Need Your Input re: Exhaustion as a Symptom

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ottagal

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Aug 7, 2008
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Hi VR family,

I have another one of those "is this a symptom" questions.

I have an upcoming cardiology appt. next month to decide whether I will need AVR or not. I would really appreciate feedback as to whether any of you experienced the following as a main symptom of severe aortic stenosis?

The reason I am asking is that my cardiologist seems to rely on the 'cardinal' symptoms (angina, syncope on exertion, shortness of breath) to render a decision for surgery (he will also look at the echo results and see if there is any ventricular hypertrophy). A few appts. ago, when I had mentioned that I was exhausted often, he thought it was unrelated.

What I have been experiencing the past while is what seems to be a decrease in stamina. I am usually a real go getter. Lately I have a hard time waking up (even after 8-9 hours of sleep) with energy picking up by mid-morning and then by mid-day I literally get so exhausted to the point that I have to lie down for an hour or so while my heart is pounding very hard/thumping away. At this time, my pulse rate does not seem to increase.

Any thoughts? Thanks everyone and really appreciate your input!!!
 
Hi ottawagal,

Fatigue was most definitely a symptom for me. In fact, it was the only trouble I was having (no SOB, no angina) and it got bad enough that I finally went to the doctor. He sent me straight to the cardio and they discovered that my AV was severely narrowed and surgery was needed. About three months later I had a shiny new mechanical valve and aneurysm repair.

I've noticed that this fatigue has started to return over the past couple of years. Like you, I used to be a bundle of energy but now I can barely make it to lunch before I feel drained. I've told my cardio about it but she just kind of blows it off. I realize that there are a hundred reasons for fatigue but it would be nice to know why it's happening.

So in my experience fatigue is definitely a sign of aortic stenosis.

Best of luck and keep us posted on what happens.

Cheers,
Michelle
 
Thanks for the quick replies Michelle and Bina,
Michelle, I hope that you get an answer to your increasing fatigue. My GP ruled out thyroid and iron deficiency. Did you get that checked?

Bina, I always appreciate the input and yes I do want to hear it!!!

I will feel more 'confident' going into the cardio appt. bringing this forward as a potential symptom again if I have 'back up'/proof from a number of members (if you know what I mean ;) ).
 
Fatigue was the main symptom I registered in the year before surgery. I went to bed tired and woke up tired. I could put in a hard day (gardening, hiking) but took a day or so to recover. I never felt short of breath, but hills popped up on my daily walk that I hadn't noticed before.

Aside from the cardinal symptoms, is your cardiologist watching measurements like aortic opening or gradients? Many people on the forum seem to have had their cardiologists watching the opening size; mine always pointed out the peak gradient increase to me. She said when it's over 50, surgery starts being considered. As I know you've read here, some of those cardinal symptoms come on so gradually that they become part of your normal self-sense.

It worries me that your fatigue was dismissed. Please try to get him to tell you what other indications for surgery he observes.

Best wishes,
Debby
 
I was always the type of person who liked to do things for myself. Very independant.
So, when I was getting very tired I just blew it off to being "too busy" and "getting older".
I thought that having my horse on my own farm, with chickens, quail, dogs, cats, turtles, and chinchillas, would make anybody tired.

Then I got dizzy spells when I would push my limits.....carrying hay bales, water buckets, and mucking out in the same day was almost killing me.
I still refused surgery until I could no longer breathe properly and had sternum pain.

Wanda, your symptoms are as individual as you are, we don't all have the same ones, and you have the opportunity to get this done while you can still choose the surgeon, place and date. That is a good thing.
Ottawa has a great facility, take advantage of that and move forward if needed.
 
Thanks very much, Debby!
Last appt. (9 months ago) the peak gradient was 66 and mean gradient was 37(?). The aortic measurement was .83 and the echo also showed a mildly dilated ascending aorta which was new from the previous appt.

I am going to try and push the cardio on my fatigue this time as I can really relate to your story. I can still push myself to go for a bike ride, make dinner, shop and then all of a sudden I have to drop from exhaustion.

I will look forward to others responses as well. I have to wonder if 'women' might present with more atypical symptoms such as they do with coronary artery disease? Just thinking out loud....
 
Ottawagal,

My faigue was increasing and increasing...all doctors tried to find every excuse except relating it to my heart which was a big mistake on their part. They blamed it on anxiety, light depression, too much tension, etc. etc. while it was a deterioration which unfortunately the echo could not reveal. I used to force myself to cook and do the necessary chores, but then felt dead...went to be tired and woke up tired. Still, cardio did not think I needed surgery then...No not enough symptoms:rolleyes::(:mad::eek:! Now I feel so much angry at that cardio and all others who agreed with him. I bet if I saw a surgeon then, he would have done the surgery.

Watch out for SOBs which I had from time to time and increased over time, yet I used to think they were sighs due to the tension the doctors made me believe in ('you may have tension but do not realize it' was their famous sentence). My surgeon was surprised how I was functioning, as my valves were much worse than what the echo revealed!! Tell this to your cardio and he is welcome to call me!

It is obvious your heart is deteriorating...this deterioration has already caused you a mildly dilated ascending aorta which was not in the previous echo! What does he want to wait for?! heart failure that cannot be reversed or another valve leak. When I complained like you of extreme fatigue to my cardio three years ago, he did not relate it to my heart, :rolleyes: unfortunately the wait caused me a leak in the pulmonary and bicupid valves which I could have avoided if I had the surgery then:mad: and avoided the severe deterioration in the mitral and aortic which could have killed while waiting for the symptoms my cardio was looking for!

Good luck :)

Are you free (in Canada) to seek another opinion if your cardio still wants to wait!?
 
Thank you for another validation of exhaustion as a symptom, Eva! Sharing your situation is most helpful. I will keep you posted on the outcome.

My GP was also questioning whether this exhaustion is mild depression or anxiety related as well!
 
Before my replacement, I was tired constantly. I was 37 yrs old and felt like I was 50 (no offense to anyone). I felt like I could sleep all day long. It was hard to play with the kids because I couldn't keep up with them. It is a symptom.
 
Ottawagal:

I had spells of fatigue over several years, often calling in sick so I could stay home and rest. Never attributed it to my MVP. Thought it was because I was burning the candle at both ends & in the middle.

I did have some episodes of probably tachycardia or a-fib going as far back as 1996, seven years before my MVR.

In mid-March 2003, I was on vacation, at home, and was too tired to get out of bed one day. Had an annual physical the end of March-early April and was sent off for a echo and then I got the news I had drawn the black bean....

So, if you're having fatigue or exhaustion, insist that your doctor seriously consider it as a cardiac symptom.
 
I don't understand your doctor. Fatigue can be a symptom of lots of things, including depression, lack of sleep, cancer,AIDS, allergies, a cold, and YES, HEART DISEASE! I didn't have stenosis, so I don't know what the numbers mean, but what is he waiting on? If it is severe, it's time for surgery. Don't let him make you wait until it's an emergency.
 
Your doing the right thing. taking control. I thouht it was that i was just getting older> the AVR gave me 10years of stanima back. The docs dont want to pull the trigger too soon and if your A-symptematic it can be a tough call. Have a look at the AHA POCKET GUIDE for your case. One major sympt for me was that my BP was way elevated during stress testing, 250/60, they had to stop the test. My heart beat was also visable looking at my neck and rists. And I had unexplainable weight loss.

good luck and best wishes.

http://www.acc.org/qualityandscience/clinical/guidelines/valvular/Valvularpocketguide.pdf
 
Sounds like another "Old School" Cardiologist who wants to wait for SYMPTOMS (i.e. signs of DAMAGE) before referring patients to a Surgeon. We hear it all the time.

My recommendation is to get a Second Opinion,
and make it from a SURGEON.

Surgeons like to get in there and FIX the problem BEFORE there is Permanent Damage to the Heart Muscles and Walls.

As you have found, once a diagnosis has been made, there isn't much that Cardiologists can do for Valve Disease other than prescribe Beta Blockers in an attempt to 'delay' the progression of Valve deterioration.

When you have a problem that can ONLY be Fixed by Surgery, get the opinion of a SURGEON.

(End of rant about Old School Cardiologists)

'AL Capshaw'
 
Hey and sorry to hear you are having this trouble. I just wanted to put my 2 cents worth in. I had my aortic valve replaced about a year and a half ago, due to severe regurgation. I have a tissue vavle that is failing, yeah this soon after surgery. I also have moderate to severe stenosis on my new valve and I can tell you I stay exhausted, much more so than with the regurgitation. My gradient numbers are also in the 60's and 30's, and my AV opening is at .97, my cardio. did in fact tell me that my fatigue was from the stenosis. I'll share with you as I did with my cardio. that I feel worse with the stenosis than I did with the regurgation. It's frustrating in every aspect. I wish you all the best as you move forward.

I hope you find out something soon. Take care of yourself.
 
Good grief! I just double-checked my peak gradients before surgery.
jun 06 62
jan 07 62 (at this point my cardio said "in the next year or so", and we agreed on May 08, after my husband's retirement)
nov 08 70 (cardio said "no later than Feb", AVR was 1/30/08)

For your sake, I sort of hope we're all misjudging your cardiologist and the upcoming echo results will prompt him to recommend surgery. But if not, follow Al's advice!
 
Lisa in Katy said:
I don't understand your doctor. Fatigue can be a symptom of lots of things, including depression, lack of sleep, cancer,AIDS, allergies, a cold, and YES, HEART DISEASE! I didn't have stenosis, so I don't know what the numbers mean, but what is he waiting on? If it is severe, it's time for surgery. Don't let him make you wait until it's an emergency.
Click to expand...


Thanks Lisa in Katy,
He is basically waiting for 'cardinal symptoms' in his words, it doesn't look good on paper, but it is stable. I hope this upcoming appt. will bring some answers!
 
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