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Heart and Circulatory
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At 78 years old, I am in pretty good shape. A couple of years ago, an echocardiogram showed a small leak in my mitral valve. A year later, a follow-up test showed some leakage in my tricuspid valve. The valves aren’t causing me any problems right now, but how will I know if they need to be repaired? I like to exercise, but don’t want to make these valve problems worse. Is it okay for me to walk on a treadmill at a speed of 3 to 4 miles an hour and lift light weights?
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Q: At 78 years old, I am in pretty good shape. A couple of years ago, an echocardiogram showed a small leak in my mitral valve. A year later, a follow-up test showed some leakage in my tricuspid valve. The valves aren’t causing me any problems right now, but how will I know if they need to be repaired? I like to exercise, but don’t want to make these valve problems worse. Is it okay for me to walk on a treadmill at a speed of 3 to 4 miles an hour and lift light weights?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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February 01, 2012
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A:

A little bit of leakage is completely normal for 3 of the 4 heart valves — the mitral, tricuspid, and pulmonic valves. In fact, for the mitral and tricuspid valves, the backflow of blood happens well before the valve closes.

Modern echocardiography equipment is very sensitive. Almost everyone’s echocardiogram shows some leakage of the mitral and tricuspid valves. So, if you have a little mitral and tricuspid valve leakage, but your doctor says you don’t need to worry about it, exercise as normal.

In contrast, the aortic valve doesn’t normally leak — not even a little. It acts like a door between the heart and the main artery of the body (the aorta). Nature probably designed this valve to close early — before blood can rush back toward the heart — as a way to direct blood into the coronary arteries. These arteries, which nourish the heart muscle, branch of the aorta just beyond the aortic valve. If the valve closes early, more blood pressure is available to fill the needy coronary arteries.

Exercise may be a problem when some valve diseases get severe. That’s especially true for aortic valve disease. But for mild or “normal” valve leakiness, there is no reason to limit your exercise.

Your valves would need to be repaired if your valve leakage became severe enough to cause symptoms or the size or shape of your heart changes. Work closely with your doctor to determine the best time to do this.

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