valve could be from unrecognized infection.

Hope that helps.