Heart rate discussion - Leaky Heart Valve


I found the heart rate discussion very interesting on this weeks episode (188). I have a leaky heart valve. It is a bicuspid aortic valve. I was born with it, but wasn’t found until my early 30s. I had already done 2x London Marathons and 2x Olympic London Triathlons. It doesn’t seem to effect me in general, but my heart rate will not decrease as quickly as a normal heart once exercise is over.

I believe this will effect the recovery sections of a workout. My heart rate will come down around 20 beats quickly. but then only slowly decrease from there. It will go back up pretty quickly again once the next section of a workout starts.

When I do muscular endurance sessions I think my heart rate will be higher than it would normally be with a normal heart. Hopefully I am getting the benefit that Chad intends. I tend do Grand Fondo’s. I am not sure what effect having this condition has on my muscular endurance during those events as my heart rate could be higher than it really needs to be.

My resting heart rate according to my Apple Watch is around 56 beats a minute, but as soon as I stand up it will be in the mid 70s.

I’m lucky as day to day it has no effect in every day life. I only need a scan every 2 years to make sure all is still good. I’m told it will need replacing one day, but not yet. I will be hitting 50 next year and hopefully I won’t need it changing just yet :slight_smile:

I know this isn’t a question, but after listening to the podcast I thought I would share my experience.


If you don’t mind me asking, what caused you to discover that you had it? Were there other symptoms that you noticed that led to having it checked, or did it come up somehow else?
Thanks for sharing your experience.


Not the same exactly, but I have mitral valve prolapse, which while diagnosed a number of years ago, is now leaking (regurgitating) and is affecting the ejection fraction. I have always had a “high” heart rate, and at almost 51, my max HR is still over 200 (my last stress test was officially 197) and routinely ride at 180’ish on long rides. With a family history of heart issues, I have been monitored regularly most of my adult life, and the cardiologists are not concerned about HR and last time I asked 6 months ago, he said not to change anything. I am due however for another check i a few weeks.


@acavell That is a good question. I had a cough that I couldn’t get rid off. I finally went to the doctors and said I should have a chest x-ray. The results came back, nothing wrong with the lungs, but you have an enlarged heart. This was in the early days of the Internet so a quick search, death, death, SAS fit :smile: I was fit, but not SAS fit. I decided to wait for the doctors appointment and the above was the outcome.

Other things then began to make sense. After my 1997 marathon I decided to training smarter. I bought a book that explained how to train with heart rate. I tried it and it never worked. I couldn’t run and keep my heart rate in the zones. It was more a fast walk than even a job. It made no sense. It was very uncomfatable to run like that. Now I know why the heart rate would get higher than it should. My marathon time was 3h 22m so not bad, but I could never run to a heart rate zone.

I wonder if all my workouts are more VO2 than muscular endurance.


@ZeroGravity I hope the check up goes well.


In general, faster heart rates are better for regurgitant valves (assuming this is what you mean by leaky) - there is less time spent in the phase where regurgitation occurs i.e. diastole for aortic regurgitation, and systole for mitral regurgitation. The converse is true for stenosed valves, where slower heart rates are better, to allow blood flow though a tight valve. A slightly higher HR is a physiological adaptation to regurgitant valves - that said if your scans/Echo’s are fine and your cardiologist is happy then do not fret ! Best get your advice from a medical professional and not the internet


Thanks @jonathanwhiteside Interestingly my cardiologist said not to do weight training. Not sure why. I just do some light kettlebells.


heavy weight training potentially causes straining, which can potentially increase intrathoracic pressure (transiently) via a valsalva manouvre, which again, theoretically can increase regurgitation though the aortic valve (transiently) - this is theoretical and lacks robust data, as very few people have Echo’s during weight training ! Sometimes physiology is extrapolation :slight_smile: but, nevertheless I’d do the kettlebells, as it’s more useful for cycling than bench pressing your body weight


@jonathanwhiteside that is my plan. Much more fun anyway. :smile: In the long run I hope the exercise helps my heart.