TEE and Heart Cath/ results Questions but don't know what forum as RHD AVR /MVR

[harrietW]

See Surgeon Sept 22nd consultation. feel terrible every day. clamy sweats and feverish, its 36° out and l literally am struggling to breath. swollen drycough but also upper respiratory infection cronic exhausted no energy at all very heavy chested and alot of headache and dizziness.
Is this normal
So Heart Cath results
Lvedp =19mmHg. 4+ MR Aortic Root 3 Al 25mmHg gradient across left subclavian artery stenosis
Pressure RA mean =9 RV=32 edp 14; PA=32,17 (24),pwp=17
Pullback across aortic valve peak gradient 15 AVA=1.47cm2 AV1=0.73cm/m2
Mitral Valve = 5 mmHg. MVA=2.94cm2 MV1= 1.45cm2/m2
2-3 AS WITH 3+AR Sever/Significant MR 3+4+ Consider MVR+AVR.
TEE Left Atrium Severely Dilated
Aortic is Tricuspid thickened calcified edges are retracted /moderate stenosis Mean peak gradient 19-30 mmHg across valve Underestimate 3-3+ concomitant aortic regurgitation.
MVleaflets diffuse thickened. Edges of mitral valve leaflets are retracted. Focal prolapse of A2 segment of anterior value leaflets Resulting in sever valve regurgitation with systolic with mild to moderate concomitant mitral stenosis with mean gradient og 3mmHg across ... What are we waiting for and can it get alot worse before OHS happens .. what is the breaking point here. With AV1= 0.73cm/m2 Tricuspid
l just read how bad 0.77cm/m2 but wth bicuspid

 

[honeybunny]

Harriet, have you expressed your concerns about waiting to your cardiologist? I'm not knowledgeable about the numbers you describe but you are clearly anxious, which is probably exacerbating your breathing problems. I hyperventilate and gasp for air when I'm anxious. It's a reflex even when I know what is going on.

I'll add that IMO, your cardio would speed things up if he/she thought there was a reason to do so. That's the thought that comforted me when, after being diagnosed with severe stenosis instead of moderate-severe as first expected, I couldn't see the surgeon for six weeks (vacation!). My cardio said it wasn't an emergency but needed to be done within a year. Ask your doc what your time frame is.

Finally I take anti anxiety medication. Perhaps talk with your PCP about something similar. Sending positive thoughts your way

Michele

 

[Fundy]

I don't think undergoing open heart surgery with breathing problems from a severe lung condition is considered low risk. You mention an upper respiratory infection, If that's severe I would think valve surgery would be extremely high risk with that. I'm guessing if there's any chance at all of your lung infection improving any time soon, then your surgeon would wait for that to happen.

 

[harrietW]

Thank you , honeybunny, Fundy
l have had cronic upper respiratory infection now for 4 years it just never goes away. I have interstitial lung disease this has been the issue all along. It is just sometimes worse than others. It took them the last year and a half to determine what was wrong and if l could with stand OHS. . Kind of don't have much of a choice at thus stage of the game. I have had sever MVR now for almost since l was diagnosed May 5 th/13 my birthday.
However also 2-3 AVR which is now 3-3+ they have been waiting for it to reach this level to avoid 2 separate vales surgeries and to be properly diagnosed and treated for lung disease. And sever sleep apnea AOS. I do use a cpap. I don't hyperventilate at least not as long as my stress level is low not to say that l don't from time to time like the day of my heart Cath l was discharged and 2 hours later go news that my sister had been found dead just an hour or two previously. Or when my mom had her 8th stroke at Christmas time. I thought both time l was going to stroke and my heart is so crazy iregular sometimes.
Both my Cardiologists l am blessed enough to have 2 now as a second opinion was called for by the first Doc and my family doc tell me this trumps all !! It's the actual (holidays) surgery control by the government over surgeries in the summer in Alberta as l am sure elsewhere. My cardiologist and GP said this surgery Needs to be long done before the end of the year !!!!
Yes honeybunny l do get anxious and have little panic attacks when l am so breathless but it just seems to get worse on the daily.
Also l have had a cronic bleeding nose for 3 + yrs. All of the sudden they .. the doctors want to do something about it for obvious reasons Valve R and Coumadin . Waiting to see a Nose throat ear doctor. I just don't know why they had to leave that til the last minute here.
Yes l am probably a bit bitchy and to much so at this point but l gotta say l am tired of feeling so awful all of the time. Be so grateful when the healing process has started and the surgery is behind me. I just want to feel better. It as l am sure most has been a long journey.
Thanks for your feed back.

 

[harrietW]

Oh Michelle. ..
I had such a hard time reply to your pm !! Just 3oildnt send ..Unknown error lol !
So thank again and my reply is now not so private hahahaha!
honeybunny. . Thank you so much for your kindness. And your prayers l think we could all use an extra word in there l so appriciate it. Im not going to lie it has been an incredibly tough time for my family this last 6 mths. Probably the toughest in 40 years. I am wearing down. I actually did have my GP give me a shot of something to get me through my sisters funeral in June it actually was incredibly helpful whatever it was. But the heart ache of watching her only son (he is 28 ) found her dead. And it is just aweful to see him in so much pain. GOD knows what he is doing and l trust that he has a plan for all of us.
We're going to be just fine you and l.
You are also in my prayers.
Love light and prayers to you honeybunny your an amazing women. Thx u Xx
Take good care.

 

[honeybunny]

You are pretty amazing yourself, kiddo ~

 

[carolinemc]

harrietW, have you sit down and write down some questions to ask the cardio the next time you see him/her? It would help talking to the doctor and find what the wait for surgery is for. And to ask for information of the condition of the heart itself, of what you are to do if something happens. I had developed CHF while wating for surgery. Over the past 13 years, the heart has gotten its strength back. And no longer have CHF. It was a sideaffect from the wait for surgery. Just keep leaning on the Lord and he will see you through it all, it did me. Hugs for today.

 

[harrietW]

Thank you Carolinemc
Sigh.. all great questions. I tried to see my GP and of course on holidays. I will see him next Fri. . I actually don't even see my Cardiologists again first time in almost 3 yrs they didn't reschedule a follow up. Just instructed to see Dr.Maitland Surgeon in Calgary on Sept 22. I actually call the office manager to remind them l hadn't received there letter yet. She informed me l would recieve it next week.
Emergency surgeries only until after the end of August hence why my appointment is in Sept. Office manager told me they could move my appointment up if need be upon request. My arteries are actually in pretty good shape l don't know what my EF is this time however my LA is severely enlarged. My body is quite noticeable swollen abdomen looks and feels Blotted very dry cough but lots of flem and wheezing frequent urine increase at night. So without being completely obsessed with ever little change twinge etc l am treding very carefully until l see my GP next week but if need be l will get myself to the hospital and or call my Cardiologists before hand.
Thank you so much for your insight experience and knowledge of CHF . Glad to know you are well. And honestly God is great and l trust He will get me through this. I have faith although can't see me waiting much longer. Xx bless you Caroline