Translated echo-result

[Debrinha GT]

This is what I heard from my doctor, now into English. Can anyone tell me what ithis means in practical terms, what does it all boil down to: The valve I have now had for nearly nine years is a Pericardium bovine bioprosthetic cardioprothesis valve #29

February14th, 03 Biological prosthesis with satisfactory cusps, sufficient and competent opening ,Maximum GRAD =16mmhg; medium grad med=08mmhg; valvular area (doppler)=4.09cm2. Enlarged Left Atrium.

January29th, 04 Biological prosthesis with slightly thickened cusps, sufficient and competent opening, max GRAD 14mmhg; Medium GRAD =08mmhg; valvular area (Doppler)= 2.99cm2. Enlarged left atrium

July22nd 2004, biological prosthesis with slightly thickened cusps, sufficient and competent opening, maximum GRAD = 14mmhg;Medium GRAD =7mmhg; valvular area (Doppler) = 2.68cm2. Increased left atrium.
Tricuspid valve, normal opening with mild regurgitation.
Sistolic pressure in the pulmonary artery estimated at 30mmhg

When I asked my cardio about this last result, he said that nothing much had changed, but when I got home and took a closer look at the exam, I noticed that he'd added two things that weren't there before as you can see. I recall my mum saying that during my first surgery the doctor had to touch up my tricuspid valve, but that was all and I'd never heard any mention of it until now. Could this mild regurgitation have something to do with that procedure done nearly 30 years ago? And what about the pulmonary artery, any connection there? I've had this same cardio for 10 years now, and although he usually answers my questions, he doesn't really say more than what he judges necessary. I've tried to get some information from my former cardio, but she totally refuses to comment on anything regarding my first two surgeries. She's in her 70s now so, there's no use trying to convince her that it's important for me to understand more about my past heart history. I'm considering getting in touch with the hospital in São Paulo, but I doubt they'll still have any records on something that happened such a long time ago. But if they do, can they simply refuse to help me? Any advice there too? I know that a couple of you have already replied to my questions, but any aditional information and opinion will be most welcome. Thank you all.

Débora from Brazil

 

[PapaHappyStar]

Hi Debora,

Even though I am not an expert in translating echo results either, I can give it a try. If you want some background you can try this link -- this passage is on the hemodynamics of mitral valve disease. Its filled with medical physics terminology, a bit hard to decipher:

http://cardiacsurgery.ctsnetbooks.org/cgi/content/full/2/2003/901#Hemodynamics

For the mitral valve the valve area calculation seems to be even more uncertain than the aortic so maybe the differences in the valve area numbers are not cause for alarm, the pressure gradients across the valve seem to be fairly constant: They refer to the force with which blood is expelled from the heart, in general the larger it is the smaller the valve area.

February14th, 03 Biological prosthesis with narrowed cuspids, sufficient and competent opening Maximum GRAD =16mmhg; medium grad med=08mmhg; valvular area (doppler)=4.09cm2. Increased Left Atrium.

January29th, 04 Biological prosthesis with slight cuspids, sufficient and competent openings, max GRAD 14mmhg; Medium GRAD =08mmhg; valvular (Doppler) area = 2.99cm2. Increased left atrium

July22nd 2004, biological prosthesis with thin cuspids, suitable and sufficient competent openings, maximum GRAD = 14mmhg; GRAD average =7mmhg; valvular area (Doppler) = 2.68cm2. Increased left atrium.
Tricuspid valve, normal opening with minimum reflux.
Sistolic pressure in the pulmonary artery estimated at 30mmhg

Going by the numbers from the article above I dont think there is too much bad news here -- you should monitor yourself for symptoms as usual, there is a danger of atrial fibrillation from the enlarged left atrium. Also go by what your doctors tell you they probably have access to more complete reports ( and greater knowledge ), but educate yourself nevertheless and ask questions...

All the best

 

[tobagotwo]

In the US, the doctors should not have more detailed reports, but Brazil could be another matter entirely.

I concur with PapaHappyStar. While there is evidence that your mitral opening is getting smaller, the gradients don't appear to be climbing, and the news doesn't generally look all that bad.

There is no mention of mitral regurgitation or calcification, which may be a result of different forms or partial information. Information regarding that might be helpful.

I believe these are probably pointing to an eventual replacement, but I would not guess this year.

How about you? How do you feel? Your symptoms and quality of life are a good key to your heart's status as well.

Best wishes,

 

[Debrinha GT]

very grateful!

very grateful!

Thanks the two of you for answering. I don't really understand echo results and the only thing I usually look at is the part where the doctor writes his conclusions. The exam itself has far more details than what I've posted, but everything else seems to be normal. I remember my mum saying that when they opened me up the first time, they had to touch up my tricuspid valve and I wonder if this mild tricuspid regurgitation mentioned in this last echo result has anything to do with that. What do you think? My left atria has always been enlarged as far as I can remember due to an enlarged heart before I was able to go into surgery. I don't really feel sick, but I do get the occasional palpitation here and there. It either comes without warning, the heart races for a few seconds and then misses a bit, and I feel kind of hot. Then I take a deep breath and just try to calm down so that it doesn't get any worse due to my anxiety. And there are times when it comes on and off, but very weak, then I don't panic. I haven't been going for walks at the club for one reason or another, being the main one, that I just feel afraid of straining the old valve. It's as if I'm trying to protect it in order to get it to last longer. Daft, I know. However, I'm very active in the house, but I think I've become too self conscious. Where should I draw the line between imagining things and actually feeling them? I have to go back and see my cardio again sometime in November, and I hope you're right about me not needing the surgery this year yet.

Débora

 

[Harrybaby666]

This is what I heard from my doctor, now into English. Can anyone tell me what ithis means in practical terms, what does it all boil down to:

February14th, 03 Biological prosthesis with narrowed cuspids, sufficient and competent opening Maximum GRAD =16mmhg; medium grad med=08mmhg; valvular area (doppler)=4.09cm2. Increased Left Atrium.

January29th, 04 Biological prosthesis with slight cuspids, sufficient and competent openings, max GRAD 14mmhg; Medium GRAD =08mmhg; valvular (Doppler) area = 2.99cm2. Increased left atrium

July22nd 2004, biological prosthesis with thin cuspids, suitable and sufficient competent openings, maximum GRAD = 14mmhg; GRAD average =7mmhg; valvular area (Doppler) = 2.68cm2. Increased left atrium.
Tricuspid valve, normal opening with minimum reflux.
Sistolic pressure in the pulmonary artery estimated at 30mmhg

Debora,
I highlighted the line in your echo that pertains to the systolic pulmonary artery...You might want to check with your doc about this and ask him if you have pulmonary hypertension....I just found out I have it....Take Care, Harrybaby666

 

[PapaHappyStar]

I get some palpitations as well -- this means my heart beat is more forceful than usual for 10-20 minutes ( its usually when I am trying to go to sleep ). My wife says she feels something like that too sometimes, her heart seems normal though ( no murmur ), so she is my control sample....

I think you should keep in touch with medical personnel and keep going for checkups as regularly as possible, a little paranoia dosent hurt, the alternative might....

 

[PapaHappyStar]

PS
( might live to regret that statement about my better half ... must remind self to remove the post if she ever signs on )

 

[tobagotwo]

Regarding Harry's mention of PH, you might want to also peruse this thread, to which Harry and Nancy have added good links:

http://www.valvereplacement.com/forums/showthread.php?t=8479

Best wishes,