Confused Need help

[RandyL]

I went to the DR 4 years ago and they said I had a murmur. They sent me for a echogram and basically said they would keep an eye on it.

I went 2 weeks ago and my echogram was .8 cm The cardiolgist snt me to the hospital immediately for a catherization. Had that done and the result was 1.04 cm.

I had a follow up visit with him and he recommended aortic valve replacement with the diagnosis being aeortic valve stenosis.

I went to my primary DR who recommended I get a second opinion. I had my tests sent to the new cardioligist and he recommended we wait and see.
Told me to come back in 3 months.
I am not sure what to do at this point.
Please Help
Thanks

 

[Nancy]

Symptoms are important here too. What kind of symptoms are you having?

 

[RandyL]

At times I feel some pressure on the left side of my chest but can't tell if it's my brain fooling me or the real thing.I quit smoking 3 weeks ago and the shortness of breath seems much better.Sorry I can't be of more help but I'm at the point where I just don't know anymore

 

[tobagotwo]

That's common. It gets hard to tell what's real and what's coming from your mind. Here's something on angina. You can search the site for more as well: http://www.valvereplacement.com/forums/showthread.php?p=119047&highlight=angina#post119047

If you're not having strong symptoms, and are showing no great enlargement of the left ventricle, a valve area of 1.04 is usually a wait-and-see size. It is definite that the size is on the decline, though. Unfortunately, there is nothing to reverse it, or that's proven to slow it down. They may offer some medications that can slow damage to the rest of the heart in the meantime. Surgery will fix the problem, and your heart will go back to its normal size, as long as they don't let it get too damaged/enlarged before surgery. Likely, yours is not in danger of that at this point.

You are probably finding that you have less energy than you used to, and are thinking you're out of shape or getting older. Later, when the surgery is past, you'll discover that wasn't true.

It's certainly a surprise, and it's no fun, but you're now in the Waiting Room for open heart surgery.

Forget smoking. You're done with that now. A lot of us were former puffers. Things taste better without tobacco slime in your mouth, and you'll smell better, too. Getting rid of those little sticks that owned us is one of the most worthwhile things most of us have ever done for ourselves.

Poke around, read some posts, learn to search through earlier postings that address your interests. We'll be here for questions and for some of the angst that people who've not been through it won't fully understand.

Best wishes,

 

[ALCapshaw2]

Welcome to our world Randy.

You have some time BUT with a valve area around 1 sq cm you are definitely headed for Valve Replacement Surgery. Medication MAY postpone it some BUT as the Heart Enlarges to compensate for a more and more narrow valve, it will reach a point where Permanent Damage may occur. Most SURGEONS like to operate BEFORE you reach that point.

THIS is the time to go Surgeon Shopping. Look over the Valve Selection Forum, learn about the differences between Tissue Valves (which WILL wear out in 10 to 20 yers) and Mechanical Valves (which require lifetime anticoagulation on Coumadin/Warfarin). Then dig deeper into the different types of valves in each category.

At that point, you should be ready to ask the appropriate questions to the surgeon(s) you interview. Look for one who has lots of experience with the valve(s) you are interested in (and be sure to have a Second Choice in mind, just in case the first is not viable).

FWIW, my Cardiologist put me on an ACE inhibitor to hopefully postpone my Aortic Vavle Replacement by 3 to 5 years. ONE year later, I became more symptomatic and my valve area had decreased to 0.8 sq cm which many doctors use as the 'trigger point' for sending their patients to surgery. I think I got there *just in time*, so don't wait TOO long.

'AL Capshaw'

 

[RandyL]

Thanks for all the info and help. My echo was .8cm and my cath was 1.04.
Which one is more reliable?
Thanks

 

[Mary]

Everyone says the heart cath is more reliable. I had numbers similar to yours; echo said .7, cath said 1.0 I knew the cath was wrong, but never got confirmation until my presurgery cath at a different facility. Apparently some type of flaw skewered my first heart cath results, and I went round and round with the cardiologists concerning it.
There are other measurements they use that are nearly as important as the valve opening, so that might be another avenue to use for comparison.

 

[ALCapshaw2]

Usually the Cath is considered more accurate than a standard echo.

There is another imaging test that gives better pictures, the TEE (TransEsophageal Echo) where an untrasonic transducer is placed down your throat until it is right behind your heart.

Do a SEARCH for TEE and you find LOTS of discussion on the subject. Some people don't care for it very much. I've had two with NO problems. Just tell your doc you don't want to See, Feel, or Remember anything and they can make that happen by administering the appropriate amount of Versed and Demerol. If you would prefer to be conscious but 'not care', they can do that too.

'AL Capshaw'

 

[tobagotwo]

The cath is usually deemed more accurate. If the cath had also come out under 1.0, they might have split the difference and sent to to a surgical consult. With that much between them, the cath is the more likely accurate.

Best wishes,