How is it Possible?????

[georgi]

I have been reading the thread about "Symptoms" and it seems so strange to me that many of you with Heart Valve issues that required surgery had "NO" symptoms. How could that possibly be? I mean having a valve replaced is not a day at the beach. Even a bad tooth , gives you an ache. Just courious as to what makes us all so very different? I would think that we all would have SOME symptoms. For those that don't...........well it must be hard to get the needed surgery if you feel just fine. I'm confused LOL

 

[Cooker]

It was hard to walk through the doors of the hospital to have my chest cut open and my valve replaced when I had no symptoms?..But good council from my PCP, cardio, and the learned folks here made it very clear that the time for surgery was before I became symptomatic and had permanent damage to my heart?..I also saw my father live out the last 25 years of his life disabled?.He had his valve replaced, but waited too long.

 

[NickLDN]

Well, with me, my doctor said that if you have a valve issue, it will get worse sooner or later. The trouble is that if it's left till later, when you get the symptoms, it may be too late, as you may have damaged your heart. In my case, it's a matter of time when I'll develop symptoms, but symptoms mean that the heart is struggling to cope with a faulty valve, which can damage it. A damaged heart is more difficult to treat, takes much longer to heal, puts greater risk on the operation itself, and he is in favour of doing it nice and early, to avoid any possibility of permanent heart damage.

 

[WayneGM]

...........well it must be hard to get the needed surgery if you feel just fine. I'm confused LOL

Yep, it was quite confusing as I went from no heart murmur to a severe one in the course of one year between annual check-ups with my GP. I had not prior indication of any heart issues. Also, on the one hand all the tests (echo, angio, etc) all confirmed I had severe valve regurg and the early signs of the heart chamber enlarging, yet I felt perfectly fine and did much better than my Cardio expected during the treadmill stress test. I'm not sure why I didn't have symptoms. I've heard that perhaps the body can compensate and mask the symptoms. All I can say is that despite no symptoms, I didn't hesitate having the surgery given what I was told to expect if I didn't.

 

[Freddie]

My Story:

My Story:

I guess the only way for you and everyone to understand what happened to me is to tell you everything, right from day 1.
Monday morning March 19th 1:00am my other half brings me to ER due to SOB - BIG TIME!!! I was panting like a dog in heat, just couldn't catch my breath.

When I went to bed that evening, I was feeling JUST FINE, but as soon as I put my head on to the pillow I couldn't breath - I tried for 1 1/2 hours to catch my breath trying home remedies (brown bag, cold air etc.) when nothing worked I woke up my other half and off we went to the ER.

They gave me an air compressor type oxygen mask,
and removed six liters of fluid - from where I don't know, my ankles, face or hands weren't swollen. They took x-rays, blood work and told me I had a heart murmur. By 6:00am I was breathing like myself and thinking I could home. NO.....they admitted me. By 7:00am I was off to get an echo done and by 11:00 I was in my private room.

On Wednesday March 21 I had a angieogram(sp) done. On Friday the 23rd I was discharge with orders to call the surgeons office the following Monday morning. I was put on his "On Call List" and was called for per-op tests on the morning of the 29th with surgery Friday March 30th at 1:30pm.

Thats why my signature says shocked and dumbfounded. All of this felt like someone hit us with a 2X4 - we were all in shock with this news.
Yea, so, besides the SOB that evening in bed, I had no symptoms.

 

[Rich]

I knew about my heart murmur for over forty years but no symptoms. When I was a kid I couldn't understand why I was not able to run as far as the other kids, but that's about all. As far as the murmur all the doctors said was nothing to worry about.
Then in the spring of '96 I was going way too fast and collapsed, passed out and woke up in the hospital. Tests showed my valve was heavily calcified, but the next day I was released and felt just fine. I was told I needed valve replacement but there was no rush. Then within a month I couldn't even walk the 100 feet to my mailbox without resting at least once. Then I knew it was time.As others have said it will get worse at some point and you don't want your heart trying to make up for it.
Rich

 

[Duff Man]

I was told I needed valve replacement but there was no rush.

We must have the same doctor.

 

[Bonzo Dog]

The symptoms creep up. In most cases it's not as though valve disease is a sudden illness. For me it was a drip, drip, drip. As things slowly deteriorate we slowly compensate and in many ways are in denial. 'Yeah I don't have as much gusto as a year ago, but then I'm a year older', that sort of thinking

I found myself getting weary sooner, excusing myself from evening social events due to tiredness, spending less time renovating the wreck of a house we had just bought and going to bed earlier. It was only when standing back and being honest with myself I acknowledged any symptoms at all.

 

[upchurch131]

Georgi,

My exposure seems to be "textbook" for BAV. I had no idea until into my 40's that something was wrong. I had a "normal" childhood without any symptoms. In my 40's, I had noticable high blood pressure issues which were eventually traced back to a BAV. This was missed on several occasions of previous EKG's and echo's. I lasted now short of 10 years after discovery to the point where it is nothing BUT noticable. Almost constant shortness of breath, some chest pains and an ascending aortic aneurysm of 5.2cm besides the regirg of the valve.

I should be in surgery today, but I chose another surgeon who I have to see yet on 6/26/08.

 

[BDMc]

Georgi, My docs told me my symptoms weren't related to my valve, but I don't agree. I had sharp stabbing pains that have pretty much vanished since the surgrery, and my energy, and general health have been much better too! I don't think they know enough to say a lot of the things they say with such confidence. Hope you are feeling better. Brian Mc

 

[Philip B]

Symptoms or Not

Symptoms or Not

Hi Georgi,

Prior to the visit with a cardiologist in 2007 which resulted in my surgery, I had only visited with doctors twice about my AV issue. The first time was when I wanted to do sports in junior high school and my family GP wouldn't clear me without a referral to a cardiologist because of my heart murmur. The cardiologist I saw back then told me I could do anything I wanted.

The second time happened twenty-eight years ago, when the same GP recommended that I see a cardio doc again. Despite having no symptoms, this cardio doctor told me I wouldn't live to see my 30th birthday if I didn't let him replace my AV immediately. He also advised me to cease all physical activity. After giving his advice some thought I decided that he didn't know what he was talking about and went about living my life the way I wanted. The potential heart issues did give me a good excuse to backout of several engagements when I realized I needed out (I'm sure those girls did much better with someone else).

Frankly, I'm glad I waited and very happy that I managed to get away with waiting. I'm sure OHS and valve replacement technology improved during the twenty-seven years that I avoided seeing a doctor.

I knew that my valve would probably have to be replaced, but figured I would have some kind of symptoms which would tell me when it was necessary. An ER doctor convinced me it was time to at least get things checked again after she listened to my heart during a visit to the ER for a finger cut. What I didn't know was that I was developing a large aortic aneurysm. When I saw the aneurysm on a CT scan I realized I was probably overdue to get the plumbing issues fixed regardless of whether I had symptoms or not. It was still hard to check-in for surgery.

I don't know why some folks have symptoms and others with the same issues don't. Maybe I had symptoms and was too busy or too stupid to notice. My cardiologist has commented several times that my new valve and aorta should work better than my original equipment. So far, I haven't noticed much difference, but we'll see what the future brings. It's nice to have a future.

-Philip

 

[Ana]

With regard to my husband, he was very symptomatic, however we attributed those symptoms to other things.

We thought his fatigue was due to his starting up his own business and dealing with that. His weight gain was due to the fatigue and stress when it was actually edema. I had caught a cold with a horrid cough that lasted for almost two months before I got rid of it, so when he started coughing because fluid was filling up his lungs, we thought he had caught my cold. When he was out of breath walking to the mailbox, he attributed it to his cough. He had become more forgetful (leaving the stove on, etc) and we thought it was just overwork and long hours from his new business. When he started to run a temperature during the day and had trouble breathing at night because fluid was building up around his heart, so that he couldn't sleep, we thought his "cold" had turned into walking pneumonia. To that end, Carl saw two docs in ten days who listened to his heart and somehow managed to miss that he had a heart murmur and fluid in his lungs.

Two days after the second doc appt, I dragged Carl (who was looking rather moribund at that point) to my primary care physician who knew right away something was wrong, but only said, "Hrmmm, that murmur sounds pretty loud and I don't like the way your lungs aren't filling all the way. I'd like you to go now and get an EKG and chest xray." And that got the ball rolling. Now, 3.5 months post-surgery, all of his symptoms have disappeared.

As other's have said, it wasn't that he was asymptomatic, it's just that they crept up slowly (over the course of abut 18 months) and we were very good at rationalizing the cause. I remembering asking him twice if it could be his heart (knowing heart problems can cause SOB), but he insisted it was the "cold".

As for the two docs that completely missed a 70% regurgitation from two valves... grrrrrrrrr, don't get me started. Instead, I prefer to focus on the good part of this entire experience; that we are incredibly grateful for the care and compassion he received from the surgeons, cardiologists, nurses, and even admin staff along the way. They are such a great group of men and women I've fallen in love with them all (how can one not be enamored of the people who have treated my guy so well?) If this were Utah, I would totally be proposing left and right.

 

[Adrienne]

Hi Georgi,
First, let me explain a little bit how the heart compensates. What happens is that the chambers that have to work harder dilate so they can pump harder. This works up to a certain point. However, if they get way too big, there is no return. While the heart is compensating (and still hasn't gotten too big), it's likely there will be little to no symptoms.

 

[George]

Preventative Maintenance

Preventative Maintenance

I had no noticeable symptoms before my valve surgery. For me, it was a matter of trusting the judgment of the doctors. When the possibility of sudden cardiac death was mentioned, MY WIFE insisted we not hesitate, & take care of it.
When your mechanic tells you the brakes on your car are worn out, you may want to inspect them yourself, but once you know they are in need of attention, there's no option but to fix the problem.
This is the same sort of thing.

 

[Superbob]

Sort of a footnote to this discussion, because you are asking about valve deficiencies, not heart attacks, but it is even possible to have a heart attack without symptoms -- a so-called "silent" heart attack:

http://www.cbsnews.com/stories/2008/02/12/earlyshow/heartbeat/main3820454.shtml

It seems to be partly a matter of speculation why some people have symptoms, and some don't, but maybe the moral is to be tuned to our own bodies and listen for signals -- they may be there and we just don't realize it.

 

[catwoman]

We may think we don't have symptoms, but family members and friends may be noticing that we're not 100% up to par. This is not restricted to cardiac problems.
I went through this before my hysterectomy in March 1985. Post-op, my mom told me how tired I had looked pre-op and pointed out how I needed a nap after the 1-hour drive to their home when I'd run over after getting off work at 1 p.m. for a visit and dinner with them. Since I had to be at work at 5 a.m., I didn't think anything of taking a nap in the afternoon. I did it every day. But in retrospect, I realized that my overall condition had gone downhill before that surgery. I had just very gradually adapted to it.

Ditto with my heart surgery. I had adapted for years until it was almost too late.

 

[Duff Man]

I can remember feeling quite a bit better than I do now, but I can't tell just how much is normal and what isn't. There's a lot of things that cloud the issue like taking two blood pressure meds, being overweight, asthma, being out of shape... I guess it doesn't matter though because I have an aneurysm and it needs to be fixed at some point. It's not a matter of IF, it's a matter of when. Now or a year from now, probably.

 

[pamela]

My docs heard a heart murmur when I was pregnant with my son but said that during pregnancy increased blood volume can cause some noise. It disappeared after I lost my baby weight. I couldn't hold my hands over my head for long periods of time without my fingers tingling and the muscles tiring. I had to have an ACL reconstruction and the ortho guy heard a murmur and wanted an echo. Only problem was the tech and the doctor were inexperienced and of the wrong specialties so my aortic valve was never viewed, I'm not sure they would have caught the bicuspid even if they could have captured an image.

I had another baby and the murmur was pretty loud but of no concern since I'd had an echo and been told it was a benign thing. I have always had cold hands and feet so it was just a normal state for my nail beds to be blue. More years went by and when I turned 40, the niggling fluttering I felt periodically, my hands falling asleep, slight reynaud's in 2 fingers and swollen feet and ankles sent me to my PCP for a physical.

The rest is straightforward. I was diagnosed by cardiologists with severe stenosis and moderate LV hypertrophy and some mild constriction of the mitral but this was more than likely caused by the thickening of the septum. So, I wasn't ever without signs and symptoms, I was simply in denial of it being caused by my heart.