Once I found a cardio who seemed to know how to evaluate and treat valve patients who were not "elderly" - patients in their 40's or 50's, not in their 80's, things settled down a lot. For the first 7 or 8 years, until my echo measurements started getting worse, we just did office consult/exam every 6 months and echo's every year. For the last year or two, we did consult and echo every 6 months. I never really did develop clear symptoms, but I did keep a diary of my running times and how I felt after exercise, and I did note a steady decline in my performance - declining at a faster rate in the last year or two prior to surgery. My cardio always told me that he would not be the one to declare that it was time for my surgery, that I would be telling him - and he was right. I finally got tired of being tired, and asked him for a few surgeon referrals. I am lucky in that I live in Chicago, and we have many highly regarded cardio surgeons here. My cardio gave me 3 names, I met with two of them, and chose Dr. McCarthy (formerly of Cleveland Clinic, now at Northwestern Memorial Hospital in Chicago). My consult with the surgeon was in December and I had surgery at the end of February. He was ready sooner, but I had to get things under control at work. Being able to carry on a normal lifestyle at that point allowed me the lusury of choosing my own schedule.
I probably could have had surgery a lot sooner, based upon echo results, but having no clear symptoms, we chose to wait. The fact that I was able to exercise at a level far beyond most guys my age made it difficult for my cardio to press me to operate sooner. Once I had an angiogram and saw the readings, it became apparent that I could have had surgery much sooner, except that my heart was compensating very effectively due to my many years of running and jogging.
Along with your second opinion, you may want to press for an angiogram (heart catheterization) to get the best view of your valves and heart. Once the docs have this report, they can more clearly advise you about how soon to have surgery. If they do not want to test, maybe find another cardio who understands why you want to know. Don't be afraid to ask questions of the doc. If he/she becomes offended, find another doc. You are the patient and you have a right to know.
