This week was half-term, and I had fully intended to have a relaxing restful time with my family. Unfortunately however, first my daughter then myself came down with a nasty cold. I can’t even remember the last one I had, as very rarely do, and have never had to take a day of work for one (apart from covid!). In fairness, this one wasn’t too bad apart from two things – the night-time cough which makes it hard to sleep, followed by pretty extreme fatigue which makes it hard to do anything much at all. On the mend now just in time to get back to work tomorrow! It’s really curbed my exercise this week too which I absolutely hate, but it can be dangerous to work out when ill so I have been sensible.
I haven’t seen any patients this week, but I did see a particular patient story which caught my eye. Many people my age or older will likely recall the years when British sport was pretty awful. Before national lottery money and the London Olympics, poor funding meant only the truly gifted got anywhere near a podium at a major event. Off the top of my head, 1990s Olympic Gold medallists include for example Sally Gunnell, Linford Christie, Chris Boardman, Steve Redgrave and Matthew Pinsent, but I would be hard pressed to name any more (I will google them later though).
I vividly recall watching the 1996 Olympics 400m final, where Roger Black won an impressive Silver medal, but was beaten by nearly a whole second in what was an Olympic record time by the great Michael Johnson. Nearly 30 years later, this feat was made all the more impressive in my eyes when I read that he has a congenital heart condition, and one which required major surgery last week in Southampton. I regularly refer patients to the surgeon who did the operation, and know he was in great hands. Roger has been monitored there since the age of 11, with something called a bicuspid aortic valve. These valves affect about 2% of the population, and run in families. Guidelines recommend anyone with such a valve should let their first degree relatives know so that they can be checked out with a heart scan.
The reason for this recommendation is that bicuspid aortic valves are prone to more rapid wear and tear. This causes the valve itself to become narrowed more quickly, and also can affect the aortic root by enlarging it. The aortic root is the pipe adjacent to the heart delivering blood around the body. Patients get regular heart scans to identify the time when the valve has become so narrow that without surgery, problems will arise. Roger had an aortic valve and root replacement to guard against this possibility.
What is interesting in Roger Black’s case, is that he reported no symptoms at all, even at the point of needing the operation. Often patients get breathless, or have chest pains or dizziness. Counselling a patient about the need for a major operation when they feel well is often a little difficult, but it’s something we do in heart clinics all the time as we are well aware of the natural history of these conditions. The commonest of these is aortic stenosis, which is exactly when patients with a bicuspid aortic valve get, only 1 or 2 decades earlier (Roger is 58).
The other interesting thing, and something I personally find inspiring, is that clearly he did not let a chronic heart condition dictate what he could or could not do in his life. It would have been easy to not do the training. Many people I expect would have felt safer not participating in sport, particularly the intensive exercise he must have had to do to get to the Olympics. I can’t imagine the pain cave he had to live in to reach the heights he reached, all the while knowing his heart wasn’t 100%. I regularly consult with patients who (very understandably) are worried they may do more harm than good by exercising with a ‘heart condition’, but the reality is that is nearly all cases, the opposite is true. Of course this is not intended to be tailored medical advice, but please do take away the following message: we can do hard things with our hearts and our bodies. For anyone reading with a heart condition themselves, I hope you too found Roger’s story inspirational, and I’m sure like me you’ll wish him a speedy recovery.
In this week’s research video, I take a look at a recently published trial of using a salt substitution on the risk of stroke, please do check it out (and apologies for the hoarse voice and bags under my eyes, it’s not been a great week!).