How does BAV impact wider heart and is this permanent? Experiences and views please

[Marcuse807]

So, just got the results of my recent echo. And it doesn't look good, compared to last year. Seems my heart is starting to detoriate in many ways.

AR remains mild, but because the jet is eccentric they can't really tell how bad it is.
Aortic root - 40mm, up from 38mm a year ago
STJ - 30mm, same as last year
Ascending Aorta - 36mm, from 35mm last year

This doesn't seem too bad. What is bad is the following:

Left Ventricular diameter - 48mm, down from 54mm last year - I guess due to the ACE I started taking a few months before
PWD - 11mm - up from 9mm a year ago
IVSD - 11 mm - up from 9mm a year ago
These reading seems to be within normal, but when you add the widths together and divide by diameter, you get 0.46. This means I now have hypertrophy!! I'm baffled that the diameter has gone down but the thickness has increased so much.

Mitral valve regurgitration - mild - up from trivial last year
While the E/A ratio seems okay (1.2) it seems the deceleration time (?) is much slower than it should be 295 m/s

Sorry for the technical jargon!

Is this general deteoriation normal for BAV. I was assuming it would just leak more, the aorta would enlarge and so would the ventricle. But the damage to the mitral vale and the thickening of the heart, and so much in so short space of time, worries me.

At what level does the damage become permanent?

I am in the Uk and it seems have to wait up to three months to speak to the consultant about my new reading. I have decided to get a private consultation instead. I expect to told just wait and see...but, the changes seem dramatic.

Sorry for the long mail and thanks for all the helpful support you have all given to previous mails.

 

[Midpack]

Hi! Just relax!

I am not a doctor, of course, but i personnally do not see any big deterioration. Echo measures are not exact to the milimeter. For instance, 36mm is basically the same reading as 35mm for your ascending aorta. Your mitral valve is not deteriorating. Mild regurgitation is unimportant (an usual finding is many completely normal hearts). Your heart walls seem to have thickenned a little. But may be the 9mm measure was a little underestimated and the 11mm has been a little overestimated, so the change may not be important. Echo values are VERY dependant of the technician, the equipment, etc. And they are measuring a beating muscle, looking at images that are pretty blurred (did you look at the monitor?...)

Do not overthink and calm down. Your cardiologist will ease your mind.

 

[Ryan CA]

Hi Marcuse,

Enlargened left ventricle, thickening of the walls etc. is pretty normal. Before my surgery I had both occurring; now 9 months later both have COMPLETELY receded to normal measurements.

I have also had mild mitral valve regurgitation and have been told to go about my life and activities without worrying about it. Of course, we will always track these things to be safe, but I don't think mild mitral valve is too much of a concern for the surgeons. I have been cleared to resume any physical activity I desire, with the caveat that they prefer I don't do any "Power lifting", in spite of the mild regurg in the mitral valve.

And to answer the question about general deterioration being normal for a BAV...it was for me. The key was to get it repaired long before any deterioration became irreversible.

 

[Paleowoman]

I am in the Uk and it seems have to wait up to three months to speak to the consultant about my new reading. I have decided to get a private consultation instead. I expect to told just wait and see...but, the changes seem dramatic.

Make sure you write down all your questions and concerns so that you make good use of your private consultation - after all you'll be paying the guy. I have Bupa and some consultants are very generous with their time when you see them privately - hope you see a good cardiologist.