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Enlarged Aortic root Second opinion
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Enlarged Aortic root Second opinion

Hi. My name is Kyle.  Im 6' 5" 200 lbs, healthy (besides a previous knee surgery), strong athletic 16 year old. During may of 2009, I was recieving a dull, heavy chest pain and pain when i twisted my torso clockwise and counterclockwise.  Also i was recieving pain when i extended my chest outward.  So i got looked at by a doctor and they did an EKG and an echocardiogram.  I don't know if the symptoms are accounted for by the diagnosis, but they said i had had a mild enlargement/inflation of the aortic root.  The diagnosis was weeks ago, and i am no longer recieving any of the previous symptoms from May.  So i talked with the doctor and she wasnt very knowledgable with sports when i as asking her questions.  she told me no more weightlifting, excersices such as leg squats, pushups and pullups, no jogging or running, and no sports like  football, basketball,soccer.  I only play volleyball now in high school and she said that was ok.  This really confused me because high school volleyball  is intense and it is a workout.  i dont play volleyball for relaxation, a play for fun and competition.  shes also said i could bike and walk.  The most confusing part is when i asked her if i could jump rope, she asked me how many times a day.  I said anywhere from 200-300 a day (which is nothing, 5 minutes at the very most if the jumps are continuous) and she looked at me like i was crazy.  she said thats to much and to only do  5 minutes a day.  they scheduled me for an MRI and another echo in a year, and a visit with a geneticist in 9 months. I dont know if she knew much about sports so thats why im asking this question here.  With my condition do you think i can play club/high school volleyball?  I am only planning on playing a year and most likely stopping at college.  If it is your opinion that i should, how do you recomend i should diet and what activites can i do?  Also, what activities can i do to mantain body stength and body tone without stressing the heart?  
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773637_tn?1327450515
Dear Kyle,

Obviously, without being able to evaluate you further and see your study results, I can’t be very specific in trying to help you.  I don’t know exactly how dilated your aortic root is.  As well, there are several reasons for aortic root dilation.  One of the more common is one of several genetic diagnoses, including Marfan syndrome as well as Ehlers-Danlos syndrome.  However, these tend to be associated with increased joint flexibility and some other physical features, which your primary doctor or your cardiologist should be able to evaluate.  Another common reason is bicuspid aortic valve, in which the aortic valve (the second valve on the left side of the heart) has 2 functioning leaflets, not the usual 3.  If you have this, the risk of aortic root dilation definitely goes up.  If you have a trileaflet aortic valve, mild dilation typically progresses slowly.

Since I can’t tell from your story, I can’t refute the exercise restrictions at this time, so I don’t know if they’re too restrictive, or not.  Typically, if the aortic root dilation is mild, I will still allow for aerobic exercise (walking, running, bicycling, swimming, etc.) as well as limited weightlifting, in which patients do low weights and a number of repetitions easily (i.e. 3 sets of 15-20 reps easily).  If you are concerned about the care you are receiving, you can certainly obtain another opinion.
4 Comments
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Avatar_m_tn
<<>>  the 3rd last sentence should be " if it is your opinion that i shouldn't play,.....".  Also when i say she wasnt very knowledgeable about sports i mean that i had to let her know about certain sports, strengthening drills, exercises and stretches.  she knew alot about the heart just not athletics.  also im a high school senior.
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Avatar_m_tn
I am not a doctor.

Without seeing the echo, it is difficult to help you.  From the information you have given, I would say that the doctor might suspect that you have Marfans which is a connective tissue disorder, hence the visit with the geneticist.  The genticsit will be able to determine if you have Marfans or not.
  The reason for the restriction of activities is that with Marfans, the connective tissues of the aorta are weaker than normal and can dilate(stretch) to the point where it might rupture.  Weightlifting can put a strain on the aorta and contact sports can injure the aorta if you get hit hard enough.

  If you have mild aortic dilation, you are a long time from this occurring.  How long, no one knows.  A second opinoin from another pediatric cardiologist might be in order, but perhaps calling the first one and clarfying  what she said might give you the answers to your questions.  There might have been some miscommunication, so it would be of a benefit to straighten it out.

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Avatar_m_tn
yea the doctor said that she was pretty sure i didn't have MARFANs but the visit with the geneticist was to completely rule it out.  The doctors english was not well enough for me to feel like she understood what i wanted to say, as well as what myself understanding what she was trying to convey. so i think i will call her back.
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