You are pre-surgery. Some of these responses are post-surgery.
I'm the 52 year old, almost 5 weeks post surgery. I have not been good about exercise over the years. I am tall and overweight. My exercise tolerance is low. My stress test 3 years ago did not last long, and it seemed somewhat inconclusive as I got so out of breath and they couldn't really tell if it was the valve or just me. Also, I am large breasted and so the scans they did were mostly blocked by the breast tissue.
For the nuclear stress test (the nuclear part being an insisted on part by my internist who is young and swears that female patienst get no benefit from a normal, male designed, non-nuclear treadmill stress test) I went in fasting. They either injected me, or had me drink (sorry, don't remember) something then did an ultrasound (or xray) of my heart while I was lying very still. The radioactive isotope thingy's show up and give them some kind of reading. Then you go onto a treadmill on which they raise the slope as you go. My slope was raised very quickly and since my only symptom at the time was breathlessness at the top of the stairs, it obviously got to me quite soon and I was done. All the while, they have you hooked up to monitors and they ask you every 10 seconds how you're feeling, any pain, any dizziness? So, for me, I was like dying, feeling, ready to explode, terrified of passing out (first cardio's words, "well you never want to get to the point of passing out...then it becomes an emergency" running through my brain like a mantra) and yet they seemed to think I would KNOW it if I was going to be dizzy and pass out. Anyway. They pushed me abit and then it was done. I had another "hit" of the radioactive stuff, and they quickly took another comparative "photo" of me. I waited (to be sure I was not ill, or woozy), ate, and they let me go home.
I think what we are suggesting is that you try to get a clear picture of why the cardio wants this done. There is risk. They could set off an incident. But so could a car accident and I bet you drive all over the place! I was also nervous about having an angiogram. There is risk with those. But I had a surgery date by then, so it was all part of that process. For you this is a diagnostic tool, for what??? to tell you that you have stenosis? To tell you if you tolerate exercise? You know that already. Is it so that they can put off surgery for awhile?? Is it to set you up on an exercise program to put off surgery? Why does he want this? What info does he need to gain from this? What is he looking for?
You might ask him about the measurements from the TEE. I know that echo measurements are subject to variation depending on the tech's reading and other factors. I think the TEE is remarkably clear and precise. The angiogram is also a very true measure of valve size. Again, ask him at what size he recommends the surgeon.
My cardios thought I should wait as long as I possibly could, safely, before getting the valve replaced. Your life isn't being impacted, your quality of life...you have few symptoms. By waiting years (if this is possible) you will have available to you, far more choices in replacement. Technology is improving leaps and bounds. Have you begun to think about your choice of valve? That is a very important choice. At your age, it is a tough choice. If you were in your 60's it would be an easier choice.
We tried to ward off the stenosis with medicine. It did not work. In fact, personally, I think it sped thing up!! Or it was just my will.....I was very impatient to have the surgery because the uncertainty of my own valve was stressful.
I am going to go off on several tangents and I don't want to confuse things here. We can be confusing, here on the forum, and I'm sorry for that. I think overall, what we are all about here is advising people to really get the facts. Sometimes it's very hard to know the questions. I hope I have helped you to formulate some questions. Then you get your answers and weigh them against your own beliefs, understandings and expectations.
Keep asking!!! We're here 24/7.
Marguerite
