Got my detailed results back today...

[Guest]

Hi everybody, I was just recently diagnosed with a bicuspid aortic valve, with mild regurgitation. I'm 30 years old, 5'11'' and way too overweight (working on it). I just received the copy of my results and I'm relatively concerned...it doesn't help the cardiologist that I sat with didn't explain any of the results outside of WHAT a BAV is, and WHAT regurgitation is...and I'm trying actively to not google symptoms and make myself crazy. I do know some of these #'s are not so good, while some are. It should also be noted that I did a cholesterol test recently and everything in that regard is perfect, outside of a "low" cholesterol level (125).

Let me know what you think.

Conclusions:
1. Left Ventricle size, wall thickness, and systolic function are normal with an EF greater than 55%
2. There is "mild aortic regurgitation"
3. Aortic valve is bicuspid and is mildly thickened.
4. The "ascending aorta" is mildly dilated at 3.8cm (that's the one that makes me nervous)

Findings:
Left Ventricle: (See above)
Right Ventricle: RV appears normal in size and function
Left atrium: Size is normal
Right atrium: Size is normal
Aortic Valve: "Mild aortic calcification without stenosis". Mild aortic regurgiation.
Mitral Valve: Trace mitral regurgitation. Buckling of anterior mitral valve leaflet.
Tricuspid Valve: trace tricuspid regurgitation present. Right ventricular systolic pressure is normal <35mmHg.
Pulmonic Valve: Normal
Aorta: Root size is normal, see above about ascending aorta
Pericardium: Normal, no effusion.
ASD/VSD; Interatrial and interventricular: intact.

There's a ton of numbers too (2d, m-mode and Doppler), but I won't post those unless requested as even looking at these things is making my head spin lol.

 

[James H]

Apparently I didn't log in to post this! Whoops.

 

[jjay32]

Hi James, overall the numbers are not that bad. The aorta is mildly dilated at 3.8. my guess they will follow up once a year or every other year.. they will look at growth rate of the aorta. The aortic valve can thicken this can cause stenosis (smaller valve opening or regurgitation ( flaps don't close all the way allowing blood to flow back into the chamber it just came from) Mild is good, ratings generally go from mild to moderate to severe. to put it into perspective, I started getting yearly echo's in 2008. MY ascending aorta in 2008 was at 4.6cm, it increased to 4.8 in 2013 and my last test has me at 4.9cm. I am looking at surgery around 5.0cm. My bicuspid aortic valve just went to severe in one of my measurements (I have aortic stenosis with moderate regurgitation.) so i think i am approaching that time where surgery most likely will be within the next year. The good thing is that you are now aware of the problems and it will not sneak up on you. Keep getting monitored and you will then know when it is time to to take action. I have been in the waiting room for 8 years and it just now looks like it is time to get it fixed. If you have more questions, please don't hesitate to send them my way.
jerome (jjay)

 

[AmyBL]

Hi James,

I admit, I came to VR because of an aneurysm, without other problems (other than the bicuspid valve). There are many members who strike me as highly knowledgable about anatomy and heart function. But from what I have learned here, your numbers don't seem "bad" at all. Ejection fraction is a measure of how much blood is pumped out of the heart and your score is in the "normal" range.

The aneurysm at 3.8 is smaller than mine was when I foundVR. If not mistaken, it was 4.6. I was told to come in every six months to get it measured, and I did that like clock work. I am not aware of surgeons recommending repair at 3.8 -- the measurement that would mean surgery for me was 5.0. Did your physician say anything about how often to come in, or a size that would require repair? I learned that the decision to repair can be based on different criteria, but I have never read anyone having surgery on the aorta at 3.8.

It is scary to learn of this condition but it can have a silver lining -- for me, walking around knowing I had a condition that could be quite serious encouraged me to assess and reassess my life. I hired a coach/trainer and made a serious commitment to health. I worked out 4 or 5 times per week and ate healthier. I had a sleep study, cut back on caffeine, and got more sleep. Four years after my diagnosis, I felt better and was healthier than I had been in years. Being healthy is very important to me now! I honestly think the diagnosis was the motivating factor that helped me get my priorities straight.

Who knows -- you may not need surgery. Many people on VR report multiple years without ever needing surgery. For me, by the time it became necessary, I loved how healthy I had become and saw the repair as mostly positive (yes scary, but I had confidence in my surgeon). So far, the recovery from surgery has been smooth.

I am glad you found the forum, and that you are taking advantage of the wisdom among the members.

Amy

 

[Paleowoman]

Hi James - I can't comment on your ascending aorta but I can see that it clearly says your aortic vlave has mild calcification and no stenosis. The numbers which you see on the report to look at with regard to the aortic valve are the aortic valve peak and mean pressure gradients, but since your cardiologist didn't say anthing about that I would guess it is still in the mild stage.The numbers should be there on the measurements page of the report. Is your cardiologist doing follow up echoes in a year or two ? Keep the report so you can compare.

 

[James H]

Amy/Paleogirl, my cardiologist told me that he really wasn't concerned and to just come back in a year to get another test done. Unfortunately, I'm not a fan of his "bedside manner" as I thought he was way too fast to just blurt out what was wrong w/ me and didn't seem to want to spend the extra time to sit and actually explain to me the details. I only knew about the 3.8 cm aorta because of this test, in example. I have a second opinion booked at the end of the month with the head of the local heart center, so i'm hopeful at that time to get a better understanding of the situations.

 

[James H]

here's the #'s I was given

2d Scan
IVSd- 1.0cm (0.6-1.1)
LVIDd-5.0cm (3.5-5.7)
LVPWd-1.0cm(0.6-1.1)
EDV(Teichi)-118ml
LVIDs-3.4cm (2.2-4.0)
ESV(Teich) 47ml
EF(Teich) 60%
%FS 32%
SV(Teich) 71ml
LA Diam- 3.2cm (1.9-4.0)
Ao Diam- 3.7cm (2.0-3.7)
Ao asc- 3.8 cm

M-Mode
Ao Diam.- 3.6cm (2.0-3.7)
LA Diam.- 3.9cm (1.9-4.0)
AV Cusp- 2.5cm (1.5-2.6)
LA/Ao 1.08

Doppler
RE Vmax 2.22m/s
TR maxPG 19.66mmHg
RAP 10.00mmHg
RVSP 29.66mmHg (<35)
MV E Vel 0.78* m/s (<1.40)
MV A Vel 0.75* m/s
AV Vmax 1.52 m/s (<1.80)
AV maxPG 9.25mmHg
AR PHT 672ms
AR Dec Time 2318 ms
AR Dec Slope 1.1m/s2

 

[Paleowoman]

Hi James - sometimes these doctors don't have a good bedside manner. For example, the cardiologist who found my bicuspid aortic valve on echo said "Oh you have a bicuspid aortic valve - you'll need an operation one day" - and that was it ! He did apologise at the next consultation !

Your readings don't look quite as how mine are expressed, but I guess that "AV maxPG 9.25mmHg" means your peak pressure gradient in the aortic valve is 9.25 mmHg - if so that is very mild so nothing to worry about at this stage. Keep it as a record to compare with next year.