Now I'm more confused...and a question

[jax3172]

Finally saw cardio (actually, his PA) yesterday to review results of my echo and I'm more confused than ever. I'm not sure what an aortic valve opening of 1.67 cm2 (this year) or 1.44 (last year) means (also bicuspid, with mild stenosis and regurgitation). Probably means the test has a pretty large margin of error. Also, cardio didn't seem too concerned over the dilated aortic root and dilated descending aorta, combined with symptoms. I am very concerned. When I pushed it, she suggested I needed a CT scan of the heart. I mentioned my echo stress from 15 months ago where the cardio (same one) said my blood pressure was "blunted" at max stress but didn't drop (thank heaven for small favors). She wasn't even aware of it and then didn't seem too concerned. I asked about my thickening left ventricle wall (mild to moderate) and she didn't seem too concerned over that either. She seemed very surprised that I had made an appointment with an aortic surgeon for 7/5. As for the symptoms (tired, slight chest pain, easily out of breath), she suggested I might have regular garden variety heart disease (blood pressure and cholesterol all in great shape, decent diet over the years), and should get a nuclear stress test.

Needless to say, I am really looking forward to my coming second opinion.

So here are my questions:
1) If my aortic opening is, say, 1.5, with the other symptoms listed above, how out of range is that?
2) Is there any other test to measure the extent of the dilations listed above? I really don't want a CT scan. I understand it's equivalent to about 250 chest X-rays.
3) If I really need it, should I get it now or hold off until the surgeon tells me to get it?
4) What does the blunted blood pressure mean and should I be concerned?
5) What could the thickening left ventricle mean? Is it reversible?
6) Are there any meds I could be taking to help all this?
7) I really think my problem is the aorta. Are there any other diagnostic tests that could be helpful?

Thankx all for listening and, thankx in advance, for your input and or suggestions.

Jack
Ocean City, NJ

 

[perrybucsdad]

Don't concern yourself with the CT scan. They are very safe and with the spiral CT's and the CT Angiogram, the docs can get some very precise three dimensional pictures.

 

[jax3172]

So the CT Scan...

So the CT Scan...

Thank you. Since I entered the original post, I have found that a cardiac CT Scan nukes you about 100X a normal chest X-ray but they say it's OK especially for adults (small kids, different).

Would love to get some answers to the other questions.

 

[Karlynn]

I consider myself an enlightened person, but I have a problem with a cardio's PA being the one discussing all these things with you. Have you spoken with the cardio at all? Did she tell you what your ascending aortic measurements were? We have known of people who's cardio's were "unconcerned" about the measurements and the rest of us knew they were approaching dangerous sizes.

Easy for the PA to say she's not concerned with this and that - but then she's not living with your symptoms, so she's not understanding your desire for more concrete, detailed answers other than "I'm not concerned." I'm glad you have the appt. w/ the surgeon. Hopefully he/she will do their homework and look at your past tests, going beyond the most recent.

I've been through too many wrotten and disengaged doctors to put up with those that dismiss concerns without fully explaining why they aren't concerned.

 

[ALCapshaw2]

The area of your aortic valve opening seems to be pretty good (I don't remember the 'normals', BUT the usual 'trigger' for surgery is 0.8 cm sq or less).

The 'thickening' needs a better explanation. Hopefully the surgeon will give you a better interpretation of your test results. Chamber enlargement is another parameter to watch.

'AL Capshaw'

 

[KimC]

I second Karlynn's comments. I received news of significant cardiac changes through a nurse. Had I talked directly to my cardio, I would've been able to put things into perspective, and perhaps saved myself and family some anxiety. I finally called my primary cardio today and voiced my concern with how things were handled. I have a first rate cardio but his new nurse is a bit green. I feel much better after having discussed my questions directly.

Good luck,

 

[CCRN]

Kicks and giggles

Kicks and giggles

Finally saw cardio (actually, his PA) yesterday to review results of my echo and I'm more confused than ever. I'm not sure what an aortic valve opening of 1.67 cm2 (this year) or 1.44 (last year) means (also bicuspid, with mild stenosis and regurgitation). Probably means the test has a pretty large margin of error. Also, cardio didn't seem too concerned over the dilated aortic root and dilated descending aorta, combined with symptoms. I am very concerned. When I pushed it, she suggested I needed a CT scan of the heart. I mentioned my echo stress from 15 months ago where the cardio (same one) said my blood pressure was "blunted" at max stress but didn't drop (thank heaven for small favors). She wasn't even aware of it and then didn't seem too concerned. I asked about my thickening left ventricle wall (mild to moderate) and she didn't seem too concerned over that either. She seemed very surprised that I had made an appointment with an aortic surgeon for 7/5. As for the symptoms (tired, slight chest pain, easily out of breath), she suggested I might have regular garden variety heart disease (blood pressure and cholesterol all in great shape, decent diet over the years), and should get a nuclear stress test.

Needless to say, I am really looking forward to my coming second opinion.

So here are my questions:
1) If my aortic opening is, say, 1.5, with the other symptoms listed above, how out of range is that?
2) Is there any other test to measure the extent of the dilations listed above? I really don't want a CT scan. I understand it's equivalent to about 250 chest X-rays.
3) If I really need it, should I get it now or hold off until the surgeon tells me to get it?
4) What does the blunted blood pressure mean and should I be concerned?
5) What could the thickening left ventricle mean? Is it reversible?
6) Are there any meds I could be taking to help all this?
7) I really think my problem is the aorta. Are there any other diagnostic tests that could be helpful?

Thankx all for listening and, thankx in advance, for your input and or suggestions.

Jack
Ocean City, NJ

Just for the fun of it, get your cardio to send you to a CT surgeon. That enlarged ventricle means it's time to see Dr. Blade and get an opinion there. The enlarged aorta is cause enough. You might just find out you're in the "waiting room" but so what, You'll already have a surgeon when you need one. Trust me....I'm a nurse. Ha! Am I as witty as Ross?

 

[CCRN]

Oh!

Oh!

Just for the fun of it, get your cardio to send you to a CT surgeon. That enlarged ventricle means it's time to see Dr. Blade and get an opinion there. The enlarged aorta is cause enough. You might just find out you're in the "waiting room" but so what, You'll already have a surgeon when you need one. Trust me....I'm a nurse. Ha! Am I as witty as Ross?

I see you DO have CT Surgeon appt.! Sorry, I'm still on drugs from my surgery.

 

[jax3172]

Still wondering about dilated aortic root

Still wondering about dilated aortic root

Thank you all for your enlightened responses.

One of you asked about measurements for the dilation issues. So my question to the PA and to all of you is: can I get information on the dilated aortic root and dilated ascending aorta without a CT scan? It's apparent that my echo showed these anomalies but no readings were included in the report except the conclusion: "ascending aorta appears to be dilated, mild to moderate."

Also, what is the "normal" range for an aortic opening? I heard 3.0 cm2, but I?m not sure.