few ?'s

[Gribur]

Hi all hope everything is well. I am now about 9 months out from a bentall proceedure and it feels like that was years ago lol. I had an internal bleed following my surgery from being on coumadin and having a duodenal ulcer, almost lost the battle with that one. I am wondering now, i have gained some of my physical endurance back but a couple things still bug me. when i bend to tie shoes, pick up anything, it feel like i cant breathe proper and when i stand i have to catch breath. Second, i have been having non stop migrains, not sure if it is the weather in ontario, we have been having non stop low pressure systems and storms and thirdly, when i get my heartrate going my wife can actually hear it pounding in my chest, like a hard thud thud. any input on similar experiences or ideas on what may be going on please feel free to comment. I am loving "being fixed" I just wish it came with a warrenty and that i was not worried that i may break so often.

 

[TheGymGuy]

For OHS they leave the pericardium open and your Heart Beat sounds a bit louder no matter what the valve is. Of course this depends on body type, chest size, etc., but I think the loud heartbeat with exertion is pretty normal. The bending over part is just how the blood flow changes, are you by any chance taking Tropol too? Whats your blood pressure like?

Anyways, for 9 month post AVR you sounds to be doing well. How is exercising coming along?

 

[pellicle]

Hi

To the OP :

For OHS they leave the pericardium open

For some quick information on this see here

http://www.heart-valve-surgery.com/...ricardium-opening-stitches-cardiac-tamponade/

and your Heart Beat sounds a bit louder no matter what the valve is.

This was not my experience. My first valve replacement was with a cryo-preserved homograph. This felt totally normal after the surgery.

I was quite surprised by the string beating thump of my new valve. In quiet rooms it is audible to people beside me. I do not believe this is related to the pericardium as much as the closing velocity of the valve.

I think my dacron sock has something to do with this too.

but I think the loud heartbeat with exertion is pretty normal.

Strangely this is where I notice it least. Either cycling or doing gym work I barely notice it. Even when at 150bpm.

Its a bit like the suspension on my ducati. Rough at low speeds, but works great at 160

 

[pellicle]

PS

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC483174/

Thus closure of pericardium helps to prevent tamponade. Reoperations some months or years after the original operation are technically easier and less hazardous if the pericardium has been closed because the closed pericardium prevents the heart from becoming adherent to the back of sternum and also because there are fewer adhesions in the pericardial cavity.

 

[TheGymGuy]

Of course this depends on body type, chest size, etc., but I think the loud heartbeat with exertion is pretty normal.

Thanks for the link Pellicle. I was indeed referring to the Heart Beat and not "valve beat", saying this for differentiation of the terms. I have a fairly large chest, you could even say I am barrel-chested, and for my body-type my heartbeat itself is louder when I breath in (expand my chest) and when I am under physical stress, IE heavy squatting, prowler pushing, etc. Funny thing is that due to my anatomy the clicking is quite noticeable with exertion, but I actually enjoy it.

 

[pellicle]

I just wish it came with a warrenty and that i was not worried that i may break so often.

Life is not that way. My wife was a strong fit woman in her 30's , a picture of health. Strong and very competent cross country skier and often embarrased male poseurs who just couldn't match her fitness and technique. She died unexpectedly of a brain tumor which was a most aggressive type and uncommon for her age.

No warranty on life , take it up with the maker.

 

[pellicle]

the clicking is quite noticeable with exertion, but I actually enjoy it.

Let's you know you're alive ;-)

PS

was indeed referring to the Heart Beat and not "valve beat

Well I'm not sure I grasp the difference. As mentioned I noticed no difference when my homograph was implanted.

 

[pellicle]

Hi
I initially baulked at a reply to this as I don't feel qualified to answer.

So couched in those terms:

I am now about 9 months out from a bentall proceedure

I wonder why they used that method rather than a Dacron sock? Are there other factors you have not mentioned?

I had an internal bleed following my surgery from being on coumadin

?? Incorrect dose or an internal bleed from stitching issues or the ulcer?

but a couple things still bug me. when i bend to tie shoes, pick up anything, it feel like i cant breathe proper and when i stand i have to catch breath.

Seems strange. What is your BP? Have you mentioned this to your doctor? Do you feel some occlusion of your chest? What is your previous fitness level, are you active? What age did you say you were? Did you have anything like this before?

Second, i have been having non stop migrains, not sure if it is the weather in ontario, we have been having non stop low pressure systems and storms

Have you ever been to a chiropractor? I found that helped after my surgery. There are often all sorts of pressures placed on you during surgery and recovery. Did you get migraines before?

 

[Trixie]

Hey Gribur--I too have some trouble breathing when I bend over. My cardiologist doesn't know what that could be--maybe caused from the diaphragm--he assures me that too shall improve. Every day gets a little better.

 

[AgilityDog]

If you are on an ACE inhibitor for blood pressure, those can trigger migraines. The ACE inhibitor degrades into nitrites with aggravate migraines.
I had to switch to an ARB rather than ACE inhibitor for that reason. I can't use nitroglycerine, either, though ideally my cardio would like me on it to increase the strength of the ventricular contractions. Nope, we're not going there, and he knows it.