a few questions

[rosewynds]

I had a doctors appointment today and found out a bit more on the echo I had done in August. I have a few questions, that maybe someone on here can answer. I have mild aortic stenosis, he said my aortic valve area was 1.6x2.6, something about 2cm. I take it that the 2cm is my aortic valve area?

I also asked him if the report said anything about a bicuspid aortic valve, and he said no. That I probably had rheumatic fever at some point in the past. My question is, do bicuspid valves always show up on echo's? I am almost certain that I have never had rheumatic fever, from what I have read, rheumatic fever almost always involves the mitral valve, and mine is fine.

Are there any other causes of aortic stenosis in someone my age? I just turned 43, so I know I don't have the kind elderly folks have.

Sorry this is so long, seems like my questions have questions....LOL

Lisa

 

[Rich]

Lisa,
I can't answer your questions about the numbers but I can tell you some mild stenosis was found on my aortic valve in my early forties.
I did have a bi-cuspid valve and the calcification was caused by rheumatic fever when I was very,very young.
The good news was it didn't have to be replaced until I was in my late fifties.
When I first found out about the calcification the doctor said it was no big deal so I never worried about it and didn't go back
for check-ups.
That almost cost me my life so don't do what I did.
Have it checked on a regular basis.

 

[Nancy]

Hi Lisa-

My husband, Joe, had rheumatic fever as a young teen, and in 1977 (age46) he had his aortic valve replaced, then in 1999, he had his mitral valve replaced. So with him, it hit the aortic valve first.

My daughter's mother-in-law had mitral stenosis with severe regurgitation and was told that it was probably rheumatic fever, but she didn't remember having that as a child.

Perhaps some cases of rheumatc fever go undiagnosed at the time they occur.

 

[joy]

Hi guys, I think most cases of rhuematic fever go undiagnosed. I had sydenham's chorea after I gave birth to my first son, and while I was pregnant with my second son, I drove myself to the hospital and got admitted a little later, with a diagnosis of pneumonia. After I was flailing around they decided to sedate me and intubate me so that I was getting the oxygen I needed, and then they transferred me to a bigger hospital that could handle me better. Once there, they found my mitral stenosis, and told my husband that my valve was only opening at .66CM. Usually it opens at 4CM. I was flown to the UWMC for a mitral valvuplasty so I could make it through the rest of my pregnancy. One thing I can assure you of is...the wait for surgery(if you ever need it) is bad, but the surgery itself and the recovery isn't that bad. I am glad that you found out that you have this early on in the stages. I remember going to my dad's church and I had this horrible cramping in my chest and all the way down my left arm, and into my legs. It was aweful. I could never figure out why my legs would go numb from the knees down. Perhaps it was that, but I may never know. I am just glad I have a second chance at life. I guess they were my body telling me that I needed to get into the doctor and get checked out. Unfortunately, it took years to get these things figured out. Well, this is getting long, so I guess I have babbled on enough. Take care!

 

[Gisele]

Lisa,

Lisa,

Are you referring to the tricuspid valve?

There are four heart valves and all will show during the echo. The tech will apply the wand over different areas of your chest so that he/she can obtain different views of how the valves are functioning. The four valves are:

Pulmonary, tricuspid, aortic, and mitral.

My mitral valve was damamged from rheumatic fever, but my echo from two weeks ago shows pulmonic insufficiency (that's new to me), tricuspid regurgitation (trace) and mitral regurgitation (trace). I guess trace regurgitation is nothing to worry about.

Also is your doc referring to: aortic root? normal range is 2.0 to 3.7 (on my report anyhow). Don't want to feed you any misinformation.

Maybe you could get a copy and do some research. I now get copies of all my medical tests. Comes in handy if you need to see another doc.

Good luck, Gisele

 

[wlaldridge]

The "Normal" cross sectional diameter of an aortic valve is 2 cm sq. You should get a copy of the report. It will show the various measurments taken and the normal parameters for each. It might be that you were just 1.6 which might start to look like mild stenosis.

I have been told that the bicuspid valve is not always "seen" on the echo, they just presume in some cases as to the underlying cause of the stenosis, usually based on the way the valve closing appears in one view of the echo. Other measures are also pretty important, like ejection fraction which is normal at 55% to 75%, the pressure gradient across the valve and the velocity of flow are usually indicators of the stenosis

Another measure often reported is the diameter of the aorta which is normal at 2.0 to 3.7 cm.

I too, would not want to misinform but think you should be asking for hard copies of your test reports. most show the normal range for any measures taken, but only the cardiologist or surgeon should be interpreting them for us.

Best,

Bill

 

[Christine]

i don't know anything about all the numbers.. but I agree with rich.. don't just let it go.. I was diagnosed at 15 with a bicuspid valve.. was told i might develop stenosis in my 50's or 60's.. kept going to the doc until i moved at 24.. all were fine before hand and basically forgot about stenosis (let alone what it meant at age 15) so at 35 i almost died out of my ignorance and misdiagnosis by my GP (who just took over the practice and didn't hear my mumur) - (apparently a past endocarditist which hit my vavle weakened it and from there I guess it was a unknown down hill battle - basically sped up my need for surgery as my surgeon told me) two days ago was my 6 month post -op anniversary.. i'm glad to be alive, realize ignorance and fear of doctors almost killed me.. so now i'm learning more about my health and health related issues more than i thought i ever would in my life.. i guess in a way, i'm glad i didn't know in advance, i think the waiting game probably would have drove me insane.. but then, i came very very close to doing permanment damage to my heart.. if i didn't already..

have a great weekend

chris

 

[pegne]

In my case the doctors just assumed that the scarlet fever I had was a misdiagnosed case of rheumatic fever and that's what caused my aortic stenosis. Later on other doctors said that it was probably congenital. Finally they decided to call it Idiopathic Hypertrofic sub aortic stenosis, which, to my understanding, just means they don't really know what caused it. I agree with Christine though, the waiting is definitely the hardest part. Good luck to you. Peggy

 

[joy]

I too had scarlett fever, but I also got strep throat a lot too. I only hope for my kids that they don't end up with it all the time. I fear for my kids though. I took Erik(my 18 month old) to the naval hospital, and they took a strep culture. I TOLD them I wanted the results back regardless if they were positive or negative. I figure most hospitals have the 1/2 hour test where they put the culture in the petrie dish and if it starts to grow it's positive, and if not they continue to check it for 24 hours. Well, I called and apparently their computers were down so they wouldn't tell me the results for like 4 days! Lucky for them it was negative or I would have really thrown a fit. I mean seriously! I called when they told me to call, and I was just upset at the whole thing. Thank goodness their pediatrician is a civilian who actually knows what they are doing! Well Peg, it's actually nice to know someone else with a misdxed case of rhuematic fever. How do they know it was rhuematic fever that caused all this, they said it was impossible to know after the fact! I have done so much research on this whole thing. I don't know. My mitral valve went, and now I have mild aortic insufficiency. SO who knows. I still feel good, and that's all I care about. I had my MVR on 8/27/01. I know I have at least one more surgery to go, and hopefully my aortic valve will hang in there for a long time! Cross your fingers!

 

[JimL]

Somewhere I saw a simple chart showing the doctor how to diagnose the cause of valve problems, all based on your age at the time problems occur. According to this chart, I missed the congenital cause by a couple of years, so I was diagnosed as rheumatic fever, even though there is no record that I ever had it, even though my valve problems were diagnosed at an age earlier than rheumatic fever usually hits.

 

[Junebug]

My diagonis from birth was Tetrology of Fallot(TOF is charaterized as 4 heart defects). My current situation is that my Pulmonary valve is leaking:moderate to severe. Also the triscubid valve is leaking as well. As I mentioned in previous posts, I have 2 different opinions on when to replace the valve:now & not now. Yesterday I was finally able to schedule an appointment with Mayo clinic for a 3rd opinion. They do a lot of TOF patients there.

The cardiologist that recommended the surgery "now" said that my Tricuspid valve could be leaking because of the Pulmonary valve leakage. And, if I'm understanding this "stuff" the PV could have been stenosing (is that a word?), but then the pulmonary pressures would go up. Apparently in my case, the pressures aren't going up, and the leakage is getting worse. The assumption is that the right atrium(?) is stretching to accomodate this leakage, which is not a good thing as it doesn't stretch back to "normal" after surgery.

I whole heartdly agree that waiting is VERY difficult....so is have differing opinions. I'll keep you all posted on the 3rd opinion.

Judy

 

[ILoVeNY25]

I had rheumatic fever almost 8 years ago, That went misdiagnosed by my pedictrician and a year later I got bacterial endocarditis. First, Was diagnosed with Aortic and mitral insufficiency. Then a few years later the damage continued as my heart enlarged and I was then DXed with Tricuspid insufficiency, Mitral stenosis and pulmonary hypertension. Hopefully your mitral valve will stay healthy. In my case, 3 of my valves were damaged and had to be replaced and repaired. Wishing you the best, Take care and God bless!