Triathlete doesn’t let heart defect slow him down

This article appeared in the Detroit Free Press in April 2011. Jonathan Hiipakka, the subject of the article, is a client of Trismarter, and is coached by Lee Gardner.

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Triathlete doesn’t let heart defect slow him down

By JEFF SEIDEL

Detroit Free Press

HEART SURGERY AND ATHLETE

Jonathan Hiipakka has not let two open heart surgeries deter him from training for a marathon and triathlons. Here he poses as he swims laps in Beverly Hills, Michigan, on April 27, 2011. (Eric Seals/Detroit Free Press/MCT)

DETROIT – Jonathan Hiipakka has a congenital heart defect, but he could be the poster child for living life to the fullest, despite his problems.

Hiipakka, who has had two open-heart surgeries, not only runs, he swims, bikes and has competed in eight triathlons.

Congenital heart defects – structural problems that can show up in the interior walls of the heart, the valves inside the heart or the arteries and veins – are the most common type of birth defect, affecting 1 out of every 125 newborns, according to the National Heart, Lung and Blood Institute. Each year, more than 35,000 babies in the United States are born with congenital heart defects.

Sixty years ago, some severe defects were a death sentence. Now, surgical advances allow many people to live full lives.

“Most diagnoses of structural heart disease are made within the first year of life,” said Dr. Michael Gaies, assistant fellowship director for research at the University of Michigan Congenital Heart Center and the Pediatric Cardiothoracic Intensive Care Unit at C.S. Mott Children’s Hospital in Ann Arbor.

There have been several recent advances in treating congenital heart defects, including different types of preoperative care, new surgical techniques and monitoring devices, and using less invasive techniques such as catheterization.

HEART SURGERY AND ATHLETE

Jonathan Hiipakka on the bike.

Even though doctors have become much better at finding structural heart problems in infants, some aren’t found. In those cases, the problem typically doesn’t show up until a young athlete has a catastrophic event and dies unexpectedly.

Gaies said some heart problems are “virtually undetectable. Our job as a community of cardiologists is to come up with the best screening techniques to identify people at risk.”

While more people are treated as infants, not every congenital heart patient will recover and end up competing in triathlons.

“We have this conversation with families all the time,” Gaies said. “There is a limit right now in terms of what certain patients can do some day simply because of the complexity and nature of their disease.”

But that can change in the future as doctors find better ways to treat specific problems.

“As we get better at our job, we are going to see generations of people who had structural heart problems doing things that we wouldn’t have thought possible 20 years ago,” Gaies said.

Which is exactly what Hiipakka is doing with his life.

Less severe problems are often discovered because of a heart murmur. That’s how it started with Hiipakka. A doctor discovered Hiipakka’s murmur during a routine sports physical in 1984 when Hiipakka was 13.

“I remember them telling my father to keep an eye on it, but they didn’t think it would be an issue until I was in my 40s or 50s,” Hiipakka said.

The heart murmur didn’t seem to have any effect on Hiipakka as a teenager. He played football and wrestled at a high school in Chicago.

In his mid-20s, Hiipakka developed edema.

“I was waking up with my head totally swollen,” he said.

HEART SURGERY AND ATHLETE

Jonathan Hiipakka running

Doctors eventually diagnosed a congenital heart defect. He had a defect in his aortic valve, which lies between the left ventricle and the aorta. The valve usually has three flaps, but only one was working.

“The other two flaps were calcified and stuck together,” Hiipakka said.

Hiipakka had his first open-heart surgery at age 27 at the University of Michigan in 1998, when a surgeon replaced his faulty valve with a pig valve. His replacement valve was supposed to last 10-15 years, but it wore out in eight. He returned to the University of Michigan and had another surgery to get a new valve.

“I don’t feel any different at all,” Hiipakka said. “The only difference is I have the scar.”

Doctors aren’t sure what causes most congenital heart defects.

“There are over 1 million people out there with congenital heart disease,” said Dr. Timothy Cotts, the director of the Adult Congenital Heart Program at the University of Michigan. “There are some people out there who are very functional and there are other people who have much more severe disease and aren’t able to do very much.”

Cotts stressed that patients with a congenital heart defect should consult with a cardiologist about their activity level. Individuals have different limitations.

Hiipakka started competing in triathlons and “half Ironmans” – triathlons that are half the distance of the famous Ironman in Hawaii – three years ago. Cotts, 39, is also a triathlete. The doctor has competed in 20-25 triathlons, and he’s impressed that Hiipakka can compete at such “a high level. His goal time is 41⁄2 hours. He’s out there, being pretty competitive.”

Hiipakka is a naturally strong runner, but he has worked to make himself a good swimmer and bicyclist. He trains twice a day, about 15 hours a week.

Cotts said Hiipakka is a tremendous example of how some patients can overcome a heart defect.

“A half Ironman is a huge commitment as far as training,” Cotts said. “I think it’s a greater effort to do a half Ironman than it is to do a marathon, personally.”

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SIGNS AND SYMPTOMS

Many congenital heart defects have few or no signs or symptoms. These signs can appear if severe defects are present:

– Rapid breathing.
– Cyanosis – a bluish tint to the skin, lips and fingernails.
– Fatigue.
– Poor blood circulation.
– Heart murmur, caused by abnormal blood flow through the heart. A doctor can hear a heart murmur with a stethoscope. However, not all murmurs are signs of congenital heart defects. Many healthy children have heart murmurs.

Source: The National Heart, Lung and Blood Institute

POSSIBLE CAUSES

If you have a child who has a congenital heart defect, you may think you did something wrong during your pregnancy. But doctors usually don’t know why congenital heart defects develop, although smoking during pregnancy is a possible link.

Heredity may play a role. And children who have genetic disorders often have congenital heart defects, too. For example, half of all babies who have Down syndrome have congenital heart defects.

Source: The National Heart, Lung and Blood Institute

TYPES OF CONGENITAL HEART DEFECTS

Congenital heart defects change the normal flow of blood through the heart and often cause the heart to work harder.

In a normal heart, the right side pumps blood to the lungs to pick up oxygen. Then, oxygen-rich blood returns from the lungs to the left side of the heart, and the left side pumps it to the body.

A congenital heart defect occurs when part of the heart doesn’t develop properly before birth. Some congenital heart defects are simple, such as a hole that allows blood from the left and right sides of the heart to mix, or a narrowed valve that blocks blood flow to the lungs or other parts of the body.

Other problems are more complex. These include combinations of simple defects and issues with the location of blood vessels leading to and from the heart.

Examples of simple congenital heart defects:

n Holes in the heart (septal defects). The septum is the wall that separates the chambers on the left side of the heart from those on the right. If oxygen-rich blood mixes with oxygen-poor blood, some oxygen-rich blood is pumped to the lungs instead of out to the body.

n Atrial septal defect (ASD). An ASD is a hole in the part of the septum that separates the upper chambers of the heart.

Source: The National Heart, Lung and Blood Institute

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