mitral stenosis and tiring easily

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mom2angel

Premium Level User
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Sep 25, 2011
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187
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Nebraska
Hi, I have a question about mitral stenosis. Does anyone know what the normal pressure gradient range is for a 25mm St Jude mitral valve? I cannot find anything online. If anyone has any insight, it is much appreciated. My mean pressure gradient was 10mmHg in 2014 and 2013. It was 8mmHg in 2006. These are the only yearly reports I have in my possession. I have been symptomatic lately, so of course, it is causing a little anxiety. Thank you
 
I found something online that says 2.5mmHg +/-1. That doesn't make sense to me since I am at 10mmHg. At least my yearly appt is in 3 months. I'll let the Dr. know of my symptoms and go from there.
 
Hi mom2angel, Looks like no one has any information for you. I can only find the information for aortic valves. Glad you have an appointment soon so that you can address it. Hang in there. Do keep in mind that echos aren't always accurate. I am not a doctor or an expert, but extrapolating from "aortic valves", 10mmHg is not considered a high pressure gradient.
All the best and take some deep breaths. It is good that you are sharing your symptoms with your doctor. My understanding is they look at a number of variables, not just the pressure gradient.
 
Thank you so much ottagal. I've decided that stress and thinking about it is making my symptoms worse. I'm using this stress to force myself to get back into exercising on a regular basis. a friend teaches a boot camp exercise class that I quit going to 2 years ago. I am starting back next week. We can always turn a negative into a positive. Thanks again.
 
They bumped my appointment up, so I saw my cardiologist Wednesday. His tests showed that my mean pressure gradient is currently 8. He said it should be 3-4. He explained that my valve is too small and needs to be replaced with a larger one. I've had this one for 24 years, since the age of 13. He explained that my gradient has been high for several years. We were just letting it slide because I was asymptomatic. I believe the symptoms are finally starting to show, and we are getting closer to time for surgery. I'm hoping to hold out as long as I can. My new goal is to exercise and eat better to lose 10-20 lbs. Every pound I lose will help my heart. I'm not overweight, but I say that I am overweight for my heart. Thanks for the responses.
 
Sounds like you got the info you needed. My mitral pressure gradient is
7.0 mmHg at HR 63 bpm, classed as moderately increased, due to the stenosis (apparently the heart rate affects how they interpret the gradient). My chart says 10 or greater is severe.

Did your cardiologist say losing some weight would help, or is that your conclusion? I assume the same but have never been told it'd help with the valve issue.
 
Dornole. Thanks for that info. Is yours an artificial mitral valve too? Mine is a 25mm St. Judes. Curious what yours is. My echo from 2013 and 2014 put the gradient at 10, but this last one said 8. I know their numbers can differ. My cardiologist did not say anything about losing weight. I just personally think it will buy me some more time before surgery. It can't hurt. I've gained 22lbs in 2 1/2 years since stopping exercise from hurting my knee. The knee can tolerate it now, so I would love to get back into it. I'm getting into it at a slower pace. The SOB and fatigue make me a lot slower. I hope you are doing well and handling any symptoms you have.
 
Thanks. Luckily for me I still have my native valve. My cardiologist was able to break the stenosis by inflating a catheter-balloon inside the valve and "cracking open" the scarred-stuck leaflets (that was 15 years ago now). That left me with moderate regurgitation which is now mod-severe, and the stenosis is also creeping back up, but considering that he originally estimated the repair would last 10-15 years, it's a great outcome. Not affecting my daily comfort and activity at all yet (I'm pretty much just hiking and yard-work kind of person and I can do those easily). I've tested at gradients as high as 12 but when they did a TEE to double check those, the more accurate test showed 8 or 9.

It all depends for me on how the stenosis develops vs. the regurgitation if they can try the same catheter-based procedure again or not. That'd be nice but I'm not counting on it. It is only good for stenosis and tends to make regurgitation worse, so it is a great tool but only in the exact right situation. Alternative is MVR.

Good luck with the weight loss plan, I hope it provides some relief for you and a sense of some control over your health. It takes a special kind of determination to exercise when you have limits you didn't before. But worth it for many reasons.
 
Thanks. I hope they can use that same procedure on you again. Glad it is not affecting your daily life right now. That's great news. I've lost 2 of my 22lbs already. It won't be hard to take off. I just had to find the motivation. I think these symptoms are motivation enough. Haha. Hope all goes well for you. Take care
 

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