Mechanical valve ticking

[Patr83]

Hello everyone I am 41 and 6 months post surgery. I opted for the mechanical valve for the durability but sometimes I struggle at night with the ticking sound I hear. Does anyone have any advice on what you do to drown it out a bit? So glad I found this page.

 

[Windfinder]

Is it the noise or the thumping that bothers you? Or both? People in this forum say it gets a little bit better with time but mostly they say you get used to it. I’m just 7 weeks post op and for me more than the noise I’m trying to get used to the thump, sometimes it really feels like someone is hammering my sternum from inside…I wish it was just the noise. Some people say the on-x may be a bit noisier than the st Jude…but I think it really depends more on your anatomy.

 

[Patr83]

Is it the noise or the thumping that bothers you? Or both? People in this forum say it gets a little bit better with time but mostly they say you get used to it. I’m just 7 weeks post op and for me more than the noise I’m trying to get used to the thump, sometimes it really feels like someone is hammering my sternum from inside…I wish it was just the noise. Some people say the on-x may be a bit noisier than the st Jude…but I think it really depends more on your anatomy.

For me it’s the ticking late at night I hear in the back of my head. I am so thankful I hear it but maybe I am just not used to it yet. Thank you for reading my post!

 

[pellicle]

Hi and welcome

Does anyone have any advice on what you do to drown it out a bit? So glad I found this page.

6 months is still recent enough that some tissue may still not have fully settled down.

Myself my valve sound conducts through my body worst when lying on my left side, which I did for some years. But recently I've developed tachycardia which is definately triggered by right side sleeping, so I've become a left side sleeper again.

¯\_(ツ)_/¯

I don't really mind the thudding, but the 120BPM ticks me off, wakes me up and I have to roll over :-D

I hope you find some accommodation which works for you.

 

[Patr83]

Hi and welcome


6 months is still recent enough that some tissue may still not have fully settled down.

Myself my valve sound conducts through my body worst when lying on my left side, which I did for some years. But recently I've developed tachycardia which is definately triggered by right side sleeping, so I've become a left side sleeper again.

¯\_(ツ)_/¯

I don't really mind the thudding, but the 120BPM ticks me off, wakes me up and I have to roll over :-D

I hope you find some accommodation which works for you.

Thank you! For your feedback!

 

[christopherj]

Hello everyone I am 41 and 6 months post surgery. I opted for the mechanical valve for the durability but sometimes I struggle at night with the ticking sound I hear. Does anyone have any advice on what you do to drown it out a bit? So glad I found this page.

My daughter has one of these which I now keep close. https://purrble.com/

 

[Warrick]

I struggled with the sound also, what iv found that works best for me now is instead of the mental fight not to hear it I focus on listening to it and generally the next thing I know is I wake up in the morning.

 

[Patr83]

Thank you for the responses! Trying to explain this issue to those who don't understand is frustrating and I am thankful I found this forum to get input from those who are going through this.

 

[Chuck C]

Hi Pat and welcome to the forum.

I noted that in another post you indicated that your EF dropped all the way down to 15% and has since partially recovered to 40%. With your EF dropping that low, I expect that you probably had significant, possibly severe, LVH (left ventricular hypertrophy) heading into surgery. Do you happen to know if this was the case? Most who go into valve surgery due to AS have LVH, to one degree or another, due to the adaptions that the left ventricle muscles make to attempt to get sufficient blood to the body in the high pressure environment created by severe AS.

The good news is that after surgery, generally remodeling occurs, and the LVH reverses. For some it reverses back to normal, but typically depending on how far the LVH progressed, it may not reverse all the way back to normal and there may be some residual LVH.

The reason why I bring this up is that I recently read a study indicating that LVH is associated with a louder heartbeat. This could explain a few things. 1) It could explain why many hear a thumping after surgery. Most report that the thumping gets much better over time, which could be explained by LV remodeling. 2) It could explain why some people do not have issues with thumping and clicking sounds and others do. Some remodel to normal LV size and some have some level of LVH even years after surgery. Probably a number of factors as to whether the heart fully or partially remodels, although I would suspect that the #1 driver would be how far the LVH progressed and #2 might be age of the patient, with younger patients likely having more ability to remodel.

There may be other factors contributing to the loudness of the thumping, but based on a few recent papers I read, I suspect LVH and residual LVH might play a role. The good news is that the heart continues to remodel for a couple of years after surgery. So, to the extent that this is playing a role, there is good reason to hope that it will improve for you. Others report that it improves, so regardless of whether it is driven or partially driven by LVH, you have reason to hope that it will improve with time.

If you're interested, I'll try to dig up a paper or two regarding this and link them when I get some time in the next day or two.

 

[Patr83]

Chuck, thank you for reaching out! I did have severe LVH and it is trending in the right direction now that we have medications squared away. It is not so much a thumping of my heart but the ticking noise the valve seems to me making. Prior to my surgery I could hear and feel my heart beating and working much harder which left me fatigued all the time. I now have more energy than I have had in a very long time and feeling great. I would love any insights and want to contiune to learn as much as I possibly can so I can help others in a similar situation.

 

[gpr100rs]

Hello everyone I am 41 and 6 months post surgery. I opted for the mechanical valve for the durability but sometimes I struggle at night with the ticking sound I hear. Does anyone have any advice on what you do to drown it out a bit? So glad I found this page.

I have the INSPIRIS RESILIA valve, a biologic, but the thumping heart beat can be annoying at night. I use a white noise unit called Hatch which helps. https://www.hatch.co/restore. You can play multiple different sounds from fan noise, rain, etc.

 

[Chuck C]

"I did have severe LVH and it is trending in the right direction now that we have medications squared away" I suspected this was the case. With EF at 15% I would have expected severe LVH.

It is not so much a thumping of my heart but the ticking noise

Ok. I do think we are talking about the same thing. For me, I would describe it more of a thumping than a ticking, but neither one describes it accurately. @pellicle uploaded a recording of his which many seemed to agree that it reflected what they also hear or feel. BTW, mine is very light- I can't even hear mine unless I take deep breaths or exercise hard. I don't have LVH- got my surgery when my LV was near the LVH threshold but before it crossed into LVH territory. LV walls, septal and posterior were 11mm each just prior to surgery- very high end of the normal size range, but not LVH. Now they have remodeled down to 8mm and 6mm. I'm not certain if that is why I rarely hear/feel my valve, but I suspect it plays a role.

I now have more energy than I have had in a very long time and feeling great

That is great news! Hopefully your LV will continue to remodel- I expect it will do so. If you manage to bring your EF above 40%, you should feel even better.

I'm curious as to why you did not get surgery until your EF was down to 15%? Is there a story behind that? You are fortunate that yours has recovered so much. Once EF goes that low, I believe that many do not recover. Being young helps in this regard- at 41 you are very young in the valve surgery world. Glad things have partially recovered and hoping that they continue in the right direction for you.

 

[pellicle]

Good morning gentlemen

It is not so much a thumping of my heart but the ticking noise the valve seems to me making.

it of course appears (if not manifests, at least is described) differently to different people.

. @pellicle uploaded a recording of his which many seemed to agree that it reflected what they also hear or feel.

So Pat, to bounce off this, the "recording I uploaded" is at best a representation of what others hear because (not least) the microphone is not embedded within my body like my hearing system is

So because my microphone is embedded in the bone of my skull, which is strongly connected to my spine, then rib cage and is surrounded by all the vascular system that picks up the sounds from the actual valve directly in a fluid its presented very differently (think going diving or snorkelling and under water you can hear a motorboat for miles). This is not unlike microphone handling sounds (and why we go to great lengths to isolate them from handling, the desk and of course wind).

For a start the high frequencies fall off fast in air, the low frequencies are actually conducted in the same way as a sympathetic resonator in a speaker system (which have almost no influence from high frequencies).
Clicking will suggest high frequency component, thumping low frequency.

Then there is scar tissue and possible adhesions to contend with.

HTH

Attached is an MP3 recorded directly by my Zoom. I recommend listening with headphones or a good speaker system (your phone or laptop speaker is actually crap).

 

[SatoriFround]

Is it the noise or the thumping that bothers you? Or both? People in this forum say it gets a little bit better with time but mostly they say you get used to it. I’m just 7 weeks post op and for me more than the noise I’m trying to get used to the thump, sometimes it really feels like someone is hammering my sternum from inside…I wish it was just the noise. Some people say the on-x may be a bit noisier than the st Jude…but I think it really depends more on your anatomy.

Well this has me a little worried. The part about your anatomy. My wife already says my heartbeat feels/sounds closer to the surface due to my Pectus Excavatum. At 50 years old I really don't see an option besides a mechanical valve. Oh well, I guess I'll figure it out.

 

[Windfinder]

Oh no! Of course my intention was not to worry anyone, by anatomy I am more thinking that it depends on your body and how things resonate in your thorax ( Pellicle, Chuck and others have given very good possible explanations) and if you search more this topic I remember some people had said they were very thin and petite and they could not hear it. I think at 50 mechanical is a great choice if that’s what you like, I personally would never consider noise a decision factor at all….

 

[pellicle]

Oh well, I guess I'll figure it out.

yep ...

My personal Diesel engine goes unnoticed by me for lengthy stretches ... but often I simply can't hear it at all (just put a chainsaw down)

Sufficient for a work bench now

 

[Patr83]

"I did have severe LVH and it is trending in the right direction now that we have medications squared away" I suspected this was the case. With EF at 15% I would have expected severe LVH.


Ok. I do think we are talking about the same thing. For me, I would describe it more of a thumping than a ticking, but neither one describes it accurately. @pellicle uploaded a recording of his which many seemed to agree that it reflected what they also hear or feel. BTW, mine is very light- I can't even hear mine unless I take deep breaths or exercise hard. I don't have LVH- got my surgery when my LV was near the LVH threshold but before it crossed into LVH territory. LV walls, septal and posterior were 11mm each just prior to surgery- very high end of the normal size range, but not LVH. Now they have remodeled down to 8mm and 6mm. I'm not certain if that is why I rarely hear/feel my valve, but I suspect it plays a role.


That is great news! Hopefully your LV will continue to remodel- I expect it will do so. If you manage to bring your EF above 40%, you should feel even better.

I'm curious as to why you did not get surgery until your EF was down to 15%? Is there a story behind that? You are fortunate that yours has recovered so much. Once EF goes that low, I believe that many do not recover. Being young helps in this regard- at 41 you are very young in the valve surgery world. Glad things have partially recovered and hoping that they continue in the right direction for you.

I was stubborn and was told I just had pneumonia. Thankfully my wife made me go to the hospital because my cough would not go away and it was discovered.

 

[Earthsciencerocks]

Well this has me a little worried. The part about your anatomy. My wife already says my heartbeat feels/sounds closer to the surface due to my Pectus Excavatum. At 50 years old I really don't see an option besides a mechanical valve. Oh well, I guess I'll figure it out.

I love my 25mm St. Jude Masters HP so far! (4 1/2 weeks post AVR) Third AVR.

 

[Earthsciencerocks]

I have heavy thumping and some clicking. Like others said, it is worst when sleeping and lying on my side.
I’m praying remodeling will happen! After 3 AVRs I’m a bit of a mess in there. Thumping is very loud when I take deep breaths. LVH was in my history each surgery.

 

[mecretired]

I have a St Jude grafted aortic valve. The ticking/thumping doesn’t really bother me. I have noticed that when I lay on my right side to go to sleep the ticking is really loud. When I lay on my left side I hardly hear it. So I almost always go to sleep on my left side. I haven’t seen anyone else make this comment.