connection between bicuspid and ph

[MichyB]

Hi all. I'm two months into this and more confused than ever. I previously reported that I was in the clear with respect to PH because that's what the ph docs told me, and then I got a call on my cell phone that they want me back for a stress echo, so I'm having that done this week.

Everyone on the PH boards and here always says make sure you go to a ph specialist, which I am. Everyone also says get a catheterization. Well, last time I met with the ph doc, she said that a catheterization is invasive and not indicated in someone who does not have signs of ph. So, I rested easy. Then I get the call about the stress echo, so now I'm concerned again.

Here's my question. Everything I read about bicuspids involves the left side of the heart. And everthing I read about ph involves the right side of the heart and/or tricuspid valve.

Is it possible that the two could have something to do with each other? Can someone with a bicuspid valve cause high readings as to pulmonary artery pressure on an echo in a less-skilled tech? The echo that caused me to go to the ph doc in the first place wasn't just abnormal. It was WAY abnormal. But, the ph doc's echo was totally normal as far as pulmonary artery pressures.

Who do I rely on? What questions do I ask at this next meeting? And, if the stress echo turns up normal, too (which I'm hoping for) can I really put this to bed and (just) worry about he bicuspid?

 

[bvdr]

PH is quite common with rheumatic heart disease, particularily with mitral stenosis. I don't know how common it is with bi-cuspid valves but once there is a gradient present than the pressures start backing up and affecting other areas of the heart.

As far as your stress echo is concerned, I think it is an excellent idea. It is the one test both my cardiologist and I wish I would have had before surgery. He thinks it would be valuable information to have for comparison since we have to keep an eye on some other areas of my heart. I'm glad they called you for it since (INMO) they were a little cavalier in your case.

 

[Nancy]

Michy-

I'm reading between the lines a little and speculating. But I'm thinking that there was some kind of discussion about you and your problems, and the result was the call to you to have you take a stress echo.

This is a positive thing because it seems to indicate that your case just wasn't dropped. It seems to indicate that they are trying to find out just what the nature of your condition is. It sounds as if you have a little more complicated situation than the ordinary one.

Please let us know how things go for you with the test.

 

[PapaHappyStar]

I did some simple-minded literature searches on this, combining terms mostly: "pulmonary edema", "pulmonary hypertension" and "aortic valve" -- so far havent found anything that would be relevant.

Since you dont have marked aortic valve disease as yet ( its a bicuspid AV as far as i understand without > mild-moderate stenosis/regurgitation ) I dont know if the cardiac hemodynamics is affected to an extent to cause LV and LA inflow tract problems.

I think what they are trying to see with the stress echo is what happens to the hemodynamics of the heart given a bicuspid when a larger cardiac stress is applied -- that may be the extent of what they want to see ( crossing all the t's etc. ). You should ask them what is the indication for the test -- you are entitled first because for any test they do you should be told why, second because this is a more "stressful" test not to be done without accounting for the condition of the patient i.e. in certain cases a stress echo is contra-indicated.

Hope everything goes well for you, keep us posted.....