Good news! No longer on short list for surgery

[Shari Thomas]

I had an echo yesterday and my heart is improving, taking me off the short list for surgery. The ejection fraction went from 70 to 72% and the heart wall is no longer thickening.

I still have the moderate leak in the aortic valve and mild leaks in both the mitral and pulmonary valves, and am in persistent a-fib. Will be converted again for the third time Nov 18.

We're not sure exactly what brought about the improvement, as I've had my first thyroid ablation (RAI), am now on CPAP (low pressure) and have been taking a beta-blocker cocktail including corvedilol, digoixin, Multaq, and pravastatin, as well as lasix, potassium, and magnesium. Of course, I'm also on warfarin, which is still not fully controlled.

At any rate, I'm cleared to begin going up and down stairs (with caution), and even doing some light cardio work. It's winter here, and my outside work will be more limited. I do get to feed the sheep, cows, chickens, and horses as I feel able.

This doesn't take me off the list for surgery, it hopefully delays it for a couple of years.

 

[ALCapshaw2]

You Heart is IMPROVING ? That's Unusual (and probably not likely).

Did your Cardiologist say that?

A change in EF from 70 to 72% is a VERY SMALL difference that could EASILY be operator 'interpretation' and not a real measurement difference.

Also, you need to know that the Normal Range for Ejection Fraction is 50 to 70% (Every Hospital seems to have their own slightly different range that falls within those limits).

An Ejection Fraction over 70% is seen in Two Types of People:

Group 1 - Highly Trained Athletes such as Cyclist Lance Armstrong.

Group 2 - Heart Valve Patients whose Hearts are Compensating for a Diseased Valve.

Which group is the most likely for you?

Bottom Line: An increasing EF is Not Always a Good Thing.

'AL Capshaw'

 

[tobagotwo]

Sounds like your heart isn't worsening as fast, or may even be holding steady for the time being. I'm glad it seems you may be able to do without the surgery for a bit longer. However, I'm not seeing what would be an improvement within your post.

I have to agree with Al on the EF. Fortunately, a 2% change is well within the error range of an echo, so it may not signify an actual change. Not as fortunately, unless there is a large change, wall thickness increases may not be picked up, from one echo to the next. Echos are good, but not dependable for minute accuracy, such as say, 2% of EF, or 2 mm of wall growth (2 mm is just narrower than a lower case "b" in a standard paperback romance novel).

EF should stay within a range, usually given as 45% to 65% ("normal" ranges are different, coming from different physician groups).

Anything around 70% for an average or even moderately atheletic person is a cause to look for left ventricular hypertrophy (enlarged heart muscle). It's the way the heart muscle responds to the added stress of having pumped blood leak back (regurgitate) into the chamber it was just pumped from, or attempting to pump its regular supply of blood through a narrowed (stenotic) valve opening.

The things you might want to look at are any symptoms you are having (fatigue, shortness of breath, angina, dizziness, etc.), and overall growth of either ventricle or either atrium, which would also be on your echo reports.

Are you having echoes every six months? I'd want that, if it were me.

Best wishes,

 

[Shari Thomas]

Hi Guys,

Thanks for straightening me out on the EF numbers. My cardio HATES numbers.

What he meant by "improvement" is that even though I'm still A-fib for another 3 weeks, my heart rate has remained "normal" (that's less than 80bpm) by taking the beta-blockers, the diuretic, and accompanying minerals, as well as the Multaq.

As for the thyroid, I saw the Endo today, and my numbers are adjusting a bit. The good news there is that I didn't drop to hypo like a rock. The goal is to coax the thryoid (and the nodules) into range without going goofy and killing it all right away.

The cardio was happy to hear I'd gotten the thyroid done and was also on CPAP therapy. His goal now is to get me out of A-fib for a much longer time. I sense how I respond to the next cardioversion will put him squarely on one side of the fence or the other.

As for echo's, this one was done at 3 months, and I'm sure there'll be a strict schedule for them.