Bicuspid aorta valve

[wsgxf08]

I am 44 yrs old and have recently been through a heart test due to a flutter sensation from my heart, ecg,echocardiogram & treadmill etc.
The feedback from the clinic nurse was that the test went well but during the scan they found that I had a congenital bicuspid aorta valve which i will need to have scanned annually.
I have an appt with doctor tomorrow to go over the results, can someone advise the type of questions I should ask about my condition.
Also is there anything can be done to improve my condition ?
I work out 4 - 5 days per week, treadmill, punchbag and sit ups to help my general health is this ok to continue ?

[DavesMom]

Excellent advice from skydnsr - especially about getting a CT scan or an MRI.  

I also have a bicuspid valve and had aortic valve replacement/aneurysm repair in '99.  I've had yearly echos since then and none of them have ever showed a problem.  

I then learned that us BAVers are prone to more aneurysms so I asked my cardiologist to do a CT scan and guess what?  It picked up an ascending aortic aneurysm measuring 4.5 cm. My cardio says that's considered "moderate" and that surgery is usually recommended when the aneurysm reaches 5 cm.  However, I'm a pretty small person and may need repair earlier than that.

So I am VERY grateful that I asked for the CT - otherwise I would never have known about the aneurysm. In fact, I just had an MRI/MRA last Thursday to check on it, so I'm hoping it hasn't changed.

Best of luck!

[skydnsr]

Just saw your latest post.  Good luck on everything.  I have the same condition and had valve replacement surgery in 2004.  Post again or feel free to PM me if you have any more questions.

[wsgxf08]

Thanks for the feedback, I really apreciate it, I had my consultation with my doctor who confirmed that my heart & blood tests are fine, cholestorol is 4.9, she said that my congenital condition has been picked up during tests and is A symptomatic and i should continue to exercise and eat healthy, I should receive an appt to see my cardioligist over the next two weeks and he will be better positioned to advise me on my condition.

[skydnsr]

Oh, also ask about taking an ARB, which is a type of antihypertensive medication.  Blood pressure control is very important, and even if you do not have high blood pressure, there is some relatively new research coming out, suggesting that ARBs are good for people who have aortic aneurysms.  I don't know if there is any research suggesting that ARBs can prevent aneurysms if you don't have one, but if you need to take medication for high blood pressure anyway, maybe an ARB is the one you should take.  nickppatel on this site knows a lot about this.

[skydnsr]

There isn't any type of exercise you can do to rehab the valve itself, but staying in shape is just as good a thing to do with a BAV as without.

[skydnsr]

You should definitely ask the size of the aortic root and find out if it is larger than expected.  A very big root is considered an aneurysm, although it is hard to tell you an exact size criterion.  

If the scan you just had was an echocardiogram, then you should also expect to be referred for CT or MRI to visualize the entire length of the aorta, as people with BAV are at elevated risk for aneurysm all along the aorta.  A transthoracic echocardiogram can only "see" the aortic root and maybe part of the ascending aorta.  It takes a whole-trunk scan of some sort to see the whole aorta.

You can ask whether the valve is regurgitating (leaking backward) or stenotic (occluded) and how badly.  Regurgitation is rated as mild, moderate, moderate-severe, or severe.  Severe regurge or mod-severe with symptoms (which you have) indicates surgery is not far off.  Stenosis is rated by the size of the effective valve orifice, with an effective valve orifice of about 1 square cm or less indicating that surgery is not far off.  Occasionally, a bicuspid aortic valve will be both regurgitant and stenotic.  

In terms of exercise, usually heavy lifting or anything that induces a valsalva maneuver (google it) is out.  You can use light weights and go for reps, rather than trying to "max out." You should still be able to run and punch the bag.  Sit-ups, I don't know;  it might depend on your technique.  

See www.bicuspidfoundation.com for more detailed info.  

Good luck, and post back anytime.