Disappointing result after check up

[Peachy]

Hi all,

Had my checkup today with Cardiologist. Two and a half years since my AVR. Everything was fine until I had my echocardiogram.
Cardiologist said that my valve was working fine and the leaflets were performing as normal. Then the but came .... he said that something had increased since last year. Something to do with pressure. It had risen by 25 mm of mercury. I am to get another appointment in 6 months instead of a year and get another reading and take it from there. I'm now very confused. How can my heart valve be in perfect working order but the pressure has increased. Can anyone shed any light and what might the remedy be? I feel fine and do lots of exercise but I've to contact the Dr if I feel dizzy or get tightness in the chest.

 

[tobagotwo]

That might be the peak or mean gradient pressure of the blood flow, usually measured through the aortic valve.

The question then would be if there is stenosis. If you had a copy of all of your echo results since surgery, that would help you to determine which thing has changed.

Best wishes,

 

[scottvant]

Hey Peachy--

The "pressure" you're referring to might be the "pressure gradient" across the valve--that is, the difference in blood pressure in the ventricle vs. the pressure on the other side of the valve. If the valve is stenotic, i.e. not opening all the way up, the difference between the two measured pressures will increase, as the blood trying to exit the chamber runs into resistance from the valve not opening up all the way.

This may or may not be something that'll need to be treated, depending on how severe it is and if it causes symptoms in you.

At the moment, my cardio is "watching" the gradient on my RV side, because of the pulmonic homograft I got during my Ross. No real life-interfering symptoms, just occasionally, extra time required to "catch my breath" after a heavy workout... (Also shows "normal" on echos..)

Scott

 

[Yaps]

The pressure

The pressure

things are playing with my mind...

 

[hensylee]

Peachy, I am so sorry to hear this. You have done so well. Hang in there - worrying is not a good thing and you need some answers.

I suggest you go to about.com and look for heart disease/cardiology (Dr Rich). Dr Rich is a real doctor and will answer your question if he can - won't give you any advice, but will answer your questions.

 

[ALCapshaw2]

Hello Peachy,

I recommend that you obtain copies of ALL of your Echocardiograms and chart all of the parameters. Check the reference section to find a link to what they all mean.

Cardiologists often only look at the latest readings and this can cause them to miss important CHANGES with time. Charting allows you (and your cardiologist) to see the 'whole picture'.

Your cardiologist is best suited to explain what may be causing these changes. You may want to ask him about the expected longevity of your valve in someone your age and what he would recommend if / when it needs replacing.

'AL'

 

[bvdr]

Hi Peachy,

If I haven't ever told you before, I love your avatars! I used to love the one where you were swinging too.

I'm sorry you had one of those check-ups that brings up more questions than it answers. I'm glad your next appointment is only six months from now so you can find out what the trend of your pressures are. As you know, sometimes echoes aren't all that accurate and maybe (hopefully) that is the case here.

As Bob and Al have mentioned, do get a copy of your reports so you can see for yourself what changes have occurred.

 

[Mb]

Peachy:

Sorry to hear of this recent event. My husbands' recent echo said also" transmitral and transaortic gradients have increased. He has two St. Jude valves. Funny, if those areas are becoming stenotic, as on his OTHER side, his tricuspid valve doesn't close all of the way due to dilation of the right atria and ventricle. So that side is wide open, and the other side is closing? Where are the experts here? Heehee.

Best wishes for your next checkup. - Marybeth