Congenital Heart Defect

[rageshrub]

I have a client with a congenital heart defect. He is decently overweight and looking to shape up. The defect is in his aortic wall, which is apparently weakened from what I can gather. His cardiologist recommended he not lift anything over 20kg.

I was wondering if you had any experience in this area or could point me in the right direction of any resources. I understand this is a pretty heavy question. Is it possible to construct any sort of real strength training program or is this guy doomed to a life of cardio?

Any relevant questions to ask the cardiologist would also be really helpful.

Thanks

[Mark Rippetoe]

I'm not in this age group, sorry. Perhaps we'll get a comment.

[Dastardly]

Can someone point out to me by which mechanism lifting a weight greater that 20kg puts a dangerous stress on the aortic wall that is worse that doing some traditional "cardio" which gets heart beating strongly and rapidly?

[rao00010]

Sounds like it might be cystic medial necrosis. Not a lot of data in this area, but I would worry a lot about lifting heavy weights and the potential for increased afterload from the Valsalva leading to aortic rupture.

Sunil

[rageshrub]

Can someone point out to me by which mechanism lifting a weight greater that 20kg puts a dangerous stress on the aortic wall that is worse that doing some traditional "cardio" which gets heart beating strongly and rapidly?

I can see how traditional cardio can put stress on the heart. I can also believe, however, that lifting heavy weights can put a lot more stress on the system and have much higher peak pressures. Hard data escapes me at this moment as I don't have time to dig any up, but I can imagine maximal training would not be particularly safe.

Sounds like it might be cystic medial necrosis. Not a lot of data in this area, but I would worry a lot about lifting heavy weights and the potential for increased afterload from the Valsalva leading to aortic rupture.

Sunil

My first thought would be to avoid using the valsalva maneuver. I am more curious to see if it is safe to lift light to moderate weights, quite possibly using the "classic" breathing pattern of exhaling during exertion. Although I guess that makes it a tradeoff between back safety and not exploding

[tnumrych]

Sounds like it might be cystic medial necrosis. Not a lot of data in this area, but I would worry a lot about lifting heavy weights and the potential for increased afterload from the Valsalva leading to aortic rupture.

Sunil

Does he have a colostomy bag as well cause taking a shit will certainly put him at similar risk. And coughing. And pushing his car when it breaks down. And a litany of other human activities that he may have to perform in the course of being, well, human.

[mstrofbass]

Can someone point out to me by which mechanism lifting a weight greater that 20kg puts a dangerous stress on the aortic wall that is worse that doing some traditional "cardio" which gets heart beating strongly and rapidly?

Have you ever lifted anything heavy?

[tertius]

Does he have a colostomy bag as well cause taking a shit will certainly put him at similar risk. And coughing. And pushing his car when it breaks down. And a litany of other human activities that he may have to perform in the course of being, well, human.

I confess to having the same thought, but INAD. So. My thoughts on the issue are kind of moot.

[Ello]

If you could get us a diagnosis it would go a long way to helping.

[rao00010]

Does he have a colostomy bag as well cause taking a shit will certainly put him at similar risk. And coughing. And pushing his car when it breaks down. And a litany of other human activities that he may have to perform in the course of being, well, human.

That's dumb. The valsalva is more intense when you're squatting 315 lbs. than when you are taking a shit...unless you swallowed a bucket of cement. And yes - we would tell that person to avoid pushing their car. Patients with cystic medial necrosis (or any disease where the integrity of the aortic wall is in question like Marfan's, Ehlers-Danlos, etc) have a high risk of sudden death from aortic rupture.

This isn't a situation where the person in question needs to "man up" and just start lifting heavy. There are real risks here so caution is warranted.

Sunil