Dr. Jon Gelber discusses UFC Heavyweight Stefan Struve's leaking aortic valve and enlarged heart diagnosis

Copyright Martin McNeil

Time to consult the experts!

When you're a mixed martial artist, you never want to hear about any issues with the heart. A bad ticker and unarmed combat are not a good combination.

That's what made UFC Heavyweight Stefan Struve's recent diagnosis of a leaking aortic valve and an enlarged heartso scary.

"The Skyscraper" is currently on hiatus while doctors wait to see how his body responds to medication and whether alternative and more risky options are needed.

In the meantime, I consulted with Dr. Jon Gelber, M.D. out of Mount Sinai in New York, who is slated to do a sports medicine fellowship at the Cleveland Clinic in 2014. Gleber also founded FightMedicine.net, a website which is entirely devoted to fighter safety, MMA injuries and training.

Gelber was recently a guest on The Verbal Submission where he discussed a variety of topics, none more important than everyone's favorite 7'0 MMA athlete. He got it started with a simple human anatomy lesson:

"The heart as we know pumps blood to the rest of the body. The way it connects to the rest of the body is through a long tube called the aorta. The aorta goes from the heart, up near the neck and all the way down basically to the legs and the blood goes out from there. That's the main conduit to the rest of the body."

Then it was time to get to the thick of it, Struve's leaking aortic valve, what it means exactly and what the implications are for his future fighting career and being the nice guy he is, he relayed it to us in layman's terms:

"There's a little valve between the heart and the aorta that's sort of a one-way valve. That way the blood gets pumped out and doesn't come back in. Well he was born with what is called a bicuspid valve which has two flaps and usually there's three. Now because he has this abnormal heart valve, it allows the blood to leak back in. This means every time his heart pumps blood, not all of it goes out, some of it leaks back in. They's why they called it a leaky valve.

What that means is as he is training or fighting and his heart is beating faster and faster, he's got to get oxygen to the rest of his body through the blood, he may not be getting all the oxygen he needs and that can actually affect his cardiovascular stamina, could affect his training, could affect his fighting career. Eventually the heart can enlarge, the valve can enlarge or even burst and you'll need a replacement. If he ends up with a replacement, that's really a career killer because you need to take anticoagulants which prevent you from clotting. You can imagine a guy can't go out there and fight because if he gets cut, they won't be able to stop the bleeding. Even Aspirin alone can cause some guys to bleed a lot in the Octagon so if he goes down that path, it's a career killer.

He may not have to go down there. If he has yearly follow-up, has a good doctor, has somebody listening to his heart and checking how much it pumps. You can check that by doing an echocardiogram, which is an actual imaging of the heart so they can follow it and if his heart starts to deteriorate, they'd have to pull the plug on him. As an athlete, they put more stress on his heart than you or I might so that's why it might deteriorate more quickly than a normal person's.

So it could be a career ending injury, but it could also be something they could control with medication and he'd be allowed to fight a few more years."


If that wasn't bad enough, the enlarged heart diagnosis appears to be a symptom of the leaking aortic valve. Gelber elaborates:

"The heart muscle can actually hypertrophy and get bigger. What happens is the muscles get so big that it blocks the blood from getting out so every time the chambers of the heart squeeze, they are blocking the blood from going out of that chamber because the muscle is just so bulky and gets in the way... It can actually get bigger in two ways. The heart can get bigger muscularly or it can get bigger in terms of the size of the chambers of the heart. They can actually expand. That's what can happen with Stefan Struve because the blood flows backwards so the heart has to widen to accommodate that and when it widens, it doesn't have the same strength to contract and push the blood back out."

Perhaps the best news out of all of this is that Struve has had the condition his entire career and has managed to go a respectable 26-6 overall with a 9-4 record inside the Octagon dating back to his debut with the promotion in 2009. If medication is able to treat his enlarged heart and get it back to a reasonable size after some extended periods of rest, we may see him fight again someday.

Let's just hope the nuclear option isn't required.

You can follow Dr. Jon Gelber on Twitter @FightMedicine.

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