Correlation between pressure and valve area???

[Lorimacm]

I was wondering if anyone else has had this same experience with the correlation between pressures and valve area. My valve area has rapidly decreased and is down to .63-.70 but my pressures are still within the normal range. My cardio does not know why the heart is not increasing pressure to compensate for the smaller valve area. During my cath he was almost sure my valve area was not as bad as it is because pressures were still good.

For one I'm concerned how he is unsure of how this could be. Should this be investigated further. and two could there be something wrong with the muscle why it's not working harder.

I seem to read that pressures increase as the valve area gets smaller but I don't think I've come across anyone that had normal pressures with a small valve area.

Your thoughts would be appreciated.

Lori

 

[ottagal]

Hi Lorimacm,

In my particular case, the stenosis has increased (as I mentioned in your other post) substantially and the mean and peak pressure gradients have both increased as well.

I do recall reading somewhere that some individuals can have low gradient severe aortic stenosis, but I don't know much about it. Hopefully someone else will chime in to share their experience.

Perhaps, you could ask the cardio. about this?

 

[Lorimacm]

Thanks. My cardio told me this info a few hours after my cath on Thursday so I was kinda out of it and in shock over the rapid increase in stenosis I just didn't think to question him further. He did say he did not know why the pressures did not increase. I need to make a list of questions for next week which would include valve choice information.

Thanks again.

 

[tobagotwo]

It can mean many things, but usually, you have to look at the pump (heart) or the piping (valves) for answers.

The heart may be beating less strongly (particularly if you are being treated with beta blockers). Or the heart may be enlarged to the point that it is pumping less efficiently. Some arrhythmias can also affect the heart's efficiency, such as atrial fibrillation, which interferes with the proper filling of the ventricle.

Alternatively, if the mitral valve is leaking (regurgitation, insufficiency), it can relieve some of the pressure through the aortic valve because it's leaking out the other end of the ventricle at the same time it's being squeezed into the aorta.

Cardiologists tend to be more focused on blocked cardiac arteries and less so on the plumbing essentials of valve issues. As explained to me once, some cardios seem to tend to want to treat issues separately, rather than as parts of the whole.

Best wishes,

 

[epstns]

Lori,
Another consideration for those of us with aortic stenosis is that although our arterial blood pressure may fall within acceptable ranges, the pressure inside the heart may well be quite high. The heart may not be able to pump blood out to the arteries, to the arterial pressure remains "normal" but the pressure inside the heart that is required to maintain that "normal" pressure in the arteries can be quite high. That is why my cardio wants to manage my BP at a "low-normal" level.

On the other hand, he doesn't want it to get too low, as that can result in light-headedness or fainting from the low BP. . .

 

[Mileena46]

Hi Lori,

Well in my case, they never said a word about the pressure inside and I was being watched closely for Mitral Stenosis. I was told only that my valve was getting smaller and I didn't know enough about it to question what it was doing to my heart. Now that my surgery is almost 6 weeks behind me, I am being told that my ventricle is quite large because of the pressure. I was doing my echos every year to watch and my stenosis was going slowly....last year it was 1.3 so I didnt understand why I rapidly got so sick. Every year I was losing only .1...I went from 1.6 to 1.5 to 1.4 to 1.3....right on target...so I was guessing 3 years before surgery. Go in with problems and find I am at .9! with an enlarged ventricle which my cardiologist says if VERY large and he doesn't expect it to go down to normal.

So, what I am saying in a round about way....is maybe it does have pressure and IS enlarged and they won't know that until they do surgery. IF mine was enlarging all along I wasn't TOLD. I was only told that the Stenosis was getting worse every year.

Good Luck!
Mileena