Extra valve noise in my right ear

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G

Gisele

I wasn't sure where to post this question, but here goes. I noticed a few years ago that I would hear this sound through my right ear with that distinct tone (the one the valve makes) and it sounded as though the disc wasn't shutting snugly, but flapping a bit before my next beat. (wow-this is hard to explain). This was an intermittant thing that didn't seem to be related to my heart rate. When I told my cardio he didn't know what to make of it and ordered an echo (which he said came back fine). Now these episodes seem to be increasing.

Has anyone ever had any similar to this? I have a Bjork Shiley valve that is nearly 21 yrs old. This extra noise I hear when it happens is really starting to anoy me, and unless this happened when I was getting my echo I don't think it wouldn't show up.


Any ideas guys? Thanks.

Gisele
 
Could it be from some type of arrhythmia? Just guessing. My husband also has an old Bjork-Shiley. His is 25 years old. That's a pretty tough old valve.
 
Not an arrythmia

Not an arrythmia

Thanks Nancy.

It is difficult to express other than "that noise" but not associated with my heart rate. I know it sounds odd. Just imagine the disc when it closes it blocks any more blood from entering the heart chamber, but it seems as though it"flaps" a few times. That "flapping" is the noise that I hear. Very odd. It started a few years ago, and by that time I had my valve long enough to know it was a new occurance. That is the only way I can think of to explain it. The only way to capture this even would be if it happened during an echocardiogram.

I was just curious to see if anyone else ever experienced this.

Gisele
 
Gisele-

Keep pursuing it with your doctor. I don't want to alarm you, but many years ago, Bjork-Shiley had several defective valves. Joe's wasn't one of them, but it took a lot of investigation to find that out. He had to go to Lahey Clinic (where his card was at that time) to have a very special xray, looking at the structure of the valve and its integrity. Maybe an xray such as that would ease your mind.

I'll be thinking about you. So let me know how things go.
 
Thanks nancy

Thanks nancy

My valve was not one of the recalled valves. However when I go in Feb. for my semi-annual cardio exam I will bring it up again. I know I sound crazy saying I hear something and it isn't normal, but I have had this valve long enough to know what it should sound like. I honestly think with certain heart beats, the valve isn't shutting tight. But because this isn't with every beat or happening often enough, it doesn't show up. I guess we will see what happens. Not too many others out there with the same valve this old for me to compare with, huh? There is me, and Joe, and anyone else????
 
Hi Gisele,

If your echo was fine, my guess it may be an arrhythmia. Sounds like a PAC to me. Premature atrial contraction. I do get these myself, but less frequently these days.

Also, I am more aware of my valve sound when my INR is on the higher side. It somehow enhances it and makes the valve sound 'crisper'.

Ask your cardio if he could order a 24 hour holter monitor or an event monitor which are usually kept for a few weeks.

Keep us posted
 
Thanks Gina

Thanks Gina

But not associated with an arrythmia. Believe me, I can tell you when I am experiencing a Winkebach arrythmia, or a PAC, or a PVC. These don't apply. In fact my rhythm is "normal" when I hear this extra sound. Also not related to my INR. It sounds as though my disc isn't shutting tightly, like a shutter flapping in the wind so to speak. The valve shuts and is supposed to remain shut until the next beat where it opens to allow the chambers to fill up. Each time it slams shut, a "noise" is emitted. What happens is there will be for example three very rapid "slamming shut" noises that I hear that are unrelated to my rhythm. It is very hard to explain. I was just hoping that maybe someone else also had this. I figure if anyone was experiencing this they would know what I am talking about.
Thanks for the imput.
Gisele
 
Joann of John and Joann, had a Bjork-Shiley, but I do believe she had hers replaced.

You know that these valves cause mucho turbulence, but your system must be used to that by now and you haven't had any other changes to your cardiac system, right? Maybe the disk fitting has gotten a little sloppy over time.

Well, I'm sure you'll pursue it to the max. Sounds like you have the contacts to do that.
 
valve sounds

valve sounds

I have a St. Jude Valve and a Grafted Cadaver Pulmonary valve. Have you had any other different problems at the same time as the extra sound? When I had pneumonia this past summer and just after my surgery when I had fluid in one of my lungs I had an extra sound and the normal noise my valve makes also became very noticable. I don't know that this would be your problem but if some type of resp. or pulmonary problem is to blame it would not neccesarily show up on an echo.

Lettitia
 
My update

My update

Well, my latest is I have mentioned to my doc about my extra "fluttering sounds" that increased from maybe three flutter sounds (when it started about two years ago) to seven or eight flutter sounds. It also has increased in frequency and there are days it drives me crazy. It is a higher pitch than my regular valve sound and I find that I pick up on it very easily. My doc doesn't seem too overly concerned. He hasn't dismissed it-honestly probably because I won't stop complaining about it, and he has recommended a loop monitor. I had a stress test last week (due to increased SOB) and my echo is schuduled next weekend. I will see him the week after and we will discuss my test results. He did however call me and said my stress test was fine.

I tried to tell him that I didn't think a loop monitor would pick up on it as it is not related to my heart rhythm. My pulse isn't affected by these sounds. Let's face it-my valve is the only metal part in my body, and after having a mechanical valve for the past 20 years I know where that sound is coming from. Doc seems to think that loop might show some abnormalty during heart rate that I might not be aware of.

So for now, I will just show up for my ehco to make sure that SOB isn't caused from the valve and I will see him at the beginning of Dec.

Nancy, your husband never heard anything like this has he? Not too many of us Bjork Shiley people left around to compare notes with.

Lettita, thanks for the imput. I doubt it is my lungs, but I will mention it at my visit.
I will keep you updated.

Thanks, Gisele
 
Hi Gisele-

I asked Joe about any unusual sounds or extra sounds, and he says he's never had that, just his ordinary valve sounds. He does have a murmur which is always with him, and if he gets sick, it can get loud. When he has had lung problems, it has acted up. Any chance you're packing some CHF fluid in your lungs or elsewhere?

I'm glad you're going for an echo. I hope it can rule out any problems with the valve. The fact that they're increasing begs a lot of questions, though, and also combined with your SOB symptoms.

Are they planning a chest xray or ctscan?

What was the reason for your valve replacement?
 
A long, long, time ago......

A long, long, time ago......

LOL, when I was ten years old, the docs thought that the fever I had been admitted to the hospital with was probably rheumatic fever. It left my mitral valve damaged. That was in 1966. At that time there was one clinic in my city for cardiac patients (this was when every doc was just a family physician before specialists were the trend). After a while they said there was nothing much they could do for me besides make me take pennicillen three times a day and they referred me to Children's Hospital in Boson. I was followed there until I was about 20yrs old and my city finally had a cardiologist. Not wanting to continue travelling to Boston I hooked up with the only cardio guy in town. Now there are many to choose from in this area.

Not sure why the sounds have increased but some days I don't hear them at all. Funny huh? I am trying to block them out and not stress over every little thing. If my echo proves to be normal I guess my SOB on exertion could be attributed to "getting old". I guess I can't expect to do as much as I used to, although I don't know why??? I will just have to increase my exercise and groan, my cardiac (I hate doing a cardio "workout").

My doc did not mention a chest x-ray, nor did he mention a ct scan. I think he feels that if the stress and echo come back normal that the valve is functioning properly. However, if I am hearing this sound, someone, somewhere with a valve might also hear this too. With all the valve patients around I would think I wouldn't be the only one who has come across this.

I will just have to wait and see how the echo comes out. I am going Sunday morning. I will keep you posted.
Gisele
 
Update

Update

Ok, I had my echo, and my doc called to say he saw some left atrial enlargement from my previous echo (9mos ago). Although there is nothing alarming now, he will do a follow up echo in 6 mos and gave me yet another pill to take daily. Not sure what caused this to happen, and to make matters worse we were playing phone tag and he ending up calling me the day after Thanksgiving while I was at a huge sale in Kohl's. Quite distracting, but he did say I could hold off seeing him for one month instead of coming Tuesday.

Not sure how to get my atrium back into shape, but I guess I will just cross my fingers and hope for the best.

Hope everyone had a great Thanksgiving.

Gisele
 
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