take time for 2nd opinion

[fionathiel]

HI All
Went to see a second cardio this week for another Echo and to get his slant on what is happening with my MVP. Good news he has rated me as moderate with minimal dilation of LV and ejection of 70% and will now monitor me. He also suggested i may live with this for 10,20 or 30 years and that "if" i needed surgery he would refer me to a surgeon in Melbourne that is doing Robotic surgery. This is a far cry from the first cardios diagnosis of Severe regurgitation a misread or mis interpretation of my ejection fraction by some 30% (report said 72% , yet he told me it was 47%) and that surgery was inevitable and almost "enjoyed telling me" that i would need open heart surgery.
I feel so much more comfortable with the second Cardio, he is much more caring and easier to talk to. Regular monitoring will be so much more bearable now as i feel he is listening to me. So, my advice, if you are not happy, shop around until You are happy.
Fiona

 

[Ross]

Sometimes even a third is needed. Glad to hear it worked out for you.

 

[ALCapshaw2]

When it comes to making a decision about WHEN (not IF) to have surgery, I think it best to actually consult Surgeon(s) for their perspective.

BTW, a High Ejection Fraction (>70%) *can* be a sign that the heart is compensating for a defective valve. It would be wise to continue to monitor the EF *and* look for signs of chamber enlargement which is a sign of damage to the heart muscles and walls.

Whatever you do, be sure to get regular echocardiograms, at least every 2 years, and preferably annually or even semi-annually if your symptoms worsen or there are signs of 'changes'.

'AL Capshaw'

 

[Cooker]

fionathiel
....I echo what Ross and Al said....A 2nd and 3rd opinion are always good....It is very important to be sure but it is also important to make sure that we are not looking for a doctor who will tell us what we want to hear...I was told to get as many opinions as I wanted as long as I was not looking for the "you don't need surgery" opinion....I was also told by 2 cardios and 2 surgeons that the time to have surgery is "before" I became systomatic....

I hope your surgery is years out but please do not look for the answer you want to hear out of fear.

 

[Lisa in Katy]

This kind of reminds me of a girl who lived in my dorm in college. She and her boyfriend had decided to get married before graduating because they wanted to have sex, and being good Catholics, couldn't live with the guilt of sex outside of marriage. However, they didn't want children until they graduated and both had good jobs. Being Catholic and not believing in birth control, this was an issue. So, she went priest shopping. I'm not sure how many priests she visited (more than a small handful), but she finally found one that said it was okay to use birth control short-term for financial reasons. In other words, if you ask enough people, you probably will find someone who tells you what you want to hear.

Your first cardiologist sounded like he had some issues, this guy sounds good, but you still might want to go for a 3rd opinion. My EF was quite high because my heart was trying to avoid left side failure and the chambers were having to pump extemely hard to get enough blood out. The longer that goes on, the weaker the muscle becomes.

 

[Hot Rod Harry]

This kind of reminds me of a girl who lived in my dorm in college. She and her boyfriend had decided to get married before graduating because they wanted to have sex, and being good Catholics, couldn't live with the guilt of sex outside of marriage. However, they didn't want children until they graduated and both had good jobs. Being Catholic and not believing in birth control, this was an issue. So, she went priest shopping. I'm not sure how many priests she visited (more than a small handful), but she finally found one that said it was okay to use birth control short-term for financial reasons. In other words, if you ask enough people, you probably will find someone who tells you what you want to hear.

Your first cardiologist sounded like he had some issues, this guy sounds good, but you still might want to go for a 3rd opinion. My EF was quite high because my heart was trying to avoid left side failure and the chambers were having to pump extemely hard to get enough blood out. The longer that goes on, the weaker the muscle becomes.

LOL... That's right.. If you ask enough people, you'll get the answer that you want..

 

[tobagotwo]

Certainly, you should feel happy with your doctors, and you weren't happy with the first. However, I also agree that a third opinion may be warranted here.

Based on what we see regularly here, I would have trouble crediting your second one's statement that you can live for 10 or 20 years before needing surgery if you already have dilation (I'm assuming that he is using that word synonymously with enlargement) of the left ventricle and are already at a 70% ejection fraction. (Unless you're a bicycle racer, of course.) These things indicate that your heart is under stress and is already compensating heavily. LV enlargement and high EF go hand-in-hand with severe, or sometimes moderate-to-severe valve disease. In either case, it's a sign of advancing concern. Not necessarily this year's concern, but probably not a decade away, either.

I don't know your age, but if you're quite well along in years, he may feel that you can live out your span without surgery, and might not mind the limitations. If you're young, he may feel that he can slow down the progress to your heart's damage with drugs, which may or may not be successful.

If you're in your fifties or sixties, you may wind up waiting long enough so that your heart may not recover fully, and your overall health may be greatly stressed by the operation itself. Not meaning to scare you, just meaning that you should keep that somewhere in your mind when decision making.

There are a lot of considerations that can go into this decision, more than a doctor alone would be privy to. If you like this doctor, stay with him, but please don't ignore the possible value of a third opinion.

Best wishes,

 

[Aussie Chris]

Hi Fiona,
I am pleased to hear that your second opinion was so positive but was wondering how there could be such a divergence of views on your status.

If you are interested in a third opinion a cardiologist I found very good was Dr Greg Scalia at Wesely Hospital in Brisbane. I found him to be a very straight shooter but with an excellent patient manner. You can see a bit about him at this web address.

http://www.heartcarepartners.com.au/page/Cardiologist/Greg_Scalia/

He performed a Trans Osophogeal Echo (TOE) on me which finally gave me a real picture of how far my valve had deteriorated and gave me the best information on when to have my surgery.

Hope this is of some benefit.

All the best,

Chris

 

[fionathiel]

2nd opinion

2nd opinion

Thanks all for your feedback. Maybe i didnt explain myself properly. The first cardio had misread the report and relayed a different ejection fraction to me. When in fact both results came back the same ie LV and EF its just that he told me the wrong figure. So in actual fact both Cardios are telling me the same result , except the second has a slightly more positive attitude. I am off for a stress echo with him to start the 6 monthly monitoring. So will take your advice to keep an eye on the LV.
I will also mention the TOE.
Thanks