Can You Exercise With a Leaky Heart Valve?

If you have a leaky heart valve, you might think it’s safer to take it easy and not exercise. But actually, regular exercise and physical activity are some of the best things you can do for your body, even (and especially) if you have heart issues.

“People with heart conditions are often afraid to exercise, thinking it may put too much stress on their heart,” says cardiac clinical exercise physiologist Erik Van Iterson, PhD, MS. “That fear is natural, but it shouldn’t stop you from being active, as long as your healthcare provider says it’s OK.”

Dr. Van Iterson explains the importance of exercise when you have a leaky heart valve (aka heart valve regurgitation) and how to safely get started.

Can exercise help a leaky heart valve?

Exercise won’t reverse a leaky heart valve, but it can help your overall health, including strengthening many heart functions. This may keep your condition from getting worse.

The benefits of regular exercise for people with a leaky heart valve are the same as the benefits of exercise for everyone else. But Dr. Van Iterson explains that when you already have a heart condition, it’s more important than ever to stay on top of your heart health so you don’t develop other conditions, too.

Here are some of the ways regular exercise benefits your body, which are especially important when you have valve disease.

• Lowers your cholesterol. “Bad” cholesterol (LDL) can build up in your heart valves and affect how well they function. Routine exercise improves cholesterol levels.
• Lowers your blood pressure. High blood pressure adds stress to a leaky heart valve. Exercise is a well-known way to reduce blood pressure and boost heart health.
• Improves blood glucose. Unmanaged blood glucose can lead to insulin resistance and Type 2 diabetes, which increases the risk of heart disease. “Regular exercise reduces insulin resistance and improves glucose regulation while helping to lower heart disease risk,” Dr. Van Iterson shares.
• Improves your overall heart health. “Regular aerobic-based exercise and physical activity participation reduce your risk of heart disease and improve your overall heart health,” Dr. Van Iterson says. Exercise can help you maintain a healthy weight, sleep better, lower stress and anxiety levels, and even reverse the presence of important heart disease risk factors like Type 2 diabetes and high blood pressure.

Exercise recommendations when you have a leaky heart valve

“It’s important to find some type of intentional regular exercise and physical activity that works for you and your valve condition,” Dr. Van Iterson says. A 2022 British study recommends that everyone with valve disease “should be encouraged to avoid sedentary behavior” by doing at least 150 minutes of physical activity each week (including strength training).

But the activities that are right for you will depend on a variety of factors, including the severity of your leaky valve and how you feel.

• Mild to moderate. “If you have mild to moderate leakage, don’t have symptoms and otherwise have good heart function, most types of exercise and physical activity won’t make it worse,” Dr. Van Iterson says. “So, stay active and continue to regularly check in with your healthcare team.”
• Severe. If your condition is advanced, your provider may recommend keeping exercise at a low intensity while focusing on aerobic-based routines. “Low-intensity aerobic-based exercise activities are usually suitable for most people with moderate and severe conditions,” he notes. “Your healthcare provider can work with you to develop an exercise plan that fits your lifestyle and heart health.”

If you’re having heart-related symptoms, it’s very important to talk to your healthcare provider about what type of exercise is OK for you to do.

“At a minimum, low- and mild-intensity types of aerobic-based exercises that don’t provoke symptoms could typically be considered appropriate for benefitting overall heart health,” he adds.

Some symptoms to keep an eye out for that you should talk to your healthcare provider about include:

• Chest pain
• Fatigue
• Heart palpitations
• Shortness of breath

Finally, other health factors also play a role in your physical activity recommendations. These are factors that affect everyone, heart condition or not, like your age, recent exercise history, fitness level and overall health. In other words, there’s a lot that goes into figuring out what’s right for you, so don’t try to figure it out on your own.

“When you have a heart condition, it’s always important to ask your healthcare provider what kinds of physical activity are safe for you to do,” Dr. Van Iterson advises.

Low-intensity exercises for a leaky heart valve

If you have severe leakage, your provider may recommend that you stick to low-intensity activities. But what, exactly, does that mean? Dr. Van Iterson says it’s not just about the type of exercise you’re doing, but also the pace at which you do it.

“It’s maintaining a pace where you can still carry on a conversation without needing to pause to catch your breath,” he explains. “You can modify any exercise you enjoy and do it at a lower intensity.”

To be sure you stay at a low intensity, try to have a conversation while you exercise. If you’re exerting yourself too much to talk, that’s a sign to take it down a notch. (But don’t use your heart rate to track exercise intensity without first discussing this with your healthcare provider. It may not be a good measure, Dr. Van Iterson warns, because some medications, like beta-blockers, can lower your heart rate.)

Although it’s recommended that you always maintain some form of aerobic-based exercise in your routine, it’s also important to choose additional activities that match your interests and lifestyle, like:

Aerobic-based exercises:

• Walking. Choose this slower-paced option over running.
• Cycling. Hop on a bike to strengthen your heart, blood vessels and lungs. Just be sure to moderate your pace, as it can quickly become a high-intensity activity. “If you’re just starting out or it’s been a while since you’ve been on a road bike, a stationary bicycle can be a great starting point for gradually building conditioning and learning how to pace for when you eventually get out on the road,” Dr. Van Iterson suggests.
• Swimming. Channel your inner Nemo for a low-intensity aquatic exercise that helps strengthen your heart, not to mention your lungs and muscles. “Don’t be afraid to take some lessons if you’ve never swam laps for exercise,” Dr. Van Iterson recommends. “Swimming can be more intense than you think, and you won’t always feel it until you get out of the pool.”
• Hiking. As long as you choose your paths wisely and avoid hills and steep climbs, this can be a great low-intensity option.

You can also try non-aerobic exercises and physical activities, like:

• Yoga. Try slower varieties, like gentle yoga, yoga and chair-based yoga.
• Tai chi. This slow-moving, ancient practice is so low-intensity that it’s typically considered safe even for people with serious medical conditions.
• Dancing. No need for intense tango lessons or a night at the club. Just turn on some music and dance in your living room for a little extra movement!
• Walking your dog. Yes, walking itself is aerobic — but curious and easily distracted dogs stop a lot! Taking your pup around the block is still good movement, but it’s not the same as exercise where you set the pace.

As you do any of these activities, you can adjust your pace up or down as you go, depending on what you can handle.

“That may mean walking a little more briskly to get your heart pumping,” Dr. Van Iterson notes. “If you’re jogging or hiking, you may have to slow down to avoid breathing fast and heavy. You should be able to consistently carry on a conversation without difficulty.”

And all types of movement can count! Even an hour intentionally spent leisurely working in the yard or casually doing housework can count as low-intensity physical activity.

When to talk to your provider

Talk to your healthcare provider before you start any new exercise program, especially if you have a leaky valve. They may recommend an exercise stress test, which checks how your heart functions when it’s working hard. This helps identify which activities will be safe for you.

And when exercising, Dr. Van Iterson stresses the need to be aware of signs that you may be overdoing things. Stop your exercise routine and check with your provider if you:

• Have symptoms like chest pain, heart palpitations or lightheadedness
• Feel more fatigued than usual after a workout
• Start taking longer than usual to recover

Set yourself up for success

When you’re starting a new workout routine, take it slow. Begin with a few minutes of activity each day and slowly increase that amount over time. Think big picture: You want an approach that’s sustainable over time. Ask your provider to help you set goals for how much and how often you should exercise.

“Trying to do too much too fast can be discouraging, or even increase your chance of injury, especially if you haven’t been active in the past,” Dr. Van Iterson emphasizes. “You don’t have to be a lifelong exerciser to be successful. You can benefit no matter when you start, as long as you have the right plan designed just for you.”

So, be patient with yourself. Your progress may feel like one step forward and two steps back, but you’ll improve with practice and with time. That’s what training does. Give yourself the credit you deserve by celebrating the steps you’re taking toward a healthier you.