Lifting with a Bicuspid Aortic Valve (BAV) Lifting with a Bicuspid Aortic Valve (BAV)

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Thread: Lifting with a Bicuspid Aortic Valve (BAV)

  1. #1
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    May 2016
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    Default Lifting with a Bicuspid Aortic Valve (BAV)

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    Hi Rip,

    I am a 20 year old male who started Starting Strength in January and have gained about 20 pounds of muscle since. I have gone from looking like I came from a concentration camp at 120 pounds to a reasonably healthy looking 140 pounds (5'8). However, I was recently diagnosed with a Bicuspid Aortic Valve, a disease in which the aorta only has two flaps instead of three like a normal person. This means I am at risk for aortic dissection which is potentially fatal.

    I went to see a geneticist regarding this condition and she said I couldn't do any lifting at all and that it was "very dangerous" to lift weights. The only thing she said I can do is dumb cardio things like swimming that would really only cause me to lose weight. Needless to say I am very disappointed. I really, really enjoyed lifting and I was totally committed to working out three days a week, and only missed 3 workouts since January. The worst part about this advice is that it means this is literally the best shape my body will be for the rest of my life and the most I'll ever weight unless I get fat.

    What is your advice or understanding regarding BAV? I know that Arnold Schwarzenegger has a BAV and he obviously hasn't died after 50+ years of weight lifting, so I don't understand why I can't lift anything. I feel as though this geneticist just told me not to lift anything because she didn't know any better. I am still going to see another doctor who is supposed to be a world expert cardiologist regarding BAV, and hopefully he can give me a more definitive answer.

  2. #2
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    We'll ask the board.

  3. #3
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    One would assume that cardio exercises would be more strenuous to the cardiac muscle, but again, I'm no doctor.

  4. #4
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    I am not a doctor, and don't claim to have the medical expertise required to give reliable advice...

    But two data points.

    Arnold Schwarzenegger had a bicuspid valve, and clearly it didn't stop him, so n=1 evidence there... though he later had it replaced with a tissue transplant in 1997 once his bodybuilding career was over.
    On the other hand, Jon Pall Sigmarsson, the famous strongman and deadlifter, died mid-deadlift when his aorta ruptured from the strain. He was known to have some heart issues running in his family.

  5. #5
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    Quote Originally Posted by grumble View Post
    I am not a doctor, and don't claim to have the medical expertise required to give reliable advice...

    But two data points.

    Arnold Schwarzenegger had a bicuspid valve, and clearly it didn't stop him, so n=1 evidence there... though he later had it replaced with a tissue transplant in 1997 once his bodybuilding career was over.
    On the other hand, Jon Pall Sigmarsson, the famous strongman and deadlifter, died mid-deadlift when his aorta ruptured from the strain. He was known to have some heart issues running in his family.
    On the third hand, John Ritter collapsed on set doing apparently no weight lifting at all.

    I did a quick amatuer pubned search and came up with some hand-wringing cases, but nothing that actually detailed a statistical causal (or even correlated) analysis.

    ObDisclaimer: IANAD.

  6. #6
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    May 2016
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    Quote Originally Posted by grumble View Post

    On the other hand, Jon Pall Sigmarsson, the famous strongman and deadlifter, died mid-deadlift when his aorta ruptured from the strain. He was known to have some heart issues running in his family.
    I looked him up on Wikipedia and it's not clear he actually has the same heart condition I do. I didn't see anything pertaining to Bicuspid Aortic Valve being a cause of his death.

    Just a quick update, the geneticist confirmed that so far I can lift up to 50 pounds. This makes me feel slightly better. My empty barbell is only 45 pounds, so at least I can get under that again. Does anyone know of a good program that involves a high amount of reps? So far I'm just lifting the empty bar with 3 sets of 15 or so reps. Better than nothing I guess.

  7. #7
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    Looks like we may be on our own here. Have your doctor explain why 55 pounds will kill you.

  8. #8
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    OP, you may find the following articles enlightening:

    Article 1

    Article 2

    Very little is discussed about weight training in particular, but I found the following passages interesting:

    A marked increase in aortic root size is recognized in elite strength-trained athletes, in all segments (the annulus, sinuses of Valsalva, supra-aortic ridge and ascending aorta), and is most evident when the duration of the training is taken into account.

    The transient hypertension due to increased heart rate and cardiac output has been well documented in strength training and is exaggerated during the Valsalva manoeuvre. The blood pressure and cardiac output response during weightlifting can explain an increase in aortic root diameter through a structural reorganization of the aortic wall and consequent morphologic alteration of the aortic root. Aortic regurgitation represents the result of increased aortic root diameter when aortic valve cusps are unable to expand in area, and the degree of cusp overlap is reduced.
    From the results obtained in the large group investigated, sport activity does not play any additional role in cardiac morphology and function of trained BAV athletes. Further studies will be necessary to investigate the possible protective role of regular sport participation in this population. A large cohort of subjects, from different types of sports, will be necessary to verify possible differences among the diverse sports practised.
    Both articles were inconclusive, but the condition is serious enough that, if it was me, I would ask my doctor to explain exactly how weight training affects the condition differently than cardio (or would find a doctor who could give me an answer). Best of luck.

  9. #9
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    Oct 2014
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    This topic is of interest to me, as I too have a Bicuspid Aortic Valve. I don't have high blood pressure or Marfan's Syndrome. In searching the site, I found this thread on the topic: Lifting with a BAV (Biscupid Aortic Valve...)

  10. #10
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    starting strength nutrition camp
    I asked a doctor with whom I work about this. She said heavy lifting shouldn't be a problem as long as an ECHO shows no impairment in valve function.

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