Massive thumping from heart at top of sternum, is this normal?

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sunonwaves

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Hi all,

My fiance had his aortic root / valve replaced (Bentals procedure) 6 weeks ago and he has had a massive thumping heart beat on his sternum, mainly when he takes a deep breath in.
Its so loud I can hear it when im 2 metres away from him. Not surprisingly its driving him nuts, and I cant help but think it could be damaging his new valve as it really knocks on his chest.
He has asked his surgion, cardio, nurses, everyone! and they all have no idea what it is, the usual answer is "its the new valve clicking" but its not the clicking, thats a totally different thing, this is a huge thump on the top of the sternum, you can feel it when you place your fingers there, its a real knocking.
Anyhow he recently started on Beta-blockers (i have no idea of the spelling, at a guess its metropolol) 25mg morning and night and this has helped greatly with his super fast heart beat, but hasnt really reduced the thumping, which he was hoping for.
Do you think taking a higher dose of the betablocker would help reduce the thumping (he would off course discuss taking a higher dose with his cardio first)
Or do you think its something that will just go on its own with time.
We would love to know if anyone else has experianced this and if so has the knocking reduced with time or has it stayed around even after 6 months or more.
Thanks so much in advanced! This forum has been such a brilliant support :thumbup::smile2:
 
I'm assuming he is fresh out of surgery ... For months after my surgery I could feel and hear a thump like sound ... I hardly ever notice it now, it just takes time, everyone is different ... it takes about a year give or take a few months to completely recover ... time is the key ... it can be maddening but it will pass ... IMHO....
 
The thumping heart beat -Very Strong- took getting used to, after all I've got 100% blood flow after the surgery. It was very noticeable for 2-5 wks, feels like my whole body thumps with it. If I hold a newspaper the paper moves with the beat rythum. I don't notice it now unless I'm stressed, or have exercised. Doctors told me that Beta Blockers are to reduce the heart "muscularity" not a good thing-it had to work really hard to keep the blood moving prior to surgery. My heart rate has evened out, lessened to resting HR to 50bpm 4 mths post op from 62bpm after surgery. Cardio Rehab has been the BEST!!!! I started off with 24mg of Atenenol but the cardiologist and surgeon recommended cutting to 12.5mg per day. My energy level increased with the reduction, I felt better-motivated instead of sluggish (something that can go un-noticed)

Bob
 
I don't think increasing the dose of the betablocker would help that much. I had thumping, but mine was more like feeling my heartbeat in my head. It felt like I had a metronome implanted.
If you can hear it, and it's when he takes a deep breath, I would stay after the surgeon and cardio for an answer. I doubt that it's anything serious, but they should provide an answer. If they don't know what the answer is, they should find out!
Please keep us informed if they share it with you.:smile2:
 
Many people especially if they had their Aortic valve replaced, have talked about their heart thumping very hard after surgery, as their heart gets used to the new improved valve and as their heart remodels, the thumping goes away. hopefully that will be true for your fiance

Does he have a dacron graft/tube connected to his new valve? Hopefully the thumping will be less as time passes. There have been a few people who had trouble with thumping and vibrations in their sternum. In their cases its been described as a waterhammer effect, that you can see and feel. Seth started a few threads about his thumping sternum, here is one but you can click on his name to read the old posts he started discussing it. http://www.valvereplacement.org/for...944-Valve-pounding-against-sternum&highlight=
He hasn't updated for a while, so I don't know how he is doing, or what they decided, maybe it's improved over time. But he also did a survery asking people to contact him if they had the thumping (not the normal clicking) so It might be worth PMing him.
 
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The key is the DEEP BREATH. This is is done by elevating the ribcage and pulling down the diaphragm. This creates a vacuum in the chest. Air rushes into the lung, but also the chest expansion causes the heart to expand as well due to the drop in pressure around it and draw in a lot more blood than when you breath out. This happens normally but just isn't nearly as noticeable before the AVR surgery. As the heart remodels, this response will change and the pounding will be less obvious, but the fact that it is primarily when she is taking a deep breath is a normal physiologic response. I had this happen to me and it has decreased over time. Perfectly normal. Also, my HR after surgery was in the mid 90s and really bothered me as pre-op I was about 60. Metoprolol and time have helped a lot, although mine dropped over a few weeks.
 
I still have a thumping heart beat, and mine is louder when I take a deep breath. I am five weeks out of surgery today, so still fairly new valve, and mine does the same. Mine can't be heard from 2 meters away, though. It is more something that bothers me, not really those around me. I have noticed in the last week or so that the pounding has either reduced or I have become more accustomed to it.
 
Well said Neil, but Jeeze man, Ringo star, you must know of a better drummer? Like someone who can at least work a double bass pedal. LOL!

For the most part it doesn't matter if you were the recipient of a tissue or MHV. If the LH ventricle was working to eject blood through a narrowed AV, the LH ventricle probably hypertrophied pre surgery. The blood is presently exiting the new valve at an increased volume. In time the LH ventricle will atrophy and less blood volume will be ejected through the AV. Hence that annoying sound will quiet down. You must give it time. It takes a heart a year to remodel.

Just so you know, I was implanted with a MHV and had a graft of the ascending aorta accomplished on Mar 21. The hypertrophy was defined as medium as the wall thickness of my LH ventricle was 16 mm. Sure I notice on occasion a thump thump sound in my neck and upper chest cavity. I spent the last 30 plus years my life time around jet aircraft engines, Perhaps this explains why I am not bothered by the noise from my mending heart!
 
bdryer said:
For the most part it doesn't matter if you were the recipient of a tissue or MHV. If the LH ventricle was working to eject blood through a narrowed AV, the LH ventricle probably hypertrophied pre surgery. The blood is presently exiting the new valve at an increased volume. In time the LH ventricle will atrophy and less blood volume will be ejected through the AV. Hence that annoying sound will quiet down. You must give it time. It takes a heart a year to remodel.

Just so you know, I was implanted with a MHV and had a graft of the ascending aorta accomplished on Mar 21. The hypertrophy was defined as medium as the wall thickness of my LH ventricle was 16 mm. Sure I notice on occasion a thump thump sound in my neck and upper chest cavity. I spent the last 30 plus years my life time around jet aircraft engines, Perhaps this explains why I am not bothered by the noise from my mending heart!
Click to expand...

This is pretty much what I think is happening to me except I had a tissue valve implanted with a dacron sleeve for my aortic root and ascending aorta (surgery 2/22/11). My left ventricle was enlarged due to my valve leaking and the heart having to work harder to pump enough blood to my body. I call mine a pounding heart. When I take my walks or I am otherwise active I don't notice it. I think that is because my heart has to work harder when I am active so it keeps the pounding away. But if I am sitting down or when I lay down to sleep it pounds away to the point my cardio prescribed Ambien for me because I couldn't sleep at night. I think when I am inactive I don't need my heart to work as hard but because it is still in the process of remodeling it still thinks it has to (because of enlarged LV). I hope these answers have helped you and put your mind somewhat at ease.
 
The more I see here, the more relieved I get. Surgery in one week! Sometimes I feel so tired I wonder if I can even make the train down to USC, but I will have someone with me. My uneducated guess is I go into a relatively elevated BNP number, but then they drop. I feel okay enough, normally, to go make tea..even vacuumed(light vacuum) my bedroom, who can stand cat hair everywhere?) then whoosh, on my back, deep breathing, get my systole back up.... The day I DID have my BNP done, I had been feeling well for a day or two... Reading below 100. When I was down AT USC, the PA was getting me up ( I had been resting) and I gave a little cough. "HA!" was his answer to that ( that I needed surgery now) but I thought he was just being a little old grumpy lady. And this has what to do with this thread...(?).. Just glad to hear aBOUT the remodeling . You guys are so cool... Hope you all smell this wonderful spring coming on!!! Michelle
 
I had a St Jude mechanical valve with the aortic graft installed about 13 weeks ago. Once I started getting up and active after surgery I too noticed Exactly what you describe your fiancee as having. I too asked my surgeon and my cardiologist (and anyone else who would listen) about it. It was tough to get them to understand I wasn't complaining about the ticking or that I wasn't talking about a racing heartbeat either, just a strong and loud thumping that was causing me a lot of worry.
The closest thing to a good explanation I got was that since the pericardium was opened and the fluid inside removed during the surgery that there was no longer the same amount of cushioning and sound dampening going on prior to the procedure. I was told that as I healed the thumping "should probably" become less noticable.
I do have a friend who had the same procedure seven years ago and he said that it took about a year before he wasn't quite so aware of the pounding.
For me anyway it seems to bother me more if I do something that puts a strain on my chest like bending forward a lot or if I lie down on my stomach or side too much when sleeping.
I would have to guess too that with the new dacron graft and a much more efficient valve, that we will always be more aware of the heart just doing it's normal job than we were once used to.
Hopefully, as we heal, your fiancee (and me too) will notice one day that the annoying pounding has gone away for good.
 
Thanks for all the feedback, greatly appreciated!
I really hope it begins to chill out a little as its driving him nuts, he really dosnt mind about the clicking at all, infact i think it sounds fine hearing it, nice to know the hearts doing its thing :) , however the POUNDING sounds terrible only because it sounds like it can be damaging his heart..
Strange how so many people have this issue yet the surgeons and cardiologists have no idea what it is?
Anyhow fingers crossed for us all that it calms down!
 
Lynlw said:
Many people especially if they had their Aortic valve replaced, have talked about their heart thumping very hard after surgery, as their heart gets used to the new improved valve and as their heart remodels, the thumping goes away. hopefully that will be true for your fiance

Does he have a dacron graft/tube connected to his new valve? Hopefully the thumping will be less as time passes. There have been a few people who had trouble with thumping and vibrations in their sternum. In their cases its been described as a waterhammer effect, that you can see and feel. Seth started a few threads about his thumping sternum, here is one but you can click on his name to read the old posts he started discussing it. http://www.valvereplacement.org/for...944-Valve-pounding-against-sternum&highlight=
He hasn't updated for a while, so I don't know how he is doing, or what they decided, maybe it's improved over time. But he also did a survery asking people to contact him if they had the thumping (not the normal clicking) so It might be worth PMing him.
Click to expand...

Lyn, Seth still has severe vibration problems, they haven't gone away and I don't think he has been given any hope that they ever will unless he has another surgery to replace the mechanical valve with a tissue valve and that's not a given that that will fix the issue. He doesn't come on here at all anymore, so pm'ing him will not get a response. If someone does want to reach out to him with a question about this vibration issue, I do have his e-mail address and would be happy to pass it along.


Kim
 
kfay said:
Lyn, Seth still has severe vibration problems, they haven't gone away and I don't think he has been given any hope that they ever will unless he has another surgery to replace the mechanical valve with a tissue valve and that's not a given that that will fix the issue. He doesn't come on here at all anymore, so pm'ing him will not get a response. If someone does want to reach out to him with a question about this vibration issue, I do have his e-mail address and would be happy to pass it along.

Kim
Click to expand...

I'm sorry to hear Seth hasn't gotten any relief over time. Even tho it had been a while post op and he was still having the pounding, I was hoping for his sake, since we haven't heard from him, it was a case of no news is good news. If you talk to him please let him know he's in my thoughts.
 
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