is it time

[sfconstrct]

Hi, I am a 50 year old stud with a bad aortic valve. I have been very active (till now) in competitive basketball, surfing. Been three years since I saw my cardiologist. Had my first dizzy spell couple weeks ago, playing basketball. Decided it was time to re-visit. Anyway echo showed that valve is getting worse .7 adjusted to .5 for size and weight. Just got the nuc. stress test, did the entire test without any problems to target heart rate of 160. Will get angiogram within the next two weeks. Anyway I was already making up my mind to get this overwith asap, cause thinking about it drives me nuts. Anyway my thought is that I am still going to the gym not playing basketball or surfing at the moment, but not pushing it doing the cardio machine thing. Sorry my questions is I am now rethinking ( will wait till after the angio) about rushing the replacement. I seem to be in pretty good shape still and am wondering if the adjusted gradiant is more consertivitive than the gradiant on the echo. I have read that at about .4 it is bad. I am just amazed that I am contemplating the surgery at this time as I can still push my heart rate and or excersise routine to a good level without feeling any problems. I am just concerned about the scale of the gradiant as mentioned above. If I am at .7 instead of .5 I would feel much better about waiting. Hopefully I have made my point. Sorry for rambling. Anybody out there surf after operations? Steve in Ca.

 

[sfconstrct]

Thanks, i did forget to mention that according to the echo my heart itself in still in normal perameters, resting heart 60 other than the tight valve, I do have regurg as well. The day I got dizzy I was probablly dehydrated too much vino watching survivor night.

 

[Marguerite53]

Welcome to our wonderful community. I do remember there is a surfer here and he had a memorable and optimistic line about the whole surfer/OHS thing. Ross??? who was that?

I'm 51 and not in good shape at all and have just been downgraded from moderate to severe stenosis at .7. My cardio is very conservative and has told me I can (don't need to rush) now see a surgeon. I'm going in Jan. 9th. I've been at moderate for at least 2 years (probably more, as I let the annual echoes slide for afew years). The dip down (from 1.2 to .7) was in the space of 2 years. I'm anxious to get it over with. I'm very ready.

You need to think about the fact that you are at the numerical measure (.7 is severe) and you ARE having symptoms. That dizziness was not the wine! Please, be clear on what your echoes have stated. Is there any enlargement of the heart? are there any abnormalities at all? Any changes over time from echo to echo. There may be more clues to your readiness than you have been made aware of.

We each have our own choices to make. Please just be certain that you have all the information you need to make the best choice.

Best wishes!

Marguerite

 

[epstns]

Another Steve? ? ?

Another Steve? ? ?

Hi, Steve, I'm another Steve. Welcome to The Waiting Room -- the virtual room in which many of us await our own turns at valve surgery.

I'm a couple of years older than you (58), have moderate to severe aortic stenosis, and am able to continue "controlled" physical activity. By controlled, I mean that I am allowed and able to do cardio exercise, which in my case means jogging about 20 miles/week at a 9:30/mile pace. I've slowed somewhat over the past 5 years or so, but that's life. I am allowed to do weight training, as long as I keep the weight down to 40 lbs. or so -- don't want to raise BP too much. I can do many reps, though. . .

What I've been told NOT to do is any sport or activity having a high "dynamic range." In other words, not to do things in which I would have to go from resting to full-speed instantaneously. This is too difficult for a heart with a stenotic valve to adjust to, and could be very dangerous. Thus no more basketball, football, most sports. I can do those things in which I can "ramp up" my heart rate, but not the rest. At the present my cardio is not worried that my usual exercise routine brings my heart rate up into the low 160's for extended periods -- he just says "If it doesn't feel good, stop." Sometimes I'll have to tone it down, rarely do I skip a scheduled day.

I do find that I am now more sensitive to water weight gain if I eat salty foods, and that it takes longer for my body weight to return to normal, but the cardio is reluctant to prescribe any diuretics beyond that which is combined into the Avalide I take for hypertension.

Sorry to bore you with a long dissertation, but the point I wanted to make is that each of us is different. That you've had some suspicious bouts that "may" be symptoms, I'd plan to have a "heart to heart" with your cardio about when it may be time to meet some surgeons. If you decide to wait, I'd remain in regular contact with the cardio for follow-up exams, just to be sure.

In any case, we're glad you've joined us. Make yourself at home here in The Waiting Room, and ask all the questions you want. I'd bet the information here is better than we get at most doctors' offices, and the people here are just plain wonderful.

 

[sfconstrct]

sf

sf

Thanks you guys, appreciate the advice, concern. I am in the care of a very good cardio. I will be getting the final test the angiogram within a couple of weeks. My cardio's name is David Kawanishi, a Yale grad, and at USC for 12 years now a part of Mission Internal Medicine, in Mission Viejo, Ca. I believe he told me the surgeon he prefers is Dr. Yokoyyama who operates out of St. Vincent and another hospital in L.A. As stated at first I just wanted (not really) to get this done asap, although he said probablly not for a year or so. I am now thinking depending on the outcome of angiogram of just letting him follow me and doing it as late as possible, am hoping for the inevasive stuff to happen. If not so be it. I can excersise at the present time pretty, I am in good shape and am fit. Staying away from basketball as the quick start and stop thing. Will probablly get back in the water when it's mellow and just pace myself. So far my heart is fine in normal range, changed lttle in the last three years according to the two echos I have had. In the nuc, stress test took the whole program to get me to 160. Still felt fine. I guess that is what has me rethinking whether or not to just get it done or wait. I am having a hard time believing that it is close to the time when I can function well at a above average level without any problems. The only time I got dizzy was the first one, while playing basketball pretty hard second game in a row, too much vino the night before as well, was ok till we stopped then the gym started spinning. Nothing since. Thanks again you guys for all the advice and or help. Peace To you all! Steve in So. Ca.

 

[RandyL]

Good to see you found this place. I have been on here for a couple of months now and have learned a lot from these fine people here.

I can't tell you what to do since I am still learning about all this. I will tell you that I have aortic stenosis myself with a echo of .8 which was in September. My cardio recommended surgery for me based on this and some sypmtoms I have ie. fatigue, shortness of breath, andI now get a little light headed when I first stand from sitting for a long time. I am scheduled for AVR on Jan 5th of 2006. So it is coming up soon. BTW I am 54, 25lbs overweight and am not in very good shape and smoked for 35 years until just quitting in September.I gained 15 lbs since quitting smoking. It sounds like you have a good Doctor and I would just take his advice. If the symptoms start than I would look harder at surgery based on your reading.

 

[jax3172]

Based on your numbers...

Based on your numbers...

...it seems you're gonna need the valve job very soon. I would get it done asap while you're still in good shape. Lots of good resources and good people on this site to help you determine type of valve, hospital, surgeon, what diagnostic tests you may want done, etc. Good luck.

Jack

 

[Mary]

Thanks you guys, appreciate the advice, concern. I am in the care of a very good cardio. I will be getting the final test the angiogram within a couple of weeks. My cardio's name is David Kawanishi, a Yale grad, and at USC for 12 years now a part of Mission Internal Medicine, in Mission Viejo, Ca. I believe he told me the surgeon he prefers is Dr. Yokoyyama who operates out of St. Vincent and another hospital in L.A. As stated at first I just wanted (not really) to get this done asap, although he said probablly not for a year or so. I am now thinking depending on the outcome of angiogram of just letting him follow me and doing it as late as possible, am hoping for the inevasive stuff to happen. If not so be it. I can excersise at the present time pretty, I am in good shape and am fit. Staying away from basketball as the quick start and stop thing. Will probablly get back in the water when it's mellow and just pace myself. So far my heart is fine in normal range, changed lttle in the last three years according to the two echos I have had. In the nuc, stress test took the whole program to get me to 160. Still felt fine. I guess that is what has me rethinking whether or not to just get it done or wait. I am having a hard time believing that it is close to the time when I can function well at a above average level without any problems. The only time I got dizzy was the first one, while playing basketball pretty hard second game in a row, too much vino the night before as well, was ok till we stopped then the gym started spinning. Nothing since. Thanks again you guys for all the advice and or help. Peace To you all! Steve in So. Ca.

Why don't you wait and see what the surgeon recommends? I think you will get a definite recommendation one way or another. If he thinks you can wait, then I'd wait, and try to put it out of my mind.
One of the worst things about this process is the amount of time squandered over useless worry. Get an expert's advice, and then follow it!

 

[sfconstrct]

Thanks Mary for your candor, I agree I pretty much will take the advice of the cardiologist and surgeon, one more test left. Anyway maybe I wasn't clear for all. First I made a mistake on my origional post. My valve was at .9 not .7. He then said adjusted to a .5 for height and weight. So my real question is does anybody know what the bench mark for the valve measurement is. Are you guys aware of the acutal measurement by echo, vs. the adjusted measurement. That brings my other point. I read of all the people that are tired out of shape, overweight etc. of which I am not. Thus back to my bottom line question. I still feel good can exercise at a good level, took the treadmill to the max. incline to get to my target rate of 160 set by the cardio. So again I am wondering am I really at a point 5 or a point 9, because that is the way I feel and perform? Just wonder what is the right bench mark or is this just cardiologist to cardiologist, mine is a preventional cardiologist. I just would hate to think I was premeture when I could have waited a year or more without damage to the heart muscle, and miss out maybe on something new or inevasive. Thanks to all. Steve in So. Ca.

 

[ALCapshaw2]

It's not clear to me what your numbers mean since you didn't say what parameter you are reporting or what units are being measured.

IF you are talking about Aortic Valve effective area, then 0.8 sq cm or less is generally considered a 'trigger' to recommend surgery.

It is NOT uncommon for conditioned athletes to feel NO SYMPTOMS (because their bodies can operate more efficiently on less oxygen) yet be close to serious heart damage or failure. Surely you've heard of athletes that fall dead on the basketball court or football field? A valve that has closed off is one possibility. THAT is why Doctors tend to go by the NUMBERS (with due consideration given to symptoms if they are present).

As TobagoTwo has often said, "The worse it gets, the faster it gets worse" so don't dismiss your diagnosis and play till you drop. It's best to operate BEFORE your heart begins to enlarge from having to work too hard to pump blood through an ever decreasing opening. Eventually a point is reached where PERMANENT DAMAGE is done to the heart muscles. At that point, valve replacement will fix your valve problem but will do nothing to alleviate damaged muscles / walls.

Listen to your docs, especially the surgeon(s). They (surgeons) like to operate before the heart becomes permanently damaged.

End of sermon.

'AL Capshaw'