cath vs echo

[kman]

After being told my valve diameter was 0.9 and that immediate surgery was called for I had a cath done yesterday that showed the diameter to be 1.3, I understand the cath is much more accurate than the echo. Good news! but I feel like Ive been strapped to a yo yo. Believe me Im very happy to postpone surgery but this doesnt explain my symtoms, Im six feet tall and weigh 175, Im willing to believe Im just old or burned out with my work but why dizzy and short of breath? Thanks again for all your thoughtfull and considerate advice and experience with this stuff I cant imagine anywhere else to go with a question like this one. Thanks, K Man

 

[Marguerite53]

Definitely news to celebrate! Everyone likes time!!

I had 3 years to wait. My valve went kinda quickly (or at least, quicker) at the end of the waiting time. what kind of schedule do they have you on? Will they check you again in 6 months? 3 months?

Your symptoms are indicative of your declining valve. Absolutely. Nothing to do with your age. It's the valve. I would think that your doctor would be alert to your symptoms and be factoring them into the equation.

Perhaps, now, you have time to seek a second opinion should you feel the need to. I did, just as a matter of course, and I was very glad to find consensus. I also learned things just from the different demeanors of the surgeons. By the way, was that opinion the one of your cardiologist, or your surgeon. Sometimes, the surgeon has other numbers that they factor into the angiogram numbers which ring more true in their surgical minds. A surgeon is who you should be getting your opinions from at this point.

Good luck! I'm sure you are in good hands. Enjoy the little sigh of relief, adjust to the fact that you have some extra time to go out and smell the roses and GO OUT AND SMELL THE ROSES!!

Marguerite

 

[ALCapshaw2]

Have you had a TEE (TransEsophageal Echocardiogram)?

That is supposed to be more accurate and give better images than a TTE (TransThoracic Echocardiogram) which is done non-invasively through the chest.

After getting conflicting readings between a Cath and Echo, my Doc's decided to wait. The next time, both the Echo and Cath were in agreement at 0.8 sq cm and I was referred for surgery.

'AL'

 

[Susan BAV]

A little brainstorming here...

A little brainstorming here...

Can you ask your doctors if something else is going on (or going wrong) in there that could be contributing to your symptoms? In my case, my mitral was having troubles too because of how badly the aortic valve was doing its job; and it looked as though it might need replaced also but once they got the aortic valve replaced, the mitral was good enough as is and didn't need anything. Anyway, for some of us who are (make that were) more symptomatic than others, maybe we have more than one heart issue.

And evidently for most of us at least, heat and humidity seems to exacerbate symptoms. Could that explain how you're feeling? Also, I found that I had much worse days and then would feel somewhat better for a few days or a couple of weeks. But steadily I had fewer better days and the dizzy times became worse. And a day where I really wore myself out would take me a few days to recover from. It was such a strange kind of exhaustion.

Or, how about your blood pressure? Are you on meds? Could you be on too much or the wrong kind? Brainstorm with your doc. You're not a hypochondriac so don't be afraid to ask a few questions until you hear some reasonable answers.

And even though your surgery may not be urgent at this point, you still have a serious heart issue. Hang in there and post again.

 

[WayneGM]

You cath results are good news. Enjoy the extra time. That said, if you are having symptoms I hope you have a regular schedule for monitoring. When they first detected my leaking mitral valve I didn't have any symptoms and was booked to be checked every 6 months. Good luck and best wishes.

 

[gageyk]

Same thing happened to me 2 years ago, echo showed 0.8 cath 1.25 surgery postponed. I got 2 more years. In retrospect I sometimes think I should have just done the surgery 2 years ago. I was asymptomatic at cath and had minor symptoms at time of surgery. The thing I hated 2 years ago was that I was mentally prepared for surgery and then 24 hours prior they tell me I didn't need the surgery immediately.

Surgery isn't too bad and if your prepared now think about doing it now. I gained 2 years but in those 2 years I was restricted on max heart rate and always cautious. I was initially hoping to get 5 years before surgery as I wanted(and received) a tissue valve so I knew a reop would be necessary. For the 2 years I often think I should have just done it 2 years ago.

Consider your symptoms and your mental preparedness, it's a very hard decision.

Good luck.

 

[tobagotwo]

The cath is considered more accurate by interventional cardiologists. Many echo techs feel echoes done properly can be more accurate. In both cases, it's an estimate, not a direct measurement.

There is also the factor or regurgitation. Most of the time, when you have stenosis from calcific deposits bad enough to cause symptoms, you're also experiencing some regurgitation (insufficiency). So your heart is having difficulty pumping blood through a very small orifice, and of what is getting through, some is leaking back. A lot of heart's labor lost. Kind of discouraging for a hard-working organ.

Plus, there's the matter of your size. Are you a big guy? It makes a difference in how much a 1.3mm or 1.0mm valve aperture will affect you.

And yout heart's size is important. The more enlarged your heart becomes, the less efficiently it pumps. As your slide into stenosis begins, your heart expands liek a good muscle from the added labor. Your Ejection Fraction (percent of blood pumped out of the heart in one beat) goes up. It pushes blood through the chambers like a strong hand crushing a grape. Now it enlarges, becoming a huge Mickey Mouse hand. Over time, it has become so large that it no longer has any leverage over the tiny chamber. The chamber is like a grape getting lost in a hand so big, it can't close efficiently enough to squeeze it. The EF goes gradually down.

So there are a number of major components feeding into your symptoms. I would go after the original echo heart chamber size records and your newest echo records and see how much your LV (Left Ventricle) has expanded. This is another one of the criteria for surgery. Your symptoms are also criteria. It's not all valve size.

Best wishes,