Question from C. Hermann from Reichenbach: I am 52 years old and have been doing endurance sports regularly since I was twelve. Until 1998, my training focussed on running (marathons and middle distances). I then shifted my training to short triathlons and cycling, as strains and aches and pains in my musculoskeletal system became more frequent. A thyroid problem was recently clarified and treated with hormones. As a left heart strain was diagnosed during a routine X-ray examination, an ECG followed. This revealed minimal mitral valve insufficiency. Can I still continue to do endurance sports to the extent described?
Answer from Dr Eifler: The heart has four valves that determine the direction of the blood flow. Between the atria and the ventricles are the so-called leaflet valves, which direct the blood flow into the ventricles: the tricuspid valve on the right and the mitral valve affected in your case on the left. The blood flow from the ventricles - on the right into the pulmonary circulation, on the left into the systemic circulation - is channelled by so-called pocket valves (pulmonary and aortic valves). In the case of valve defects, a distinction is made between narrowing (stenosis), which demands increased ventricular pressure from the heart muscles or provides a reduced inflow volume, and - as in your case - incomplete closure (insufficiency). This results in the blood flowing back into the ventricles in both directions or during the cardiac pause (diastole), which leads to an increased volume load.
Pressure-accentuated valve defects (stenoses) are less favourable for exercise capacity than volume-accentuated defects, which include the mitral regurgitation you have. Mild forms are often accompanied by normal exercise capacity. The severity is often not related to the observable changes; symptoms are often only slight shortness of breath during heavy exertion. Mitral regurgitation is often combined with stenosis. Initial changes can also be recognised on X-rays. There are no objections to cycling in the sense of non-competitive cycling, as long as this is done under the supervision of a sports physician and cardiologist.
