Murmurs

[Paul1972]

Just got back from my check up with the hospital and I’m told I have got a murmur and need an echocardiogram. Has anyone else been told they have a Murmur with Their mechanical valve. After my first few check ups nobody mentioned a murmur, I have had a different surgeon/cardiologist every time I’ve been so they might just hear the sounds and have different interpretations. I’ve only had the valve in just under 2 yrs.

 

[tom in MO]

My GPs listen to my heart and tell me it sounds good. Same thing with my cardiologist. I believe there are certain valve problems that can be heard with the stethoscope. They don't need to have heard your heart before to hear something out of the ordinary, but they do probably have to know what a mechanical valve sounds like. When I was in the hospital, there was more than one intern that wanted to hear my valve both before the AVR and after the AVR to learn what a crapped out valve sounds like and to learn what a new mechanical valve sounds like.

The echocardiogram will help them know what's causing the new sound and if there is cause to take action.

 

[Paul1972]

Cheers for the reply Tom , it was one of the surgeons at the hospital who listened to my valve,as have other surgeons that have listened before but never mentioned a murmur. This particular surgeon said it’s a small valve they put in for a man of your size.Not to sure what he meant by that. He was in so much of a rush I didn’t get a chance to ask, he was out the door before me. I suppose the echocardiogram will give me the answersCheers Paul

 

[Paleowoman]

Hi Paul - I don't have a mechanical valve but a tissue one, but I do have a very loud murmur. It is, from what I understand, a "flow murmur" which is loud due to the fact that my valve is small for my body size (I have moderate patient prosthesis mismatch). I also have high pressure gradients across the valve. At three years post op I had a transoesophageal echo to check the valve thoroughly, specifically to check that there is nothing wrong with the valve leaflets. Nothing is wrong with the valve, it's just the valve is small so there is turbulent blood flow across it which leads to this "flow murmur" and high pressure gradients. I was having six monthly echos, now down to annual.

Doubtles they will check your mechanical valve thoroughly. All the best, and try not to worry - it sounds like they are taking good care of you ! Anne

 

[Paul1972]

Thank Anne for replying, I did think of you when they mentioned that my valve was a small one for my size as I remember you saying your valve was small . I was just looking through your old posts to get some information about it The echocardiogram will tell hopefully tell me more . It seemed to me that one surgeon was trying to call the choice of valve size by my surgeon, I could be wrong.I was due to see my surgeon but he was called away at last minute.Less than six months ago I was told by my surgeon that my valve was fine with no murmurs. Best wishes Paul xx

 

[Paleowoman]

Hi Paul - the surgeon who I saw for assessment post surgery (not the surgeon who put in my valve - I don't want to see her ) explained to me that the valve size is chosen during surgery when they measure the aortic annulus with a “sizer”. He explained that the tissue there is "very fibrous” and they can’t put in a bigger valve than the space allows.

Do you have any symptoms ?

 

[Paul1972]

Hi Anne , no i don’t have any symptoms which is why I was very surprised when the surgeon said he could hear a murmur and that it could be the size of the valve causing it. I’m hoping it’s proven wrong once I get another echocardiogram done. I haven’t had a echocardiogram for 16 months so I’m a little anxious at present

 

[Paleowoman]

I hope they arrange the echo soon so that you don't stay anxious Paul.x

 

[Paul1972]

Thanks Anne , take care.xx

 

[Warrick]

Hi Paul, do you know what size valve you have?

 

[Paul1972]

Hi Warwick, I have a 23mm on-x valve

 

[pellicle]

Hey Paul

myself I think there's too much guessing involved to make any meaningful prediction. My view is that you just kick back and wait till the echo is done and see what that brings up. If it hasn't caused you any problems before it was identified then it can certainly wait a few more weeks

A variant on an old prayer for wisdom:

 

[Paul1972]

Cheers Pellicle , that’s exactly what I’m going to do is wait to see what the echocardiogram shows I’m just setting off onto the noisy building site where all my thoughts can be forgotten for 8hrs or so

 

[pellicle]

Cheers Pellicle , that’s exactly what I’m going to do is wait to see what the echocardiogram shows I’m just setting off onto the noisy building site where all my thoughts can be forgotten for 8hrs or so

I suggest one of these in the bottom draw may be helpful too (for when the prayer isn't working)

(gotta have a plan B right ;-)

 

[Paul1972]

To right , if all else fails

 

[user 16827]

Hi Paul, the mechanical valves do murmur by nature, the blood flow is different from a natural valve.

I understand that the surgeon knows his stuff but it may be just noise and nothing sinister

The positives are that the murmur hasn't been mentioned before
A murmur also doesn't mean it isnt working correctly .

The echo should help sort it out

Best wishes with it, these curve balls are often testing

 

[Paul1972]

Hi Leadville ,I hope you are doing well. Thanks for taking time out to reply, i think you are right in what you have explained it makes a lot of sense to me , what threw me a little was one surgeon saying no murmur six months ago to another yesterday saying he can hear one. He was in that much of a rush though that he more or less told me as he was escorting me out that a echocardiogram will tell us more Regards Paul

 

[pellicle]

...He was in that much of a rush though that he more or less told me as he was escorting me out that a echocardiogram will tell us more Regards Paul

its one of the problems we have in modern medicine, everyone is rushed and thus nobody has time to sit down and put their thinking hat on and see "is this outside the norms"

Were I (over the years) to have become concerned about what every doctor told me I'd be like Bill the Cat ...

 

[Paul1972]

Lol

 

[carolinemc]

Just got back from my check up with the hospital and I’m told I have got a murmur and need an echocardiogram. Has anyone else been told they have a Murmur with Their mechanical valve. After my first few check ups nobody mentioned a murmur, I have had a different surgeon/cardiologist every time I’ve been so they might just hear the sounds and have different interpretations. I’ve only had the valve in just under 2 yrs.

You can develop a murmur while having a mechanical valve cause it is usually the main reason for the valve replacement in the first place. Mine valve replace was due to a genetic aortic defect, repair at 8 years old and replacement at 36. Murmur can still return at any time. When did you have your replacement valve done? Ask your heart doctor about the murmur, cause it sounds like you already had one before the replacement and it has come back. Always ask questions about anything, even of why having a replacement. The sounds of a murmur only changes of how loud it gets, the actual swooshing sound never changes. Be proactive and ask questions, for you are the patient and you need to know what is happening. Good luck and keep being better informed. Hugs for today.