I would like some more information on training a client that has a mitral valve heart condition. My client is a 43-year-old female who trains hard with me three days/week and cardio trains four days/week at a moderate to vigorous intensity. For over a year she has made progress in the right direction, but it seems as though she has reached a plateau and is becoming discouraged because she is not meeting her personal goals (lose about three to four pounds adipose tissue and maintain her lean body mass).
First, a little medical background assuming that her problem is mitral valve prolapse (MVP).
The mitral valve ensures that blood flows from the left atrium to the left ventricle and only in one direction. When the heart contracts, the two leaves of the mitral valve close to prevent back flow into the atrium.
The "prolapse" means that the valve does not close tightly. The result is a slight click a heart murmur and a small amount of blood may regurgitate back into the atrium.
MVP is not progressive and is typically benign. Some people with MVP never display any symptoms at all. MVP affects far more women than men and is fairly common. You might be surprised to find how many of your female clients have it.
People with symptoms may experience, as you implied, fatigue, weakness and reduced endurance. Other symptoms we should be aware of include:
- Heart palpitations
- Chest pain
- Cold sweats
- Cold hands and feet
- Numbness or tingling in the fingers or toes
- Migraine headaches
- Dizziness, balance problems, vertigo
- Shortness of breath
- Panic attacks
Her doctor will tell her if she has the personal medical history or family history to cause her to limit her level of exercise. Fortunately, the vast majority of people with MVP will be cleared to participate in vigorous exercise with no complications whatsoever.
In some cases, however, MVP can result in serious arrhythmia or even sudden death. Therefore, any client diagnosed with MVP must also have their risk level assessed by a licensed medical professional.
Make sure that your client has had a thorough work-up with her physician/cardiologist before increasing her workload significantly. With the okay from her physician, you can treat her just like any other client. In most cases, there is no limitation in what she'll be allowed to do.
(Frankly, I'm a little confused. You mention that her training with you is"hard" and the cardio she does on her own is "moderate to vigorous," yet you say that her mitral valve condition limits her exercise capacity.)