Tiago's Guestbook

Hi Max and thank you for asking. I was 30 when the regurgitation was diagnosed. It’s unknown for how long and the precise reason it was there. The valve was structurally tricuspid but functionality bicuspid as 2 cuspids did get fibrosed together due to calcification. At the beginning was mild and for 7 year’s stayed like that. Then became moderate. At 46 the intervention cardiologist that is with me since the beginning spotted a small change on the regurgitation gradient but it wasn’t clear with the Echocardiogram if it was becoming severe. He thought so but wanted to confirm with a more complete observation and exams. Then I proceeded with a cardiac MRI and the results were clear in November 2023 for severe regurgitation and LV dilated. From there to surgery was a natural step. The situation evolution always depends on several specific factors that might differ from person to person. I had always had a very active life and I was about to start competing in triathlons when I was diagnosed for the first time. I had to abandon that idea because the level of effort optimization with heavy training was not good for the valve. It was obvious and peaceful to me that decision. The nature of the exercises is important to have in mind. Heavy lifting was out of question because of isometric. Dynamic exercises were always more defensive of the condition. So I kept running, hiking, indoor rowing, swimming and calisthenics. Always moderate and in non competitive objectives. Everything was very proportional considering rest/recovery/level of adequate effort for the valve condition. If I didn’t do it 5 or 6 days a week anymore no problem as the important was not stopping at all! The competitive background on sports and the structured training regimes that I had previously to the first diagnosis allowed me to adapt to the new reality and monitor the training effort. I will not say that was easy at the beginning but I managed to overcome that as I do not like to feel limitations. Of course it was very important and decisive the level of clean information and my doctor follow up. That allowed me to set up a yearly check up routine to monitor the evolution. This is the time to stress that every case is a case and despite the information that we share you should always take the lead supported by your doctor to decide the best approach for training, effort management and medical follow up. Sorry for the long reply but I know by my own experience that this is not an easy answer for patients to obtain. However here is my advice: Don’t be hard on yourself, be adaptive, be informed and work together with your doctor. There is always a solution!

Max, We all started young, I was 35 when my bicuspid presented itself during a physical. I lasted 28 years before the stenosis showed up. Each person has a different time line, but most all with a bicuspid valve eventually get stenosis. 18 months ago I had no stenosis then it went from none to severe in a short time.

My regurgitation was what showed up when I was 35, that was how i found out about my Bicuspid valve. Lived with it for 28 years and would still be living with it if it was not for the Stenosis. both of my Doctors said stenosis shows up in the 50 to 60 year old range.