Still in the Waiting Room

[MaryG]

After receiving completely conflicting info from my previous cardio I decided it was time for a change. The last Echo I had at that small cardiology group was done by a tech that was not even certified, and it was obvious to me that he was not very experienced. The new cardio is in a large group of 20+ and the techs there do tests all day, every day, which seems like it has to be a plus.

I received the copy of my recent Echo report and according to that, things are pretty stable – there has been little or no change in the past year. These numbers are basically identical to the Echo I had last June.

AVA 1.0
Gradients 22/36
Ejection Fraction 60%

So it looks like I’ll be hanging around in here for awhile, enjoying the company.

 

[Mentu]

You are right, Mary, your test results are not too bad but keep in mind that they can change over a fairly short period of time. In Nov, 2008, my valve area was 1.25 cm2; by July, 2009, it had decreased to 0.75 cm2 and by surgery in September the area was 0.69 cm2, mean pressure gradient 65 mmhg/Max 127 mmhg, but my EF never feel below 60%. We are all individuals so you may live many years without further change. Should you begin noticing symptoms, however, don't wait about reporting them to your Cardio. My Cardio is a good Doctor but when he saw the July figure he was certain that it was just a bad echo-cardiogram. Because he is a good doctor he immediately ordered a heart cath which surprised him when it produced a valve area of 0.73 cm2. I would hope that you now have the kind of Cardio you can talk with and who will not dismiss your concerns out of hand. Take Care.
Larry

 

[MaryG]

Larry-
Thanks for your reply. Your valve was certainly an example of just how fast a valve can go downhill. The year before last my AVA was 1.4, so I had quite a change from one year to the next. That's why I was so surprised when there was no further change in the year just past. However, as you said, there's no way to predict how much, or when it's going to change.

My previous Cardio didn't seem to want to give me much information, but the new one seems more than willing to discuss my condition and my concerns. He wants to see me again in 4 months, so it looks like he will be keeping on top of things.

Mary

 

[skeptic49]

Mary, since you are BAV do you know if you have any issues with your aorta...is it dilated? As you found out there is a wide variation in technical ability when it comes to echo techs. If I were you I would want to be evaluated at a major university heart center, where they are usually more experienced in dealing with more complex valve issues like BAV. At minimum, you need to know aboit the condition of your aorta. You might consider obtaining a chest MRI or CT scan at some point.

Best wishes,

Jim

 

[MaryG]

Jim -- I think what you suggested sounds like very good advice. The Echo that I had a year ago stated that I had a 4.0 aneurysm on my ascending aorta, but my latest Echo didn't mention anything about it. I know that isn't a very large aneurysm, but also realize that it is subject to change, and needs to be followed.

Because of what I have read here on VR I am planning on having my surgery at Duke, and not at a local hospital, when the time comes, but have not seen any surgeons there yet. I will address this with my Cardio when I see him in four months and depending on how that goes, maybe I'll make an appointment at Duke at that time. In either case, I agree that an MRI or CT is something that should be done.