If you're considering beginning an exercise routine, good for you: Exercise, along with a healthy diet, is one of the best ways to stay healthy for life. However, if you have a "leaky" heart valve -- caused by any number of valvular heart diseases -- you should see your doctor before beginning any exercise routines. While exercise can be good for some valvular diseases, it can be bad for others; your doctor will be able to tell you which group you fall into, and make recommendations for an exercise routine.
About Leaky Valves
Blood going through your heart usually flows in one direction through four different chambers -- two atria and two ventricles. These chambers are separated from each other, and from the vessels that lead away from the heart -- the aorta and the pulmonary artery -- by valves. In order, these valves are the tricuspid, the pulmonic, the mitral, and the aortic. A "leaky" valve is one that as a result of disease or genetics does not prevent the backflow of blood as well as it should. In people with leaky valves, then, a certain proportion of blood will return to a chamber it has left, after being expelled into the subsequent chamber.
Consequences of Valvular Disease
The reason you should care about leaky heart valves is that this condition can lead to a number of serious sequellae. For example, according to Patrick O'Gara and Eugene Braunwald in "Harrison's Principles of Internal Medicine," aortic valve disease can lead to heart failure, arrythmias and cardiogenic shock, while mitral valve disease can lead to right-sided heart failure and pulmonary edema. In some cases, exercise can exacerbate valvular heart disease; in some cases, it can be beneficial.
Risks of Exercise
In her paper on exercise training in valvular heart disease, Christa Gohlke-Barwolf notes that there is not a lot of data discussing the risks of exercise in people with asymptomatic disease, and there is no data on exercise in people with symptomatic heart disease because these people aren't candidates for exercise programs. However, she also says that what data there is suggests that a case-by-case approach may be best: In patients with mitral stenosis, exercise may exacerbate symptoms, while in patients with mitral prolapse-- a different kind of mitral valve disease that can also cause "leakiness," exercise improved symptoms.
Benefits of Exercise
The American College of Sports Medicine, which maintains a series of handouts detailing what sorts of exercises are safe for people with various medical conditions, says that exercise may play an important role in therapy for someone with valvular heart disease. Exercise won't improve the valve, the ASCM says, but improved fitness will help you with some of the symptoms you may be experiencing as a result of your disease. Importantly, the ASCM echoes Gohlke-Barwolf's observation that the type of disease is probably an important determinant of whether or not you should exercise; the group maintains that people with aortic stenosis should avoid strength-training programs, a position more or less echoed by Gohlke-Barwolf.
General Consensus
In general, the consensus is that it's impossible to say, one way or the other, whether you should exercise with your leaky heart valve. It depends on what kind of disease you have and how severe it is. If you're hoping to begin an exercise regimen with valvular disease, you should see your doctor first to make sure it's safe for you to do so.
References
- American College of Sports Medicine: Exercising With Valvular Heart Disease
- "Harrison's Principles of Internal Medicine;" Anthony S. Fauci, Eugene Braunwald, Dennis L. Kasper, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, and Joseph Loscalzo (editors); 2008
- "Cardiovascular Prevention and Rehabilitation"; Exercise Training in Valvular Heart Disease; Christa Gohlke-Bärwolf; October; 2007
