From "can you help me" Echo report

[jessemac]

I'm pretty confused and would greatly appreciate if someone could interpret what these figures mean.
ejection fraction 63%
LV function decreased by 63% in the presence of severe aortic regurgitation (is it just coincidence that both of these numbers are 63%?)
mean atrial pressure=19mmhg (by e/e'+4) moderate diastolic dysfuntion (stage 2)
left atrium severely dilated
heavily calcified and immobile right coronary cusp. Aortic valve area=1.0cm2
peak mean pressure gradient=87/55mmHg
Severe aortic regurgitation. There is diastolic flow reversal in the descending aorta
Ascending aorta 3.2 cm.

 

[ALCapshaw2]

I've never seen a report that includes a statement about a % decrease in LV function. I have a 'WAG' idea of what that could mean but it's hard to imagine that could be a correct diagnosis so I won't go into it.

Bottom Line: You need to see a Cardiologist (or Surgeon) and get this sorted out.

Your Aortic Valve Area of 1.0 cm indicates that Aortic Valve Replacement is in your future (0.8 cm sq is the usual trigger point).

Your Aortic Pressure Gradients are High and also indicative of future Valve Replacement.

If you can't find a Cardiologist in San Diego, UCLA is a Major Heart Hospital and has some well known surgeons.

 

[briansmom]

I can't help you with your echo results, but my son sees Dr. Jaski (cardiologist) and Dr. Dembitsky (a cardiothoracic surgeon and valve specialist) from Sharp Memorial in San Diego. I can't say enough good about the docs and hospital who saved my son.

 

[Lynlw]

If I remember right, Jesse doesn't have insurance so needs a surgeon/hosp that will help her

 

[jessemac]

Jesse

Jesse

Yeah I'm embarrasses to admit it but I'm unemployed, broke with no insurance. I'm a male almost sixty. Seems pretty hopeless since I gather you have to be choosy in who does the diagnosis and the work and that's not an option for me

 

[Lynlw]

Yeah I'm embarrasses to admit it but I'm unemployed, broke with no insurance. I'm a male almost sixty. Seems pretty hopeless since I gather you have to be choosy in who does the diagnosis and the work and that's not an option for me

Don't be embarrased, times are tough. I only mentioned it in case anyone had suggestions. I don't know if Deborah in NJ treat patients from all over the country for free, if they don't have insurance, but I believe they might and since you live in Cal, if they will take you, you could look into some of the Angel flights that fly people for medical reasons at no charge. Deborah just does lungs and hearts, so they are very good. IF I remember right a couple years ago one of the surgeons preformed his 10,000 surgery so you can't find much more experience than that ps ooops sorry about the "her"

 

[dick0236]

I gather you have to be choosy in who does the diagnosis and the work and that's not an option for me

FWIW, I had no choice in selecting my cardio or surgical team. I was a broke college student. While I can vaguely remember my cardio, I'm pretty sure I never even met the surgeon although I did meet one of the physicians who was on the surgical team AFTER the surgery.

No one in the USA is denied necessary health care for lack of money. I think someone posted earlier that you should "show up at a hospital ER", and it will work itself out. Tell the ER doc that you are having chest pains.......that'll get something started.

 

[Lynlw]

FWIW, I had no choice in selecting my cardio or surgical team. I was a broke college student. While I can vaguely remember my cardio, I'm pretty sure I never even met the surgeon although I did meet one of the physicians who was on the surgical team AFTER the surgery.

No one in the USA is denied necessary health care for lack of money. I think someone posted earlier that you should "show up at a hospital ER", and it will work itself out. Tell the ER doc that you are having chest pains.......that'll get something started.

I'm not sure but I believe the law for non profit hospitals is they have to treat ER care, but they don't have to cover elective surgery. and sometimes IF you go to the ER they will stablize you, but won't do surgery if it isn't life and death right then. I think alot also depends on the state, but you can call the hospitals and ask how to apply for charity care, sometimes they cover everything if you qualify, but other times they will send bills , send you to collection ect This is from a few years ago so things may have changed but it is about people uninsured in Cal http://www.consumersunion.org/health/unisuredwc.htm

I am NOT suggesting this, but just showing it that people are going to india ect because they don't have insurance and can't afford heart surgery in the US http://www.debianhelp.org/node/12457

 

[Lisa in Katy]

It depends on your financial situation. There are people without insurance who have plenty of money (Rush Limbaugh, for example) and people without insurance with no money. Obviously if the former showed up at a hospital, he will be billed and expected to pay. There are people without jobs who have plenty of money (George Bush!) and people without jobs who have no money. If you go to the ER, they are required to stabilize you, nothing else. From your numbers, it doesn't sound like you are at the emergency surgery stage yet. However, they will have the resources to refer you to the correct offices to obtain Medicaid and to providers who will accept it. It's different in every state. You may qualify under the medically needy provision.

 

[lb151]

Do your reasearch. There is help out there. Medicaid paid almost completely for my heart surgery. It was done at one of the best centers with one of the best surgeons. There is no reason you can not get the best care available. My total cost was $42.00.

 

[jessemac]

Thank you very much for all your help. Lisa - what do you mean "from your numbers" it doesn't sound like and emergency? This is what I'm trying to understand. Is severe regurgitation not critical? I'd sure feel a lot better if I knew that was true. than you all again

 

[Lisa in Katy]

I had severe regurgitation for 22 years! 63% EF is pretty good. I'm not an aortic valve expert, but I know that people around here talk about the aneurysm trigger is somewhere around 5. The only thing borderline seems to be the valve area. I'm not sure about the other numbers. It's been a long time since I actually looked at "bad" echo results as my surgery was over 10 years ago. Emergency surgery usually means you are going to die within a matter of days without it. Otherwise it's considered elective.