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Training with Aortic Stenosis (Heart Condition)


#1

I have been lifting weights for 5 years or so. My cardiologist has told me to lift in the 10+ range and avoid power lifting and olympic lifting movements like deadlifts, clean + jerks, snatches, pretty much any pulling from the ground to prevent a spike in blood pressure.

I have been training with 5/3/1 for a bit using my 5rm as my percentage instead of the 1rm. I am tired of being ego driven and want to start taking my cardiologists advice. I lifted against his orders with 1rm attempts, 3rm attempts, and all that stuff the first 4 years or so. I have also trained bodybuilding style for awhile.

My question is, what type of program/routine should I put together to follow his advice of lifting in the 10+ range? Should I strictly stick with a bodybuilding split? If so, what is one that you guys recommend? I am not used to lifting in the 10+ rep range exclusively and would like some help constructing a program or bodybuilding split.

Thank you, I appreciate whoever reads this and helps out


#2

You would do well to reduce your intensity regardless of type of split. In fact, if you were my patient, I would tell you to avoid getting to the point of doing anything that remotely approaches a valsalva maneuver.

You don't say how old you are or why you have the AS, but your cardiologist probably told you that you'll eventually need a valve replacement, and that will have its own set of consequences; deciding what type of split to use will be the least of your worries. So moderate weights at most, and avoid getting to the point where you're straining on any lift. Remember that your heart is the most important muscle you've got.


#3

I think the studies usually have people use isolation exercises, to minimize the load on the heart. Supplying your whole body with blood during clean and presses is way harder than supplying your right delt during seated unilateral lateral raises.

I bet you could find some good ideas in here: http://tnation.T-Nation.com/free_online_forum/sports_body_training_performance_bodybuilding/do_this_routine_instead_of_that_dumb_one

Or even do holymacs 360 muscle.

And no steroids or smoking.


#4

Thanks for the reply. I am 24 years old and was born with aortic stenosis.


#5

Thank you for the reply. I am going to try out the split in the first post of that thread. I will use a 10+ rep range for each set though.


#6

Read this man:
http://www.fecna.com/wp-content/uploads/2011/08/Strength-and-Power-in-Sport-Koomi.pdf#page=410

Blood pressure response is not just related to the amount of weight used, but also heart rate, momentary effort and set duration. Blood pressure climbs throughout a set and will be highest at the end of a set when the most effort is exerted, especially if concentric failure occurs.

Sorry if that confuses the situation. I'd recommend isolation exercises and higher volume with lower intensity.


#7

Interesting study. I definitely have taken that in mind. I have decided to very reluctantly remove squats and deadlifts from my workouts. I just can't see where risking my heart doing them would turn out in a positive. I can just work around it.


#8

Also avoid nitro supplements.... And really the reason for avoiding the heavy lifting and valsalva maneuver is because you can blow every valve in your heart....that will lead to cardiomegally, and nonischemic cardiomyopathy, electrophysiology problems ..netting poor ejection fraction, chronic heart failure...

Basically weight training for you, the way you are doing it, you are circling the toilet. I recommend you stop weight training, band resistance might be safe, and take up a different hobby.


#9

None of this should be considered medical advice. Let's consider this as a totally hypothetical situation...

That being said, I'd be wary of taking advice from anyone over the internet about this unless they know the all details of your own particular situation. You've mentioned that you were "born with AS." That doesn't really give a reason why you have it. It could be because you were born with something called a bicuspid valve, or a unicuspid valve, or even something else. Sometimes valves are not only blocked, but leak at the same time too. You could also have other associated abnormalities with your heart as well, like an ASD or PFO (abnormal holes or pathways between chambers in your heart), kinks in your blood vessels, or even dilated major blood vessels which would also change your management. So, in going to random people on the internet, someone might give you advice about AS in general, but not knowing that you also have something else going on inside your heart too, inadvertently give you advice wouldn't be applicable to your own individual situation.

Regardless, if you were born with AS then chances are that you will eventually need a valve replacement at some point in the future. Your situation as it is now will change after this happens. If bodybuilding is something that is very important to you personally you need to let your doctor know about it. If you've been lifting against his orders you should let him know that, too. It might change his management of you, change the timing of surgery, or might make him order other controlled tests to see exactly how much you can exert yourself before you experience symptoms.

Again, none of this should be considered medical advice, and only your own doctor will know all your specifics, so only he can best guide you. Good luck!


#10


thanks for the reply. i was born with the bicuspid valve. my cardiologist says i can lift in the 10+ range..here's his full writeup if ur intersted


#11


...and page 2 of the report


#12

bump...any other thoughts??


#13

new bump?


#14

You were born with a bicuspid valve. This means instead of having three parts to your aortic valve you only had two. I don't know much about pediatrics, but when you were younger they did something called a balloon dilation, which is like it sounds, your valve was "blocked" and they put a balloon inside of the valve and inflated it, helping to open it up. This helps the stenosis, or blockage, but as a side effect of that you now also have aortic insufficiency, so your valve is now blocked (just a little bit, probably much less blocked than before the procedure) and yet also leaks at the same time. A certain degree of this is to be expected after such a procedure, and as per the letter it is only mild to moderate so it shouldn't affect you too much. The measurements he gives (velocities and gradients) are consistent with mild stenosis. The actual echocardiogram report would be helpful, it is also something you should keep for your own records in case you ever move and need to see another physician. Specifically, you might want to know the dimensions of your left ventricle at end diastole (the end of filling) because that gives you more information about the effects your aortic insufficiency have had on your heart, and changes the recommendation for exercise. Also, you would want to know the size of your aortic root. Given that you had a bicuspid valve this may be enlarged and, if so, changes the recommendation for exercise as well.

Your cardiologist will probably get an echocardiogram every year to monitor for any progression. You may or may not need a valve replacement at some point. That will change things. Good luck.


#15

so what type of training would be recommended? He said in the 10+ rep range


#16

It's worth noting that Arnold Schwarzenegger was also born with aortic stenosis, specifically with a bicuspid valve. This was the cause of his mother's death, and the reason for his heart surgery about ~14 years ago.

You might want to do a search on how he continued training after he first learned that news (which was when he was in his 30's). Obviously your physician's advice is to be taken very seriously, but there are many medical write-ups of the condition relating to exercise specifically because of Schwarzenegger's condition.

I'm not going to provide specific links, because I in no way want you or anyone else to think that I'm advocating any one view of how to handle this situation, but there is a lot of interesting information out there, directly relevant to this specific thread, that entirely arose from Arnold bringing attention to the situation -- including information that you might want to print out and run by your doctor.


#17

i am aware of this and have been digging for information for months and still cannot find anything about how his training changed


#18

bump. please. any ideas on a split in the 10+ rep range fitness model type stuff?


#19

Isolation exercises would be best for you. I'd avoid anything where you're holding your breath and straining very hard. So, balls to the wall heavy weight squats and deadlifts are off the table. I don't think that should kill your hopes for bodybuilding. You can still work on your "mild muscle connection" and do high reps to target those specific muscle groups. Just let your doctor know what you're doing and how you're progressing.


#20

thanks for the reply!

i talked to layne norton awhile back about doing the PHAT program but using a variation where it's 6x3 on the power days with only 60% of my max essentially doing speed work slowly building up. I'd use the customized version he made for me a couple yrs ago just modifying it like above.