Bi­cus­pid aor­tic valve has only two leaflets

Moose Jaw Times Herald - - MJ SCENCE -

I was di­ag­nosed with a bi­cus­pid aor­tic valve at age 54 (I’m now 62). I see a gen­eral car­di­ol­o­gist an­nu­ally for an echocar­dio­gram and an EKG, and have had one trans­esophageal echocar­dio­gram. How­ever, he has never or­dered a CT or MRI to thor­oughly check my aorta. I’ve read that BAV pa­tients may have a con­nec­tive tis­sue disor­der, re­sult­ing in aor­tic prob­lems (aneurysm, dis­sec­tion).

My as­cend­ing aorta is mildly di­lated, at 4 cm. Know­ing that the size can change rapidly and without warn­ing is a con­cern. Do you think I should in­sist on a CT or MRI? Other sug­ges­tions?

The aor­tic valve, which sep­a­rates the left ven­tri­cle from the aorta (the largest artery in the body), is sup­posed to have three leaflets. About 1 per­cent of peo­ple have only two leaflets, which is called a “bi­cus­pid aor­tic valve.” Some of the peo­ple with bi­cus­pid aor­tic valves also have risk for en­large­ment (di­la­tion) of the aorta. You are ab­so­lutely right that this di­la­tion can progress much more quickly than in peo­ple with three leaflets in their aor­tic valves.

An echocar­dio­gram is rec­om­mended for young peo­ple with BAV ev­ery one or two years. For peo­ple whose aorta di­lates to above 4 (right where you are now), the eval­u­a­tion may need to be more fre­quent if the aorta is en­larg­ing rapidly (in some peo­ple, it can di­late up to 0.9 mm per year).

I can’t an­swer the ques­tion about echocar­dio­gram ver­sus CT ver­sus MRI, as the ideal imag­ing study varies from per­son to per­son. In some peo­ple, the reg­u­lar echocar­dio­gram gives good vi­su­al­iza­tion; how­ever, some peo­ple need ad­vanced imag­ing, and I would gen­er­ally pre­fer MRI, as it has no ra­di­a­tion and doesn’t usu­ally need in­tra­venous con­trast for mea­sur­ing the aorta.

You also should talk to your doc­tor about screen­ing fam­ily mem­bers.

I’ve re­cently seen on the in­ter­net that some very pres­ti­gious med­i­cal schools have had good things to say about do­ing dif­fer­ent kinds of yoga. I was very sur­prised by the an­nounce­ments. Would you care to com­ment on the sub­ject?

I’m not sur­prised at all, as there are many po­ten­tial ben­e­fits to the mod­ern prac­tice of yoga, which sev­eral dif­fer­ent styles.

The ben­e­fits are both phys­i­cal and men­tal, and some prac­ti­tion­ers find spir­i­tual ben­e­fits as well. Yoga is an an­cient prac­tice, but it has been stud­ied re­cently by med­i­cal sci­ence. There is strong ev­i­dence to show that reg­u­lar yoga prac­tice im­proves car­dio­vas­cu­lar health, strength, flex­i­bil­ity and bal­ance.

There is fair ev­i­dence that yoga may re­duce stress lev­els and im­prove over­all qual­ity of life. There is some ev­i­dence that yoga may help with some spe­cific med­i­cal is­sues, in­clud­ing help­ing peo­ple quit smok­ing, re­duc­ing symp­toms of arthri­tis and re­duc­ing over­all pain.

Com­pared with many med­i­ca­tions, risks from yoga are small.

Mus­cu­loskele­tal in­juries are the most preva­lent type of in­jury, and these are more com­mon in men, pos­si­bly be­cause most men tend not to be as flex­i­ble as women and may overdo it, es­pe­cially as be­gin­ners. Any ex­er­cise has risks, and one re­cent study showed that about 10 per­cent of par­tic­i­pants in a sub­ur­ban yoga class in a year de­vel­oped pain (that’s sim­i­lar to other types of ex­er­cise pro­grams). An ex­pe­ri­enced yoga teacher can help re­duce in­jury. has

The book­let on rest­less leg syn­drome and night­time cramps of­fers more tips. Read­ers can ob­tain a copy by writ­ing: Dr. Roach Book No. 306 628 Vir­ginia Dr. Or­lando, FL 32803 En­close a check or money or­der (no cash) for $4.75 U.S./$6 Can. with the re­cip­i­ent’s printed name and ad­dress. Please al­low four weeks for de­liv­ery.

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