A new leak!

[Eva]

In September 2008 I had my Aortic and Mitral valves replaced with St. Jude mechanical valves.

In June 2017, my cardio was happy with the echo results!

In April 2018, my echo revealed a mild Tricuspid leak! Since my surgery the leak had been trivial!

My GP told me (maybe to put my mind at ease) that it’s normal for this to happen as when the other two mech. valves were sewn, the tissues were pulled/stretched over time causing the leak!!! Does this make sense to anyone?!

I’ve been driving myself crazy trying to figure out the cause in order to avoid a fourth leak!

The only thing that I suspect is could I have a tiny dormant infection in my dental implant? I had the implant and bone graft in October 2016 (but my echo was good in June 2017), so, it’s not the implant!

Could a tiny bacteria have caused this during attaching the crown to the implant?!

The crown was installed on July 25, 2017. I didn’t take antibiotics since there was no need for it when I had the temporary tooth screwed in in May 2017.

But, fitting the crown was not as easy! It needed a few adjustments...fining it a few times! Putting it and removing it and when I rinsed I noticed some blood. Then I reminded my dentist I didn’t take my antibiotics, and he gave me 2000 mg from his office.

Thanks in advance for reading and commenting with your views.

 

[ottagal]

Hello my dear, Eva!

Getting any change in an echo is always a worry, isn't it! In my humble (and not medical) opinion, I was always under the impression that infection is the potential cause of endocarditis, not a leak.

If this helps at all, my echos always show trivial tricuspid regurgitation. My echo can never measure arterial pressure else because of this.

My cardiologist has repeatedly told me that many people walk around with trivial leaks and it should not be of any cause for concern to me. I have to believe him!
Hang in there....
Thinking of you and sending you healing thoughts!

 

[pellicle]

Hi Eva

I wouldn't ask a lady her age but depending age valve leak is normal (as is a decline in Ejection Fraction and so on). It sounds to me that your GP is on the right track (they aren't all bad, even in my view ;-) and it is just a "keep an eye on it" ... stuff wears out as we age.

I agree with Ottagal that any ingress by bacteria would not be what I expect to cause a leak (its not like something jammed in between the lid and the rim of a jar), and bacteria don't settle on the edge of the leaflet (where blood flows would wash them off. They tend to settle in quiet places and take advantage of any breaks in the 'endothelia' lining of the interior. So you'd not know till you started showing other symptoms like night sweats , fevers, sluggishness and feeling a general malaise.

Best Wishes

 

[Agian]

Don't fret, mine often mention this. Apparently, it's within normal. Both my cardio and surgeon told me this.
No infection Eva. As you were.

 

[Eva]

Hello my dear, Eva!

Getting any change in an echo is always a worry, isn't it! In my humble (and not medical) opinion, I was always under the impression that infection is the potential cause of endocarditis, not a leak.

If this helps at all, my echos always show trivial tricuspid regurgitation. My echo can never measure arterial pressure else because of this.

My cardiologist has repeatedly told me that many people walk around with trivial leaks and it should not be of any cause for concern to me. I have to believe him!
Hang in there....
Thinking of you and sending you healing thoughts!

Thank you, ottagal, for you comment. I agree and my dentist told me me the same as you said that an infection won’t cause a leak! But I’ve not been thinking right since April! But I’m calming down now and accepting the change.
I got used to “trivial” leaks, but for it to become “mild” was shocking and worrying.

Thinking of you too!

 

[Eva]

Hi Eva

I wouldn't ask a lady her age but depending age valve leak is normal (as is a decline in Ejection Fraction and so on). It sounds to me that your GP is on the right track (they aren't all bad, even in my view ;-) and it is just a "keep an eye on it" ... stuff wears out as we age.

I agree with Ottagal that any ingress by bacteria would not be what I expect to cause a leak (its not like something jammed in between the lid and the rim of a jar), and bacteria don't settle on the edge of the leaflet (where blood flows would wash them off. They tend to settle in quiet places and take advantage of any breaks in the 'endothelia' lining of the interior. So you'd not know till you started showing other symptoms like night sweats , fevers, sluggishness and feeling a general malaise.

Best Wishes

Hi pellicle,

thanks for your comment. My cardio also asked me not to worry about this “mild” leak and that we’ll keep an eye on it! Since I have no other choice, I’m now accepting the change, especially that I’ve aged ten years since my surgery (that makes me 67 years young!). Things happen, and I hope the fourth valve will stay ok.

Best.

 

[Eva]

Don't fret, mine often mention this. Apparently, it's within normal. Both my cardio and surgeon told me this.
No infection Eva. As you were.

Thank you, Agian, for your comment.

You’re right, when my Mitral started leaking a few years after rmy aortic valve’s insufficiency (over 30 years ago), there was no infection!
The word “mild” shocked me because of previous history with mild becoming severe!

Thanks for your your comforting words.

Best.

 

[epstns]

Eva - don't forget that echo's are notoriously imprecise. If this echo was done by a different tech, or used a different machine or probe, or was read by a different doc, the measurements could differ from prior echo's but there might be no real difference within your heart.

Also, count me among those who have some additional trivial or minor leakages after aortic valve replacement. My echo's aren't perfect, either. I have a small leak (IIRC, ventral-septal defect) that has been around for a long time. I also have some unusual heart wall motion, caused (we believe) by the way my pacemaker leads are implanted and how my device is adjusted.

All we can really do is watch for long-term trends. If we see some periodic changes that seem to have no lasting impact on quality of life, they are probably better described as noise. I have ll the issues I mentioned, and at almost 71, I'm in better shape than I've been in years. I am at the gym 5 days a week, and feeling quite will in spite of having an EF of about 50-55%.

I don't panic easily. Ask my oncologist. She was rather surprised when my comments after receiving a cancer diagnosis were something like. . . "Well, I guess I'll begin researching my options. I'll be making up my list, making appointments, and we can discuss what comes next after that." Yeah, my brain was screaming "What will I do???" but my conscious mind was calm and calculating. Just the same as we do here. It works.

 

[Eva]

Eva - don't forget that echo's are notoriously imprecise. If this echo was done by a different tech, or used a different machine or probe, or was read by a different doc, the measurements could differ from prior echo's but there might be no real difference within your heart.

Also, count me among those who have some additional trivial or minor leakages after aortic valve replacement. My echo's aren't perfect, either. .....

I don't panic easily. Ask my oncologist. She was rather surprised when my comments after receiving a cancer diagnosis were something like. . . "Well, I guess I'll begin researching my options. I'll be making up my list, making appointments, and we can discuss what comes next after that." Yeah, my brain was screaming "What will I do???" but my conscious mind was calm and calculating. Just the same as we do here. It works.

Hi epstns,

you’re absolutely right that echos are imprecise! One echo wud reveal a leak in the aortic position, another echo would show a leak in the Mitral position. Over years, I ignored both and concentrated on improving what I can improve.
This last echo was done in the same office of my cardio, but by a different tech. I thought I was lucky as she seemed most experienced and professional! I hope she’s wrong, but I have been feeling more fatigued than previous years, but it could be that my plate is full too! I kept hearing since my surgery in 2008 that the “trivial” wouldn’t change. I’m hoping now the “mild” leak will not change/worsen as you said. I need my energy to continue caring for my oldest sister whose health and memory are deteriorating.

I applaud you for your attitude and thank you for sharing your thoughts. I’ll include you in my prayers.

Best.