Never told about mother's Mild Aortic Stenosis

[Iceman331]

Dear All,

First, I hope you are all doing well and finding happiness and healing with your heart conditions.

Secondly, I couldn't find any other forum online to discuss the issue of mild aortic stenosis.

I know very little about heart conditions, etc, as no one in my family has ever had one. So, let me tell you what is happening and why I am concerned.

My mother was diagnosed last year with a rare immune-mediated bone marrow disease called aplastic anemia. They followed up with an echocardiogram on her heart and came back "with good heart for a woman her age" (70). They said she had no cardiac issues at all. So, a few months ago, I happened to come across her echocardiogram results online. I went over it and everything was normal (some regurgitation)...until I came cross "mild aortic stenosis." I started to get upset, not understanding why we we were not told she had this. Her AVA was 2.1 and her mean gradient was 14. I was then told that these two criteria barely make the threshold for mild aortic stenosis. They only marked it such as her peak aortic jet velocity was 2.7. (2.5 or 2.6 is cut-off). We then found out that her severe anemia may have affected some of the measurements/readings in a negative way (mainly the "flow ?", such as peak aortic jet velocity and mean gradient). The AVA would not be affected from the anemia, even though she would need to do another test to verify AVA, which can be off a few tenths of a centimeter at most.

They refuse to even take this any further, saying that a majority of older people with healthy hearts still have some degree of very mild aortic stenosis. There is no need to see a cardiologist, as her heart functional overall is very good.

I really don't know what to believe. I worry about my mother's health all the time because she has a rare bone marrow disease that has really not improved as of yet.

What do you all have to say about this? The doctors just don't act concerned, but they're not always right, as I already know with her bone marrow disease issues.

Warm regards to you all,

Matthew

 

[Superman]

Welcome to the forum.

My question is what are you looking for? Do you just want them to act more concerned? I’m sure they’ll let you pay for more tests if you want them. But any meaningful intervention isn’t going to take place until stenosis moved past moderate into severe. This barely registered as mild.

Frankly it does sound fairly normal for a 70 plus year old heart. I’d say the medical team is correct here. And since it’s not their mother and they see it all the time, their response is going to be calmer than yours. It’s new to you.

There’s certainly nothing unusual about someone in their 70’s seeing a cardiologist. I’m sure her PCP would give a referral if asked.

 

[Iceman331]

Welcome to the forum.

My question is what are you looking for? Do you just want them to act more concerned? I’m sure they’ll let you pay for more tests if you want them. But any meaningful intervention isn’t going to take place until stenosis moved past moderate into severe. This barely registered as mild.

Frankly it does sound fairly normal for a 70 plus year old heart. I’d say the medical team is correct here. And since it’s not their mother and they see it all the time, their response is going to be calmer than yours. It’s new to you.

There’s certainly nothing unusual about someone in their 70’s seeing a cardiologist. I’m sure her PCP would give a referral if asked.

Thank you, dear Superman, for your response. Nice to meet you, by the way.

I suppose you're right. It was the cardiologist at the hospital who decided that there was no reason for her to see a cardiologist before I found out she had mild aortic stenosis (never mentioned it to me). So, if the cardiologist said no, then I should just let it go.

I am just scared for her health as she has aplastic anemia. Anemia can aggravate heart conditions.

One more thing: Is it calcification that caused the mild aortic stenosis? Is that just from aging? The report mentions some calcification in mitral valve, but no stenosis there. No calcification is mentioned concerning aortic valve.

I wish you the best of health.

 

[nobog]

"mild aortic stenosis" - it could be like that for months - or decades - before any change. At this point I don't think there is anything to worry about - just monitor the situation.

Regards,

 

[Superman]

Calcification is pretty typical with age and a common cause of aortic stenosis. But anything I say is just spitballing ideas.

Many of us on this board were born with various congenital heart defects. A bicuspid aortic valve being among the more common. But aging and/or illness can lead to valve replacement as well.

I think I’d worry about the more pressing health concerns were I in your shoes. But just the same, feel free to ask questions here and share developments.

Many of us came here with a problem and stayed because we’ve developed friendships.

 

[Iceman331]

"mild aortic stenosis" - it could be like that for months - or decades - before any change. At this point I don't think there is anything to worry about - just monitor the situation.

Regards,

Thank you so much, dear nobog, for your response. It was just strange that the cardiologist never thought it important to tell us she has mild aortic stenosis. When I found it about it (several months later), same thing: nothing to worry about. Her severe anemia may have made "flow" numbers a bit higher (I don't understand the complexities of heart disease), making her a borderline case. No matter what, she still has at best very mild aortic stenosis. At any rate, I suppose we'll just forget it about for now. I am so worried about her because of her severe anemia.

Thank you all! You're all too kind.

 

[Iceman331]

Calcification is pretty typical with age and a common cause of aortic stenosis. But anything I say is just spitballing ideas.

Many of us on this board were born with various congenital heart defects. A bicuspid aortic valve being among the more common. But aging and/or illness can lead to valve replacement as well.

I think I’d worry about the more pressing health concerns were I in your shoes. But just the same, feel free to ask questions here and share developments.

Many of us came here with a problem and stayed because we’ve developed friendships.

I agree. I just get scared.

I am on a forum for bone marrow failure disease. It's been very helpful for me. I think this forum is very similar. I am going to learn a bit more about heart valve disease and contribute.

Please take good care.

 

[Iceman331]

Just a quick question? Is aortic valve velocity ratio an important number? My mother's is 0.63. Some sites say AVA is most important, while others go on and on about mean gradient and peak jet velocity. I can see that it's not always clear when someone is severe or moderate at times.

I also read that someone has been living for 5 years or so with severe aortic stenosis without surgery, and they still exercise, living a normal life. Their cardiologist still says that they don't need a replacement yet because they don't have symptoms. Wow! It's a really complicated heart disease.

 

[nobog]

Check out the Conclusion
NORMAL AORTIC VALVE VELOCITY RATIO DIFFERS BY RACE AND GENDER | Journal of the American College of Cardiology (jacc.org)

 

[Iceman331]

Check out the Conclusion
NORMAL AORTIC VALVE VELOCITY RATIO DIFFERS BY RACE AND GENDER | Journal of the American College of Cardiology (jacc.org)

My mother is within the normal range then. Thank you so much for that! That was so kind of you. Great!!!

I wish you the best of health.

 

[Iceman331]

You are not going to believe this: My mother had another heart test done (very detailed). She no longer has mild aortic stenosis. They said she was misdiagnosed because she was severely anemic when the test was done. Go figure! Her jet peak velocity was 2.7 last year - now it's 1.8. All other signs that pointed to mild aortic stenosis are gone!??? What? And the calcification is much, much less? I can't believe this. How can you get this so wrong?

All that said, they found a new problem this time: pulmonary hypertension (moderate). I'm wondering if the massive seizure she just had + the prolonged anemia didn't cause this to show up . Because less than a year ago, no pulmonary hypertension - not even mild. I think her seizure and anemia are confusing the heart/lung doctors.

 

[pellicle]

Hi

firstly, I'm glad to hear that.

You are not going to believe this: My mother had another heart test done (very detailed). She no longer has mild aortic stenosis. They said she was misdiagnosed because she was severely anemic when the test was done. Go figure

this underscores the major points

1. none of the measurement methods are actually mm precision (movement for a start, plus other limitations)
2. this is why we take measurements over time and observe trends

if you use error bars this becomes obvious (as in this example)

Despite wearing the skin of science medicine is seldom properly scientific.

 

[Superman]

Just saw your update only to see that our good friend carolinemc gave me the angry face during our earlier friendly exchange! Didn’t think I said anything upsetting.

Anyway - thanks for the update!

 

[Iceman331]

Hi

firstly, I'm glad to hear that.


this underscores the major points

1. none of the measurement methods are actually mm precision (movement for a start, plus other limitations)
2. this is why we take measurements over time and observe trends

if you use error bars this becomes obvious (as in this example)
View attachment 889225
Despite wearing the skin of science medicine is seldom properly scientific.

Thank you, kind friend.

I am glad that I got to learn about aortic stenosis, nonetheless.

They think the pulmonary hypertension was just coming from fluid in her lungs that built up after her seizure, raising greatly her arterial pressure.

It's just weird how her numbers are all so different this time around.

You're a knowledgeable community on here.

Much health and happiness to you.

 

[tom in MO]

You stated "So, a few months ago, I happened to come across her echocardiogram results online. I went over it and everything was normal (some regurgitation)...until I came cross "mild aortic stenosis." I started to get upset, not understanding why we we were not told she had this." Then "All that said, they found a new problem this time: pulmonary hypertension (moderate). I'm wondering if the massive seizure she just had + the prolonged anemia didn't cause this to show up . Because less than a year ago, no pulmonary hypertension - not even mild. I think her seizure and anemia are confusing the heart/lung doctors."

Mild aortic stenosis could be considered somewhat normal in a 70yo woman. As a linguist, maybe you shouldn't be guessing about her pulmonary hypertension either. Hopefully you don't run these alarming hypotheses by your mom. You could bring on worry and depressions which will not be good for her happiness which is as important as her pulmonary hypertension and aplastic anemia. If your mom gives you permission to review her medical records, make dead sure you are correct before you fly the semiphore flag for "Danger".