D
Der Biermeister
Just call me DB 
I am going to have several questions, so bear with me please.
I am 62 year old man, very heavy, non-smoker for past 15 years. Had two stents put in last November which I thought would correct my chest discomfort. Been walking 3 miles per day, 6 days per week for last 9 months. However, I get winded quite quickly and have to stop often for short rests. In addition to the breathlessness, I experience what feels like stable Angina (more of an ache actually) down both arms and in the chest and jaw area.
These symptoms have actually been going on for several years and I've always attributed them to be greatly overweight. 15 years ago, I was diagnosed with OSA (sleep apnea) and went on CPAP. I also underwent a battery of tests. The endocardiogram seemed to suggest I had LVH, or at least the beginnings of it. Been on Lisinopril ever since as my doc told me taking an ACE inhibitor could stop it from getting worse and might actually reverse the disease. My major complaint at that time was High Blood Pressure (malignant).
I also began a walking program at that time, and that in conjuction with a reduced fat diet, allowed me to lose 65 lbs in about a year and a half. OSA was cured. I was walking 4 miles per day at that time and could do so without ANY angina. I walked this routine for over 9 years and was in great shape at least for me. However, abouit 5 years ago, I blew out my right knee and four years ago ended up with a Total Knee Replacement. The recoup lasted a while of course and then I just got lazy and put all my weight back on plus some.
8 Days ago, in the middle of our heat wave, I experienced severe respiratory distress, thinking I was having a heart attack. Rushed into the emergency room and my doc happened to be there and he did another catheterization and found no blockages in my arteries. There was no heart attack but my O2 levels were down quite a bit and they surmised I had fluid either in (or around?) my lungs and this was causing my distress (felt like suffocation).
They immediately started me on heavy diuretics and also did an echocardiogram plus a similar test on legs looking for clots.
Now, here is where it gets interesting - my doc and hundreds of others have listened carefully to my heart -- and never discovered a murmur. But a close listen this time turner up a murmur. I had told him that I was also concerned over my low diastolic pressure (around 40 now for the last few months) where it had always been up around 60-70 before. He didn't think that was anything of significance, but he consulted another doc ( head of Pulminary) in the hospital and when I told that doc the same thing, he said "hmmm, that IS possibly significant and needs to be explored". Well, EVERY piece of literature I can find online shows that as being the sine qua non of Aortic Insufficiency -- a large delta between Systolic and Diastolic bp with the Diastolic being quite low.
A chest xray and also the echocardiogram do NOT show any significant enlargement of the LV, and I guess also from the different flow-rate data they got from the endocardiogram, there appears NOT to be any CHF.
I've been home for four days now and still feel like crap. Although, I visited my sleep lab today and am showing a slight improvement in my O2 levels. Where last Friday (my last day in the hospital) my O2 was 95 sitting at rest and 90 while walking, today I was 95-96 resting, and 92-94 walking/standing. But I don't feel any better. I feel fine sitting, but ANY exertion at all, and I have to stop, hold onto something for a minute or two.
My Questions:
1. My doc seems to think that treating with drugs will be successful. Everything I read however, states that IF the person is experiencing symptoms, and I sure am, then a valve replacement will be necessary. Your thoughts?
2. How long will I have to wait to determine if the drugs are turning this thing around?
3. I see a lot of new techniques being done at places like Univ Of Maryland. Somewhat less invasive, and even attempts to repair the valve instead of replacement. Are these new techniques worth pursuing vs. undergoing the standard open heart surgery?
4. I had SEVERE Scarlet Fever in 1947 when I was 4 years old. Penicillen was new then but it turned out I also was severely allergic to it. Not sure how much got into me, or if it did any good. While my family doc said that I did NOT have rheumatic heart disease, is it possible that I was somehow left with a bit of a rheumatic heart?
I am going to have several questions, so bear with me please.
I am 62 year old man, very heavy, non-smoker for past 15 years. Had two stents put in last November which I thought would correct my chest discomfort. Been walking 3 miles per day, 6 days per week for last 9 months. However, I get winded quite quickly and have to stop often for short rests. In addition to the breathlessness, I experience what feels like stable Angina (more of an ache actually) down both arms and in the chest and jaw area.
These symptoms have actually been going on for several years and I've always attributed them to be greatly overweight. 15 years ago, I was diagnosed with OSA (sleep apnea) and went on CPAP. I also underwent a battery of tests. The endocardiogram seemed to suggest I had LVH, or at least the beginnings of it. Been on Lisinopril ever since as my doc told me taking an ACE inhibitor could stop it from getting worse and might actually reverse the disease. My major complaint at that time was High Blood Pressure (malignant).
I also began a walking program at that time, and that in conjuction with a reduced fat diet, allowed me to lose 65 lbs in about a year and a half. OSA was cured. I was walking 4 miles per day at that time and could do so without ANY angina. I walked this routine for over 9 years and was in great shape at least for me. However, abouit 5 years ago, I blew out my right knee and four years ago ended up with a Total Knee Replacement. The recoup lasted a while of course and then I just got lazy and put all my weight back on plus some.
8 Days ago, in the middle of our heat wave, I experienced severe respiratory distress, thinking I was having a heart attack. Rushed into the emergency room and my doc happened to be there and he did another catheterization and found no blockages in my arteries. There was no heart attack but my O2 levels were down quite a bit and they surmised I had fluid either in (or around?) my lungs and this was causing my distress (felt like suffocation).
They immediately started me on heavy diuretics and also did an echocardiogram plus a similar test on legs looking for clots.
Now, here is where it gets interesting - my doc and hundreds of others have listened carefully to my heart -- and never discovered a murmur. But a close listen this time turner up a murmur. I had told him that I was also concerned over my low diastolic pressure (around 40 now for the last few months) where it had always been up around 60-70 before. He didn't think that was anything of significance, but he consulted another doc ( head of Pulminary) in the hospital and when I told that doc the same thing, he said "hmmm, that IS possibly significant and needs to be explored". Well, EVERY piece of literature I can find online shows that as being the sine qua non of Aortic Insufficiency -- a large delta between Systolic and Diastolic bp with the Diastolic being quite low.
A chest xray and also the echocardiogram do NOT show any significant enlargement of the LV, and I guess also from the different flow-rate data they got from the endocardiogram, there appears NOT to be any CHF.
I've been home for four days now and still feel like crap. Although, I visited my sleep lab today and am showing a slight improvement in my O2 levels. Where last Friday (my last day in the hospital) my O2 was 95 sitting at rest and 90 while walking, today I was 95-96 resting, and 92-94 walking/standing. But I don't feel any better. I feel fine sitting, but ANY exertion at all, and I have to stop, hold onto something for a minute or two.
My Questions:
1. My doc seems to think that treating with drugs will be successful. Everything I read however, states that IF the person is experiencing symptoms, and I sure am, then a valve replacement will be necessary. Your thoughts?
2. How long will I have to wait to determine if the drugs are turning this thing around?
3. I see a lot of new techniques being done at places like Univ Of Maryland. Somewhat less invasive, and even attempts to repair the valve instead of replacement. Are these new techniques worth pursuing vs. undergoing the standard open heart surgery?
4. I had SEVERE Scarlet Fever in 1947 when I was 4 years old. Penicillen was new then but it turned out I also was severely allergic to it. Not sure how much got into me, or if it did any good. While my family doc said that I did NOT have rheumatic heart disease, is it possible that I was somehow left with a bit of a rheumatic heart?
