Echo change???

[Carol]

How can an echo change? New echo says no BAV....No PFO. I now have 75 EF but valve down to .08 from 1.1.This all seems too strange.I have had 4 echoes with Bicuspid valve and PFO and lower EF.

 

[Adrienne]

I have no idea about the first part, but the part about the EF of 75 could be because the heart is OVER-compensating. That happened to me, and I know that it happens quite a lot when things start worsening.

 

[Carol]

Thank you for the reply.

 

[big_L]

I was told for years that I probably had a bicuspid valve, then I had a TEE and they said it was tricuspid. Perhaps, it's just not always clear with the thoracic echo. What time frame are we talkng about with the area change from 1.2 to 0.8? Mine bounced around 0.9 to 1.1 for 4-5 years, then seems to have dropped below 0.7 since the first of this year.

 

[Guyswell]

Even if it's not technically a BAV, An aortic valve can still be malformed with uneven cusps that lead to regurgitation (leaking) or stenosis (narrowing). Perhaps the third cusp exists but is abnormal.

 

[Jkm7]

It seems to me I recall my cardio saying an EF of 75% is considered higher than desireable.

 

[Carol]

The time frame is 20 months.I will go to cardio next week for explanation. Should I ask for TEE? How can we trust these results if they keep changing?I am STRESSED.....Has anyone else had Diastolic Difunction?

 

[epstns]

Carol, there is the possibility for substantial variation between echo results. This can be the result of having different technicians whose techniques may differ, could be differences between machines used, differences in the patient over time, etc. The cardio's don't usually base any real decisions on a single echo, instead relying on trends and patterns seen in sequential echo results.

The TEE is more reliable, but a bit more invasive. If they don't see anything in the transthoracic echo that points to imminent surgery, they may just watch it and see. If the echo shows that it "may" be time, then they may call for a TEE or even a cath. These are more precise, but also more invasive (and more costly to the insurance companies).

 

[Carol]

I saw Cardio yesterday.He showed me the valve on the echo....not too clear.We talked surgeons but he said I could have 6 more months.....WEEEEEEEEE.

 

[T in YVR]

Yeah, the tests can certainly tell you different things. My Echo said I had a BAV. My TEE said it was "Functionally Bicuspid" - i.e. 3 cusps, but 2 of them were calcified and stuck together and functioning like a BAV...

 

[Heart Of The Sunrise]

If it were me, I would get a TEE done. Then I would get all my ducks in a row. I would not wait six months. I would have the surgery soon. Waiting in most cases does not usually serve a useful purpose.

 

[Carol]

Yes, I do think it is time.I am looking at MassGeneral.We went thru this last year with my Daughter.She had emergency AVR in Feb 2012. I know what to expect and am scared. I am not as healthy as she was.

 

[Carol]

Ok a new one for you all....My Abdominal aortic aneurysm has disapeared. I saw my vascular surgeon last week...6 mo check up. I had recently had an MRI for another reason.I asked him to check it for my AAA. He said he could not see any. I was a 3. When I had an echo recently the tech said he could not see it either. I have been on losartan which is used for Marfans syndrome for 2 years. I will accept this, gladly.

 

[Carol]

Update.....Had echo recently.Valve is back to 1.1.valve is still trileaflet.EF is 70. Means gradient is 37. I also had a CT scan this fall for another reason...aortic aneurysm is still missing. I see cardio in 2 weeks.....Lots of Questions???

 

[Eva]

Carol,

If the last echo was done at a different clinic, or same clinic but with a different tech, then you need your cardio to look at the echocardiograph himself. Not all technicians are accurate when it comes to measurements.

I agree that 75% EF mean your heart is overworking to compensate!

When I had contradicting results from two different places, I went to a third clinic that was neutral (not affiliated with my hospital)!

Take care.

 

[Paleowoman]

I agree that 75% EF mean your heart is overworking to compensate!

My ejection fraction has always been 77% to 79%, for years, and cardilogists say my heart is not overworking. I think it depends on a lot of things, like how the heart muscle looks, whether it is hypertrophied, that type of thing.

 

[Carol]

Same hospital,different tech. My cardio reads all echoes there.I will know more on the 15 th of Jan.

 

[Carol]

Update....I saw cardio yesterday. He said all is about the same.See you in 6 Months. I asked when I would need a valve replacement,he said 6 mo. To 5 years.He was quite excited that his hospital is now doing Tavr.I said if I wait the 5 years can I have it that way? He laughed.P.S. I was serious.

 

[Eva]

Carol,

Thanks for the update. Stay well for five years or more!!