I came across an informative article about sudden cardiac death (SCD) in the online edition of the Halifax Evening Courier. The article focuses on the recent death of Boyzone singer Stephen Gately, but the content relates to the risk of SCD in young athletes as well. The article points to the need for careful screening examinations for cardiovascular disease and this fits in well with my previous post, “Who Needs a Doctor?”
The aortic valve is the valve that lets blood flow out of the heart, from the left ventricle (the heart’s main pumping chamber) into the aorta (the large blood vessel that carries blood to the rest of the body). Ordinarily, this valve has 3 leaflets that are arranged to produce a pattern much like the Mercedes Benz emblem, if you look at the valve from above. With each heartbeat, the leaflets open nearly completely, allowing for unobstructed blood flow out of the heart.
There are 2 main problems that happen with heart valves….the valve can leak or it can become obstructed. Today, we’re going to focus on narrowing of the aortic valve, that produces obstruction to blood flow, and this is a condition that we call aortic stenosis. We’ll leave the leaking valves to another day.
There are several causes of aortic stenosis, but, by far, the most common cause is age-related calcific degeneration of the valve. That is, over years and years, calcium deposits build up in the valve leaflets, making them immobile. The leaflets eventually become so stiff that they do not open properly….and produce obstruction to blood flow exiting the heart. Aortic stenosis is usually a problem for patients who are in their 60’s, 70’s, or even older. Because the problem develops gradually over many years, patients sometimes don’t notice the effects, but the 3 primary symptoms are: 1) shortness of breath with exertion; 2) chest pain; and 3) syncope (blacking out).
Patients come to medical attention because of one or more of the hallmark symptoms or occasionally because a physician hears a heart murmur. There is a characteristic sound, or murmur, associated with aortic stenosis and your physician can hear this murmur in a very particular location on the chest—just to the right of the sternum, above the level of the nipples. An echocardiogram (ultrasound) is used to make detailed pictures of the heart valves and can be used to quantify the degree of stenosis, or obstruction, as mild, moderate, severe, or critical.
Aortic stenosis is a serious medical problem. Patients with severe or critical aortic stenosis require valve replacement. There is no other treatment (ie, medicines) that can correct the problem. For patients with breathing difficulties because of their aortic stenosis, the average life-expectancy is less than 2 years without valve replacement. Major heart surgery is needed to replace the valve with a mechanical (eg, carbon fiber and metal) or tissue (eg, the aortic valve “borrowed” from a pig) valve.
But like I mentioned above, aortic stenosis can sometimes be encountered in a much younger patient….sometimes as young as in the 20’s. And this is often due to a congenital abnormality of the aortic valve in which there are only 2—and not the standard 3—leaflets. This occurs in 1-2% of the general population. For some reason, this arrangement predisposes the individual to earlier calcification and stenosis of the valve as well as leaking of the valve. This is relevant to the athlete because problems are likely to develop during the very active portion of a typical athlete’s active lifetime.
The second important consideration in patients with bicuspid aortic valve is that they are much more likely to develop enlargement (aneurysm) of the beginning portion of the aorta, as it leaves the heart. Over time, the aorta can enlarge from its typical diameter of less than 3 cm to 5 cm or more, the aorta and the aortic valve should be replaced….again, with major heart surgery
Losing weight seems like such a simple thing, but in fact it is hard for many people. With well known diets on the market such as The South Beach Diet and Atkins’ Program, many have jumped on the low carbohydrate bandwagon. But what about athletes that need protein and carbohydrates to sustain energy? These types of diets do not address their needs. While they both advocate adequate protein, the carbohydrate levels are too low for anyone in sports activities or bodybuilding.
Athletes use carbohydrates for energy just before an event or competition. Also they need adequate amounts of protein because it helps to repair damaged muscle. A diet for athletes must meet these requirements. One such diet is The Mediterranean Diet. This diet advocates the use of grains, dairy and fats such as olive oil. Olive oil is good for your heart and also lowers cholesterol; Italians eat olive oil on their bread instead of butter or margarine. People living in the Mediterranean have eaten this way all their lives and are very healthy.
The diet is named after the area where it originated and is associated with good health and a long life. The dietary lifestyle of Italy and Greece has shown consistent low mortality rates for the past 25 years. The basics of the diet include whole grains, fruits and vegetables, poultry, eggs, and fish, nuts and seeds, cheese and yogurt, olive oil and a limited amount of red meat.
The diet focuses on healthy fats, whole grains, fruits and vegetables and protein. Complex carbohydrates break down slower in the digestive system and keep energy levels sustained. This makes the diet perfect for runners and triathletes. And although athletes normally limit the consumption of alcohol, one glass of wine a day is allowed.
An example of the daily menu:
Breakfast: Coffee, Oatmeal and whole wheat toast
Lunch: Pasta e Fagioli (pasta with navy beans), salad and piece of fruit
Dinner: Fish with vegetables and fruit for dessert
Some of the benefits of the Mediterranean Diet:
Lowered incidences of heart disease and lowered cholesterol. Studies done in Europe have shown this type of diet to reduce metabolic syndrome which is a precursor to Type 2 Diabetes. Also lower obesity rates, heart disease, cancer and high blood pressure. It is believed that this type of diet also promotes longevity and increases life expectancy.
The Mediterranean Diet is healthy, well balanced and perfect for anyone who wants to lose weight. This diet is approved by doctors and The American Medical Association.
About the Author
Valery Fortie is the Awareness Coordinator of the Mediterraneanbook.com organization. She is also the editor of the blog behind it. She focus her efforts to provide scientifically driven news on healthy Mediterranean Diet eating and drinking to prevent high blood pressure. Mediterraneanbook.com is a non commercial website created to preserve the Italian healthy eating traditions. Founded in 2004 in Italy, Mediterraneanbook.com feels very strongly about having informed consumers on duty in all healthy eating fields.
One of our readers wanted to share a useful website about the Mediterranean diet.
We know that our diet is particularly important to cardiovascular health and the Mediterranean-style diet has many admirable features. In fact, many of my cardiology colleagues now recommend a Mediterranean diet for their patients with heart disease.
Our reader has also offered to guest-author a piece with recommendations on how athletes can adopt this type of diet. I’m looking forward to sharing this information with you.