Confused newbie

[Lisa in MN]

Okay...I have been hovering on this site for along time, and decided to finally post. I was diagnosed with BAV in 1994 and my echos have always been pretty good. I had one a year ago and at that time my cardiologist said that I had trivial stenosis. Didn't really tell me anything else. Now my recent appt with him to review my echo this year he said that I have mild stenosis, with my aorta being somewhat dialated. Hmmm..pretty vauge. So I had my daughter look up my records for me ( she works at Mayo) and this is what she found.

mild ascending aorta dilation diameter 38 mm at mid level
normal left ventricular chamber size with normal wall thickening calculated ejection fraction 65 percent. No regional wall motion abnormalities.
finding consistent with normal left ventricular filling pressure.
normal right ventricular size with normal systolic function.
side by side comparison to the study from 10/06/10. the aortic valve appears similar. the ascending aorta measures significantly larger, however the accuracy of the prior measurement is questionable. (image suboptimal)
FINDINGS
Left ventricle: normal left vent chamber size. calculated left vent ejection fraction of 65 percent.... BASICALLY AS THE ABOVE WHAT I WROTE.
aortic valve systolic mean Doppler gradient: 11mmHg. Aortic valve area by Doppler 1.66 cm(then a little 2 after cm) No aortic valve regurgitation. Normal mitral valve. trivial mitral valve regurgitation.
OTHER ECHO FINDINGS
The atrial septum was well visualized and appeared intact. Lipomatous atrial septum. No intracardiac mass or thrombus, but the left atrial appendage cannot be visualized adequately with transthoracic echo to exclude thrombus in this location. No pericardial effusion. Normal inferior ven cava size with normal inspiratory collapse (>50 percent). Prominent anterior epicardial fat layer.
Sorry for the long post...I'm a newbie, and have alot of unanswered questions. Plus I suffer from depression, anxiety and panic attacks, degenerative disc and the list could go on. Any input would be greatly appriciated

 

[Julian]

I'm no doctor but from the read beside the aorta being mildly dilated seems like you have mild to moderate aortic stenosis. Ejection fraction is fine. I've personally had bad experience with echos, I had 6 in a 2 year period with multiple doctors and techs and got different results from all of them. For me echos are good at giving you an overall picture but not detailed progression. Again this is my experience and opinion and not meant to freak you out. Its not completely uncommon for echos to show a mild case of stenosis but end up being a severe case because the image is just not perfect. I guess that's why doctors not only check out the echo but ask how your doing and feeling. I personally was told a year ago I had moderate stenosis, and one year later I was severe and going into heart failure at 28 years old. After fainting on a treadmill two years ago I knew something wasn't right. I started to feel strange and one doctor said it was time for surgery while another said my symptoms were probably anxiety based because my stenosis wasn't that advanced. 3 year prior to this I had no obvious symptoms and I was born with aortic stenosis. Get second and third opinions from good doctors and pay close attention to your symptoms, your body is always talking. This is just my view, everyone has a story to tell.

On a side note unless you gave a signed release for your daughter to give you your records I would speak low about how you obtained your own records. Making a copy of peoples records without signed consent can get you fired family or not.

 

[Lisa in MN]

Thanks Julian!
I have had some symptoms, but I chalked it up to anxiety or because I just started a new medicine for diabities. How do you go about getting a second opinion without ticking of your cardiologist from Mayo Clinic?? Also about your side note which I thank you for looking out for my daughter, I did sign a concent form for her to look at my records ect..

 

[Bina]

Hello and welcome.
Your echo results look pretty decent.

 

[Bina]

Are you havng dizzy spells? chest tightness ?
Sometimes it is just hard to get a complete deep breath, but we don't notice as it can progress slowly.
The first thing I noticed post op was that I could "really breathe".

 

[kfay]

I have had echo's done at several hospitals in my life, but have never had one that as detailed as the one I had at the Mayo. I'd be surprised if you found another local Dr. who is going to have as good of a look at you as they do there. I'm also surprised that they didn't send you paperwork that had that report in it after your visit. About 2 weeks after my visits there, I always receive a big packet in the mail that has copies of all my test in there as well as summaries from the Dr.s that I have seen about those tests. If you call, I'm sure they would be happy to send it to you.

Are you not happy with your care at the Mayo, or just worried that something more is going on than the "vague" assessment your cardio gave you? You can certainly go for a second or third opinion anytime or anywhere you want, and your cardio doesn't have to know about it. But I think most good Dr.'s are fine with their patients getting second opinions.


Kim

 

[Lynlw]

Hi, I agree with Bina, that your echos looks pretty good.
Im not sure what part you are worried about, perhaps the vagueness was because for the most part your heart looks pretty good and the dialation at 38 and Aortic valve area of 1.66 are mild, so there isn't really alot to say. I agree with others that echos aren't the most accurate, but I would think it is pretty rare that valves or any other part, that look "mild" on echo would end up really being severe, especially if you've had previous echos that were mild or trivial and it wasn't your first echo with nothing to compare it to..
If it makes you feel any better, chances are If the stenosis was mch worse than it looked on the cho chances are other finding would probably show problems, like for example the pressures in the left ventricle would probably be higher than normal or the gradient would be worse. They have very hard times seeing some of the areas on my Son's echo (and even MRIs) for example, but thats because he's had so many heart surgeries and alot of scarring, BUT even tho they can't get a good look by echo of his pulmonary valve and artery, IF it is getting narrow, they can see the pressures and size of his right ventricle are worse and the gradient usually is high, so do further testing to see where the reason for the other problems they can see.

As Kim said you can always get 2nd opinions or have tests done elswhere, but the Mayo is one of the every best places for hearts and so not only have the most experiences/best echo, or other tech, but usually have the latest best equipment compared to smaller centers, so the results might not be as detailed.
IF you want to get 2nd opinions, depending on your insurance, yor other doctors dont even have to know where else you are going and even if they did most of the best docotors are pretty secure in their abilities so dont have any problems with their patients getting 2nd or 3rd opinions.
IF you have any specific questions or concerns ask and maybe someone can help.

 

[Lisa in MN]

Thanks Everybody!
I guess its more my anxiety than anything. Mayo Clinic is an awesome place to go, I think maybe my cardio was just not himself and in a hurry my last appt. Thanks for the reasurance on the echo reading. I still have trouble following what they mean.
Lisa