In a reversal of yesterday’s decision, University of Florida football coach Urban Meyer has decided not to resign or retire, but rather to take a “leave of absence”. Assistant Coach Steve Addazio will take over the team after the upcoming Sugar Bowl. Meyer could come back as coach at a later date. According to press reports, Meyer apparently changed his mind at practice this morning.And if reports are true, he changed his mind despite passing out after a game.
Now it is starting to sound serious.
According to The Palm Beach Post, a University of Florida spokesman says that the previous reports of passing out and a diagnosis of a defective heart valve are both “inaccurate.” Meyer himself denied the heart attack story in a press conference earlier today.
So what is really going on? From the information that we have seen, it sounds as if Coach Meyer has a problem with one of his heart valves. Three of the four heart valves – the Tricuspid, the Aortic, and the Pulmonary – are composed of three flaps of muscle (each flap is known as a cusp). The Mitral valve is different; it only has two cusps (two flaps) and actually extends downward, it is called the Mitral valve because it looks like a Mitre, the tall triangular religious hat.
All four valves act as doors to keep the blood flowing on the correct path through the heart. All four are unidirectional – blood can only flow in one direction. Imagine working in a restaurant with large swinging doors connecting the kitchen with the dining area. If you are going in one direction and another waiter is coming from the other direction, there’s going to be a collision. To prevent this, the owner tells everyone to return to the kitchen through a different set of doors – but some of the staff are forgetful, and accidents keep happening.
So the owner drives a nail into the door frame, very close to the door, on the kitchen side. Now the doors will open into the dining room, but the nail prevents them from opening into the kitchen. Normal heart valves operate on the same principle – everything goes in one direction only.
Regurgitation occurs when the valve doesn’t seal well and blood leaks backward into the chamber it just flowed out of. When a heart chamber has more blood to pump out than it should, it will try to compensate – and this will eventually lead to problems. Seeing an enlarged heart chamber on an echocardiogram or an X-ray is a good sign that a problem is brewing. Corrective action would need to be taken.
Mitral Valve Prolapse is another guess that can be made from the limited information available. Prolapse is the thickening of one for the leaflets of the Mitral Valve, which can then become dislodged from its correct position. This leads to Mitral Valve Regurgitation. It can be fatal, but since Coach Meyer’s health issue has been described as “not life threatening”, this is probably not the answer.
My best guess – and it is just a guess, I am not a doctor, and I am certainly not Coach Meyer’s doctor – is that he has a Bicuspid Aortic Valve. A Bicuspid Aortic Valve (BAV) has two cusps rather than three, and is a Congenital Heart Defect. It is the most common heart defect that there is and may not ever be diagnosed. If it is diagnosed, it is usually caught when a patient is middle aged or older (Coach Meyer is in his 40’s) when the valve starts to calcify.
The normal course of treatment is to monitor the valve (through EKG and Magnetic Resonance Angiography) and replace the valve surgically if that is needed. Under normal circumstances it is non fatal (though there can be problems with the Aorta) and someone with BAV has a lifespan comparable with someone who does not have the defect.
As I have said before, I am not a doctor and this is based on assumptions.