Another probably silly question : )

[DavesMom]

Hi all,

We're housebound thanks to the lovely weather, so I decided to start making a list of questions for my cardio appointment next week. Well, got to looking at my echo reports and for the past two years a mild thickening of the mitral valve and mild mitral annular calcification have been noted. However, the valve leaflet motion is well preserved. I've always seen the word "mild" and never paid much attention to the measurements. For some reason they caught my attention and here they are:

2008
MV E/A 1.0
MV max PG 9.0 mmHg
MV mean PG 4.0 mmHg

2009:
MV E/A 1.2
There are no pressure gradients given for this one.

Maybe I'm wrong, but I'm assuming that the MV E/A measurement is the area of the mitral valve. Now if I read the Cleveland Clinic site correctly, 1.0-1.5 is considered moderate stenosis. Less than 1.0 is considered severe. The word "stenosis" has never been used on any of the reports, but am I correct in thinking that I have mitral stenosis?

Any info would be greatly appreciated.

Cheers,
Michelle

 

[Mileena46]

Michelle,

At my first echo I was told that I had a "stiff mitral valve". I asked what that meant and was told that it just meant that I had calcium buildup on the valve. I was having a lot of problems and was so happy to hear this, until I started researching it on the web. At my cardio visit I was told my valve which should be opening to 4-6cm was only at 1.5 and this was mild to moderate. The next year it was 1.4 and I went from there losing .10 every year. I didn't even know what a gradient was nor did I hear anyone mention that until I found this forum.

IF MVEA is your measured diameter opening of your valve I don't know why it would have gone from 1.0 in 2008 to 1.2 in 2009 unless one is a mistake. I don't think they get better over time.

As far as Stenosis, it certainly does seem to be your DX. However, why not ask your doctor? I would only be "assuming" that to be the case, as it only makes sense.

Either way, at a diameter or 1.0 or 1.2 you need to be aware that you are on the cusp of needing this corrected. At 1.2 a little more time....but in my experience once the valve gets to a certain level it goes very fast. You just have no idea when yours might do that. My surgeon also confirmed this to me for both the Aorta and Mitral valves.

You need to discuss all your concerns with your doctor.

Mileena

 

[Ross]

I don't give a whole lot of credit to echo reports. They are only as good as the technician doing them and doctor interpretting them. It's ok for seeing that there may be a problem, but catheterization would be the ultimate test for accuracy.

 

[Bina]

I think the MV E/A is the Mitral Valve Effective Area.

 

[river-wear]

The change from 1.0 to 1.2 is probably just measurement error. Someone can measure something 10 times and get a slightly different result each time - there's even more variability if different equipment is also used for two measurements.

I would conclude there was little or no change in MV E/A between the two reports.

 

[DavesMom]

Thanks for the replies.

Bina - the MV E/A does refer to the mitral valve effective area. I just saw the numbers 1.0 and 1.2 and got to wondering.

Ross, I so totally agree with you about echos. The tech I had last year seemed in a big ol' hurry and was done in about five minutes. Echo results are frustrating and can sure cause undue concern.

In other words, don't be surprised if I panic and post after I've had mine on Thursday.

Thanks again.

Cheers,
Michelle

 

[Mileena46]

Michelle,

No matter what it shows....don't panic! You are still ok. You didn't mention any symptoms at all, and most surgeons won't get in a hurry to do surgery unless you are having some. I believed myself to be ok for another 3-4 yrs, but when I started having symptoms there was no doubt. There I was thinking I had more time, and my Cardio telling me within 2 weeks.

I walked around for a few years knowing I was destined for OHS, and guessing at WHEN. If you are at 1.2 and asymptomatic, don't expect your Cardio to be ready to do surgery anytime soon. IF you are ready you might push the issue. It is my opinion that some doctors should do surgery sooner than later, and some wait too long. I know that if I had gone ahead and had my surgery 2 years ago I wouldn't have had some of the problems I had after, with my heart being enlarged.

Of course they will quote you the AHA guide lines for Mitral Valve Replacement, and the fact that your quality of life is still good. Who knows when the line is crossed and yesterday is when someone should have had surgery. I believe if the surgeon can get to it before the heart enlarges so much that it cannot go back to normal, then that was as right as any...but honestly I think that might be a small window. My Cardio tells me my left atrium will never go back to its normal size. If I had it to do over, and know what I know now....I would have insisted on my surgery long before I had to have it done. In my mind I think I believed I might never get bad enough. Stenosis will get bad enough with enough time.

Mileena