In the majority of cases, bicuspid aortic valve imposes no restrictions on physical activity. However, if aortic stenosis, regurgitation, or dilation should develop, the patient's physician will need to set safe limits for exercise to be established through stress testing and careful monitoring with echocardiography, electrocardiography, and other means.
There are no restrictions for patients with mild stenosis and acceptably low blood pressure. If there are signs of left ventricular hypertrophy (thickening of the ventricle walls) or arrhythmia in conjunction with moderate stenosis, then the patient should be confined to moderate levels of isotonic exercise and should avoid isometric exercise. Severe stenosis precludes participation in athletics or intensive exercise because of the risk of fainting (syncope) or sudden death.
Those patients who have moderate stenosis should be carefully monitored as a progression to more severe stenosis, which could be dangerous in competitive sports, can be quite rapid.
If dilatation (enlargement) of the ascending aorta should occur, isometric exercise (load bearing or maintaining a specific posture without very much movement of the limbs) and contact sports should be avoided because of the danger of rupture of the aorta or aortic root. Activities that involve pressures on or impacts to the chest could be dangerous.
Anyone with congenital heart disease, repaired or non-repaired, should consult with their cardiologist about physical activity to review the risks.