Echo Results

[bobcatrel]

3 years ago I was diagnosed with aortic stenosis. The aortic diameter was measured at 1.2 cm at my first echo. Over the past three years I have been told that my valve is significantly worse and last spring the aortic diameter was 1.1. Instead of yearly checkups it was suggested that I have quarterly checkups and 6 month echo's.

At my most recent echo, the aortic diameter was 1.4. I have had the same technician administer the echo each time. Anyone have any ideas as to why the reading would increase? Is there a + or - accuracy to the test? From what the cardiologist had told me it won't get better.

I'm wondering if I should be optimistic!

 

[Ross]

While it's wishful thinking, no it will not get better. As for the measurement increasing, echos are only good for the exact time they are taken. There are going to be variations in the measurements each time. You might be in line to have a TEE done instead to get the true picture of how bad things are. You might want to discuss that with your Card.

 

[Marguerite53]

Hello.

Hello.

Bob. You might want to get copies of your echo reports. The doctor must give you copies if you request them. You will find all kinds of interesting statistics on them, and plenty of people at this website who can help you decipher them. We, here, can only help. Our information does not compare to that of your cardio and eventually the surgeon. What I have found on this website is enough information to be able to feel like I can go to my doctors with intelleigent, well-thought out questions.

My understanding is that once the stenosis is there, it won't go away on it's own. Eventually there will be surgical intervention. You really need to get clued in on what symptoms you should be watching for as they are also important elements in determining where you stand.

Dig deeper into this website, there is a wealth of comfort and information here. Keep asking questions and others will refer you to places where you can gather more info.

Good luck and don't worry!

Marguerite (still waiting, too!)

 

[tobagotwo]

If you've been symptomatic, and have had readings around the 1.1cm² mark, they're probably close to accurate. If you're not symptomatic, then maybe they've unintentionally led you down the garden path. The first thing to consider is what reasons, other than the echo valve opening number, would they have to think you have a stenotic valve? A murmur? Other heart issues or symptoms?

Assuming a certain, base level of accuracy, I am thinking wet blanket. Although I wish it were otherwise, I agree with your cardiologist, as I've never read or heard of a steadily developing stenosis spontaneously improving. The only way I could imagine it, is if a big chunk of calcification broke off. And you would surely know if that happened, as it would almost have to be noticeably damaging, wherever it landed. Or you've stumbled across a miracle cure (which I will pay handsomely for...).

Sometimes the read isn't as good, due to movement, time spent, changes in body weight/composition, amount of heart activity (movement in your chest), etc. Or the tech has a bad day. Or there's some anomaly of your heart that makes it difficult to read (although that should have shown up, too).

I would ask the cardiologist for his take on which numbers are accurate, as there is a world of difference between 1.1 and 1.4, as far as your heart's condition is concerned. Other than redoing the echo, the most likely double-check for this would be a TEE or a cardiac catheterization.

Best wishes,

 

[KimC]

I've learned that things can change quickly ... either I had a terrible echo reader six months ago, or suddenly atherosclerosis developed during a difficult pregnancy.

My aortic valve was supposedly "floppy" last year, and this year it's thickening. My AVO is 1.5, which puts me at the mild stage of AS but given my symptoms, I'm wondering if I should have a cath to double-check. (The echo I had in Cleveland only tested for coronary spasm but revealed a 49% EF; my recent echo said my EF was 63%).

Variations are a part of the art of medical science.

Best,

 

[epstns]

Hi, Bob -
The others, I think, are giving you the straight scoop. Stenosis has not been known to improve, at least nobody I've met here has ever had it happen. Readings have, as the others noted, been known to vary in accuracy. My own (very non-professional) opinion is that if you have had several echo readings in the same range, say 1.1 to 1.2 square cm, then this one at 1.4 is what the statisticians would call an anomoly. Probably not as accurate as the others, for the reasons everyone mentioned.

I'm in about the same boat you're in -- mid to late 50's, active, aortic stenosis with valve area around 1 to 1.5 cm, and I have been advised to do annual echo's, semi-annual check-ups, and watch for symptoms very carefully. If we don't have symptoms, then all we can do is watch and wait.

So, that said, welcome to The Waiting Room -- the virtual waiting room at vr.com where many of us are awaiting our turn in the Operating Room.

 

[PapaHappyStar]

Echo Accuracy

Echo Accuracy

I am a physics student so I got interested in the accuracy of the ultrasound determination of the valve area, this follows directly from a measurement of the flow pressure gradient ( or max. jet velocity ) and is related to the dimensions of the outflow tract. Although the degree of stenosis probably dosent change in reality, a fluctuation in any of the other factors ( maybe changes in the aortic root ) can cause the measurement to fluctuate. Thats why this number shouldnt be an absolute guide to the condition of the disease, the clinician should check out symptoms and other numbers to see whether they correlate. I would say there is (conservatively) at least a 20% uncertainty in the calculation.

The gist: You should look at other indicators of disease severity ( EF, left ventricle size, wall thickness etc. ) and ask your cardiologist about them...

( I also have AS at the same computed valve area )