At what AV gradient were you symptomatic?

[Duff Man]

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Just wondering: What gradient of the aortic valve do you think you became symptomatic at?

I have a gradient of like 25-30, but the symptoms -if I have any- are vague, hard to distinguish from being out of shape, and I'm not sure if I've ever had an optimal gradient to compare it to. If I had to guess, I think my symptoms might become quite a bit more obvious after 30 mm hg.

I made a poll but it won't let me change the poll options after i clicked submit... the numbers might be too low, but... you could always answer in the thread if it doesn't suit your scenario.

 

[Superbob]

Folks are so knowledgeable here. I am going to confess: gradient is something that has never been on my radar. Don't even see it on my latest echo report. Dimensions of aortic root, sure. But no one has ever explained gradient to me or called it to my attention. So will follow this poll with interest. I have learned a lot here, and this is something else I can learn about.

 

[Bill B]

You should state whether this is peak or average. I had an average of 44 and peak of 70 a couple of months prior to surgery and was fine.

GRADIENT is the pressure difference across the valve opening. So, on the heart side of the aortic valve, when the left ventricle contracts, the pressure can go way up if the valve opening is restricted, while it stays low on the other (aorta) side of the valve. A normal valve has no pressure gradient. So, it is very free-flowing.

 

[Superbob]

You should state whether this is peak or average. I had an average of 44 and peak of 70 a couple of months prior to surgery and was fine.

GRADIENT is the pressure difference across the valve opening. So, on the heart side of the aortic valve, when the left ventricle contracts, the pressure can go way up if the valve opening is restricted, while it stays low on the other (aorta) side of the valve. A normal valve has no pressure gradient. So, it is very free-flowing.

Thanks, Bill, great explanation. I wish the medical professionals were so lucid.

 

[ShezaGirlie]

Reading from my echo report which was 4 days prior to AVR:

Peak aortic valve gradient of 42mmHg and a mean aortic valve gradient of 29mmHg.

My EF was in the 20-25% range. Hope this helps you.

 

[acr]

I dunno what these numbers mean to be honest. I can recall the surgeon grading my leak on a scale of 4 ie. mild/moderate/severe/panic! ..... and I was severe.

Ade

 

[Bill B]

Reading from my echo report which was 4 days prior to AVR:

Peak aortic valve gradient of 42mmHg and a mean aortic valve gradient of 29mmHg.

My EF was in the 20-25% range. Hope this helps you.

Here is a case where the gradient is not horrible, but you included the EF, which is very bad. So, this shows that a weak left ventricle may not create much pressure, and pressure gardients alone don't give the full picture. Yoiu needed the operation to save your left ventricle.

 

[Bina]

The symptoms in relation to various readings, i.e. gradients, EF, and valve area, are highly variable from person to person.
It just ain't that simple.....

 

[Lily]

I think there must be many variables to the entire pattern of aortic valve deterioration and demise, including the nature and/or structure of the valve and tissue.

The early "symptoms," if you will, for so many of us appeared gradually and many of us apparently didn't recognize them. For me, early on as my valve situation worsened, I thought that I just wasn't aging very well.

I'll have to dig out my old bicuspid echo to see what my gradient was when I was definitely symptomatic and looking for answers; I was feeling very ill then and continued to deteriorate from there. But that was with a 42 year old defective natural bicuspid valve that had never worked correctly.

But anyway, my replaced valve has a new development according to this year's annual echo, and is now considered "abnormal." I don't know specifically in what way it is abnormal but I assumed it was in function. The only symptom that I'm aware of has been an episode of angina in high altitude. My current Mean AoV grad is 38.4 and my Peak is 70.2, which the echo states is a "significant increase" since last year's echo. EF is 65%.

 

[Mentu]

Different people respond in their own way and there does not seem to be any rule about how one should feel at different pressure gradient values. With moderate hypertrophy of the LV and a valve area of .74 cm2, my pressure gradient values were:

Peak gradient across the aortic valve is 127.5 mmHg
Mean gradient across the aortic valve is 61.4 mmHg

My Ejection Fraction (Visual and calculated) was 60% (+-5%)

At the time, I felt ill most of the day including while lying down in the evening. Activity was very limited and invariably led to really uncomfortable palpitations and some chest pain. Shortness of breath and dizziness were pretty constant companions.

 

[JeffM]

Stenosis versus regurgitation

Stenosis versus regurgitation

I suspect the question only applies to people whose valves are stenotic or have stenosis and not to those, like me, whose valves are/were leaky. I suppose some had both conditions, but it seems if the valve opens all the way, as mine did, the gradient wasn't an indicator of heart function. We were paying attention primarily to Left Ventricle size and Ejection Fraction, which were trending up and down respectively and then I started having A-fib as my only symptom. That begin mildly in response to max effort exercise and, finally, 2 months prior to surgery, without exercise.

 

[vhmoriarty]

My gradient was 72 while I was pregnant and I was symptomatic only by shortness of breath which I blamed on pregnancy.

Now it is 100 which is critical aortic stenosis and again its just the shortness of breath after walking up stairs or carrying things.