Heart enlargement -

[Christina L]

As most of you know, my (post heart surgery) world was sent into a spin last November 1 with an echo showing "mild right atrial and right ventricular dilatation."

Okay, many second opinions later of "there is no enlargement, the chambers are upper limits of normal, etc.," I saw my PCP this afternoon and read some of the letters that were sent to him from the cardiologists about my heart.

They all pretty much say there is upper limits of normal size of the left atrium, right atrium and right ventricle - also that the "left and right atrial chambers appear to be between 40% and 50% of the volume of the ventricles." (this last statement sounds really scary to me - any interpretations?) I was told by another second opinion cardio that my heart has always been this size and it is subjective how a cardiologist wants to interpret things. This same cardiologist told me the heart was enlarged from all the years of moderate regurg (which it was moderate all through my 30s and into my 40s (had the surgery at age 44) and that is might shrink down some and may not - but it took years to get it that way and may take years to revert in size.

I am wondering if this is common in valvers - the heart size overall being enlarged. I always thought it was just the left atrium that enlarged from MVP or eventually the left ventricle. BTW, my left ventricle is fine.

My take on all of this is that I can't do a darned thing about this - just watch and wait - my heart will continue to enlarge, stay where it is (which is what one of the docs said - that it has been this way for years) or maybe even shrink down in size a bit. AND basically I shouldn't worry because it is going to get me nowhere.

I see the pulmonologist this Friday regarding my desaturating at night. My PCP told me today that who knows, the pulmonologist may think it is nothing to be concerned about.

Also, to add insult to injury, I am having more frequent flutters and arrhythmias of my heart. Are they from nerves or is it a self-fulfilling prophecy being that my cardio asked me if I was in a-fib as my heart was enlarged, I think implying that it was inevitable that I will go into a-fib.

Any comments or experiences (on heart enlargement pre and post surgery) would be most helpful to me right now - and prayers that I will be strong and accepting of whatever I'm told on Friday.

P.S. Both letters that I read today state there is NO pulmonary hypertension. I hope to get an x-ray on Friday and a definitive no from the pulmonologist on that issue.

Thanks everyone.

P.S. Ever since going on the oxygen while sleeping, I am having lightheadedness (not dizziness) during the day when I turn my head a certain direction. The PCP had no clue what this is from, nor did the cardio. Someone suggested stress. Any thoughts?

Christina L

 

[Karlynn]

Christine, I'm wondering if your light-headedness maybe do to sinus irritation from the oxygen. I have sinus issues and will sometimes get dizzy or light-headed when they are irritated. Since the whole sinus/inner ear can go hand in hand, that my best guess.

 

[Christina L]

Karlynn -

Karlynn -

that is a thought. I know I have constant postnasal drip from allergies to our cats. That could very well be the culprit.

Any thoughts on my upper limits of normal heart size?? I hope someone on VR.com can reassure me about this.

Christina L

 

[Phyllis]

that is a thought. I know I have constant postnasal drip from allergies to our cats. That could very well be the culprit.

Any thoughts on my upper limits of normal heart size?? I hope someone on VR.com can reassure me about this.

Christina L

Christina,
I think "upper limits of normal heart size" are the operative words here. Concentrate on the fact that it is still in the normal size range, always has been and probably will stay that way or get smaller.
All in all, it sounds like a great report.

 

[tommy]

Christine,

Don't know about the enlargement issue - wish you well. Phyllis makes a good point.

I started nasal irrigation a couple of weeks ago. Light saline solution. It's a little "uncomfortable" in the beginning but seems to help. My post nasal drip kept turning into something bigger. So far so good with the irrigation.

 

[Natanni]

Hi Christine

Nathan has "Cardiomegally" on his post-op discharge papers. It was known to us that his left ventricle had continued to enlarge over the last 5 years. About a year and a half ago, he had some changes that sent warning flags up that he was heading down the same path as his father, a transplant recipiant for an unspecific cardiomyopathy, with cardiomegally. I don't have Nathan's specific numbers on me at the moment, but would be more than happy to look them up for you. They Mayo felt that Nathan's overall enlargement was simply due to his aortic valve regurg which was moderate-severe, and that they had all hopes that all could be reversed with surgery. At his 3 month post op visit, his ejection fraction was worse following surgery, but he had been in atrial fib three times, and they were very specific about not wanting him to go back into a fib, feeling this was also related to the decreased ef. Nathan has 29 mm Carbomedics valve, which is definately on the larger end of the spectrum, and I am thinking this was relative to his heart size as well.

I will have his paperwork here on hand if there is anything specific you want to know. Ann

 

[OldManEmu]

Christine my heart was "huge" and this is my cardio?s description before surgery and the surgeon report described it as "grossly" enlarged. My LV especially was grossly enlarged internal dimension was 80mm; normal upper limit is 58mm. AVR Surgery was 11/2004 and my heart size and function has now returned to normal and the LV internal measurement is 46mm. The cardio was most surprised that my heart had been able to remodel back to normal after being so enlarged.

 

[Christina L]

Thank you for telling me your stories

Thank you for telling me your stories

and giving me some idea of what others on VR.com have had in the way of heart enlargement. I was beginning to think I was the only one. Ann, I'm sorry to hear about your husband, but maybe things won't progress any further.

Old Man Emu, congratulations on your heart going back down to a normal size! That is so great for you.

I have been told over and over that my heart has always been somewhat enlarged (the left ventricle is fine as far as I know) due to the years of moderate to severe regurgitation and the heart working so hard. I never held back on exercise or hiking mountain trails in all those years - I would pant and pant with exertion but would trudge on. So....my poor old heart had to compensate somehow.

I just hope I will be as lucky as you, OME (mind if I call you that? - hee) and my heart will start to at least shrink down a bit.

Right now it is all about mind over matter for me. I can't continue to worry about things that haven't even happened, as I am missing out on today.

Guess this is just all so much more scary as we are in the midst of the adoption process from China and I want to enjoy raising a little child, not be a burden to her OR to Wayne. At the doctor's office yesterday, I picked up a Working Mothers magazine (thought I should get an idea of what I am in for - ha) and just opened the magazine randomly to the middle and there was a story on a gal with cerebral palsy who had adopted a little girl from China. I think God was trying to tell me something.

Thanks all.

Christina L

 

[Christina L]

Old Man Emu -

Old Man Emu -

Are there any herbal or vitamin supplements that you take for your heart - have you been regularly exercising since your surgery and if so, what kind?

Thanks.

Christina L

 

[mmarshall]

wow oldmaneu....i thought i was one of the few/rare huge hearts out there. when they opened me up my lv was at 83mm and went down to 71mm by the time they closed me up. they were not sure if my heart would ever get back to it's normal size. i had my six month check up about 3 months ago and my lv was 58mm. the lv is in the normal range but there is still some restructing we are hoping for....ejection fraction, etc. i just figure that even if it never gets back to "normal"...i will just have a big heart...literally....i guess we all will.

 

[Emma]

Christina,
I know its different cos shes only small but Chloes heart was enormous at VR time - it was beating down in her abdomen and there were thoughts that it might not get back to normal even after VR. Luckily, after a couple of years it was back down to the 'upper end of normal', as yours. She started taking enalapril and a year later, its down to normal. She remains on enalapril to prevent it enlarging any more due to her two leaks.
Just sharing and empathising!
Love Emma
xxx

 

[Christina L]

Again, I know the left ventricle and left

Again, I know the left ventricle and left

atrium are the two chambers that tend to enlarge with valve disease, but what about the rest of the heart?? Is there anyone with an enlarged overall heart also? Like I said, all of my chambers are upper limits of normal size, except for the left ventricle.

Christina L

 

[Emma]

yep, Chloes was enlarged overall

xxx

 

[Christina L]

Thanks Emma!

Thanks Emma!

I have asked the cardios if there is any med that I can take that would take the stress off of my heart and they adamantly refuse to put me on any meds until absolutely necessary. Besides we tried calcium channel blockers, etc. for my PACs and they didn't work at all - just insanely lowered my blood pressure and my heart rate which is too low the way it is.

So glad to hear about Chloe - bless her heart!

Christina L

 

[mmarshall]

just a little fyi...not sure if this applies to everyone...but my cardio informed me that it usually takes about a year after surgery to see the full results. it takes about a year for the heart to "restructure"...get back to normal...if it is going to. did not rule out that there may be small improvements over time after a year...but for the most part...12 months post op was the time frame i was given.

 

[Emma]

We were told that too - and Chloes heart was down quite a bit within the year but did take 2 years to come right back down to normal size - it was massive though!
xxx

 

[mmarshall]

christina....my cardio has me on 25mg of coreg and 20mg of lisinopril for that exact reason...wants to take the stress off of my heart and help it get back to normal. it does do a number on your blood pressure so i'm not sure if that is an option. according to him....coreg is the wonder drug for the heart...but i think it is in the "wonder" category because it is not cheap..lol but seriously...it does appear to be helping me in my case.

 

[Christina L]

Chloe has youth

Chloe has youth

on her side. I pray that her heart will rejuvenate 100% and just be as good as new and serve her well for the rest of her LONG life!

Now my "old" heart may be a different story, but I am praying and hoping that if it can shrink back down a little, that it will, even if it takes a while. I just don't want it to keep going the other way.

Christina L

 

[Christina L]

Interesting MMarshall -

Interesting MMarshall -

I'm so glad for you also - that the meds are helping to calm your heart down so it won't work so hard, and the heart size is becoming normal again.

Isn't it interesting how all cardiology groups are different in what they prescribe or want done for a patient?

I will ask my cardio again about meds and see what he says. Right now I am being tested for hypothyroidism. Oh goodie. BUT, hey, if it is a reason for the arrhythmias, the sleep apnea, the "possible" heart enlargement, then maybe we can do something about all of these things.

Thanks again for the posts everyone.

Christina L

 

[Christina L]

Well I am two years post surgery

Well I am two years post surgery

and my heart isn't really budging in size at all. I know they can shrink back and they may not. My cardio also told me that many, many older folks die with a moderately enlarged heart that wasn't affecting them at all.

I think it is wild how Lance Armstrong's heart is 30% above the normal size of a heart. That just doesn't seem healthy, but for him, I guess it is.

Christina L