The Basics

[breakingwaves]

I am going to ask once again for the expertize of those that have gone through this process. I would like to have a run down of what seems to be pretty basic when it comes to what happens to someone who needs valve replacement. Like the steps. Now I know they won't be exactly the same for everyone, but enough to provide beneifit for we under educated people.

Is the first step the echo? I have had several over the years. Then what do I expect next? What schedule of tests, when the surgeon gets involved, does the cardio insist on a new cath before you meet the surgeon, when does a TEE come into the picture, things such as that. Is there such a thing as this test follows this and then you progress to this? Is there something new and different that you have experienced I have not learned yet in the testing process? I would appreciate any and all info.

Thanks in advance!

 

[Ross]

In my case, it started with a chest xray, then nuclear stress test and gamma camera imaging, then echo, then catheterization, then TEE, then off to the surgeon with all the results.

 

[Tom F.]

For me it was MRI, then echo, TEE, cath, then surgery.

 

[tobagotwo]

For me, it was echoes for a few years. Then a cath was done the day before surgery as a final sanity check. During surgery, they run a TEE on everyone, but as you're knocked out, you don't know it. Some of us wind up with voice problems afterwards for weeks or months, which I blame on having too much equipment in my throat at the same time. My voice issue has since resolved.

I had an MRA later, but it was not directly related to my valve. Because my heart had been so noisy before the surgery, they wanted to ensure that there were no blockage issues in the carotids.

Best wishes,

 

[Paul_R]

In my case it was Echo, TEE, Cath, Echo, Holter Monitor, MRI and then surgery. My issues are mostly congenital in nature and that was the reason for the multiple echos and MRI. If your over 40 they pretty much automatically do a Cath to check for blockages.

 

[JimL]

Once again, I'll try to summarize what my brain thinks it has deduced, but which may be entirely wrong.
They do progressively more serious tests to find out what's going on in your heart; each test becomes more invasive and also more informative. So you can range the tests in a list, like X-ray, echo, cath. The cath tells the card a lot more than the echo, but nothing is as informative of what's going on inside as OHS.
So then you have an echo, and if it looks alright, you go no farther. When the echo indicates things are looking worse, you get more invasive in the testing. In my case, they didn't discover just how bad my valve was until they cut it out.

 

[breakingwaves]

Ross

Ross

I hope I don't sound really dumb asking thiese questions, but what is gamma camera imaging?

 

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Tom F.

Tom F.

Does an MRI really tell you much about the heart, I have gotten chest xrays in the hospital but not the MRI.

 

[breakingwaves]

tobagotwo

tobagotwo

Is an MRA different than a MRI?

 

[bvdr]

It seems like everyone is a little different. For me it was:

EKGs, chest x-ray, stress test, echo, radionuclide stress test, heart cath, and a second echo. These took place over a 5 month period of time. I did not have a TEE until during the mitral valve replacement surgery.

 

[breakingwaves]

Paul R

Paul R

what is the purpose of the Holter Monitor?

 

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Jim L

Jim L

I agree OHS certainly would be as informative but not something that can be done too often right? Do you know what is the average number, is it 1, 2, 3 or more for the surgeries?

 

[breakingwaves]

Bvdr

Bvdr

This has been helpful for me to see a progression in tests, helps me get my thinking wrapped around it!

 

[tobagotwo]

BW,

MRI means Magnetic Resonance Imaging. MRA just means Magnetic Resonance Angiogram - in which they use the MRI technique to look for blockages in the arteries. It's a technique that doesn't use radiation, but instead alters the magnetic polarity of your body's atoms, and forms an image by measuring the energy produced when they spin themselves back into their normal polarity. There is an injected dye involved to create good contrast. You may be mostly enclosed in a noisy tube during the test, so you can get something ot calm yourself prior to the test if you are claustrophobic.

A Holter monitor is the size of an old transistor radio on a sling. It is connected to you by the same type of sticky electrical pickups that are used for an EKG. That's because it basically is one. Generally, they record one, full, 24-hour day's worth of EKG readings, so the cardiologists can know whether you are having fast heartbeats or arrhythmias at home, what kind, and under what circumstances. You even have to sleep with it (they don't cuddle well, though).

Best wishes,

 

[Mary]

Linda,
I looked back at your posts to try and see what tests you have had. You posted that you have had echocardiograms. How many, and how often have they been scheduled?
I remember that you had an attack several weeks ago. What did the cardiologist indicate when you saw him? Did he discuss how severe the stenosis is? Do you know how much the valve opening is closing?
If you could provide more information, it would be easier to give you an idea of what others have experienced. Everyone is different, and everyone progresses at different rates. I have had echos and two catheterizations without surgery. Others have had one cath and immediate OHS.
I think some members have had as many as four OHS, but I wouldn't call that the norm.
Mary

 

[bvdr]

....the reason heart rates and rhythms play an important role in determining the need for surgery is that they help the physician judge how well the heart is reacting to the stress it is under. As the heart changes shape to adapt to demands placed on it all kinds of rhythm problems can develop, especially atrial fib.

 

[Ross]

I hope I don't sound really dumb asking thiese questions, but what is gamma camera imaging?

They take a nuclear dye and inject it, then take multiple images of your heart beating at diffrent intervals to see what all they can see. I actually think mine was unnecessary given all the other tests, but they did it, so I brought it up.

http://www.chclibrary.org/micromed/00067650.html

 

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tobagotwo

tobagotwo

I do love how you talk to me, I get it when you explain! I didn't know about that type of MRI, for looking specifiically at the arteries. Who am I kidding I didn't know alot of stuff, talk about the tortoise being in the shell!

 

[Paul_R]

Mri

Mri

In my case they did a 3D model of my heart from the MRI. It was pretty cool to see the 3D image of my coarctation repair. They where also able to do 3D image of my mitral valve.

 

[breakingwaves]

Mary

Mary

Most of what has been happening lately was what I had mentioned in my thread Clueless but to make my history short about 5 years ago I went to the emergency with what I felt was a heart attack. After a variety of tests most especially a cath they sent me away saying, I have a great heart. I then ended up in the emergency with an attack of diverticulitus ,I can never spell that word right, and internal medicine doctor said he wouldn't operate on me until he had a go ahead about the aortic stenosis. news to me, actually a shock because I had been told by a heart doctor, the one who did the cath that I had a great heart, one he wished he had!

So I ended up getting echos and that's all, my regular GP doc told me , even though my echos were always moderate stenosis, as well as this past August, it would probably be 10 yearts before I would need Open Heart Surgery.

Well at the beginning of September I had another attack, woke up with a feeling of pain all through my chest, arms, and neck, just an incredible amazing pressure, I could hardly move. I was ordered for a stress echo and the doctor who was reading the test at the time given told me that It would be most likely a year or two, at the most, also what had been described to just moderate stenosis was now severe to moderate. He told me to get my ducks lined up and begin the decisions about a surgeon I had tuned in here and knew to ask a copy of my test and that's what I orginally posted. whew, I think that's all! I really didn't know anything about anything, what initials stood for, what happens next, what to expect, wha to ask.

I see the cardio guy that my general doctor scheduled for me next week, and believe you me I will be taking ya all with me in spirit!