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Diana

Hi,

I am new to this site but I have been scanning it for a few weeks now and can I just say what a blessing it is to have you all here and have the link to people, just like my husband and I, here for us. I have noticed the number of you who have been here for quite a while after your surgeries and you touch my heart that you continue to be here to take the time to help people like us.

I have a few questions, as I am new to this disease. My husband was diagnosed at the age of 12 with a bicuspid aortic valve with calcification. He was followed up with when he was 13 and after that was lost to follow-up. Over the past year to year and a half we have noticed more and more fatigue and shortness of breath. The shortness of breath has been very bothersome with his job. He finally came home one day and said enough was enough it was time to see a doctor. We went to a family doctor here in town, very small town, who sent us to the local hospital for an echo which came back reporting a slightly enlarged ascending aorta, could not rule out a bicuspid valve, a gradient of 36 mmHg, and a valve measuring 1.6, which is mild aortic stenosis. It also said clinically suspect worsening heart failure or heart murmur.

A family member of mine is a retired cardiothoracic surgeon who referred us to a cardiologist to see, which we saw today. He told us that at his current age of 25, and his gradient of 36 mmHg, and his blood pressure which was 138/94, he would probably not need surgery until he was in his 50?s and that his symptoms did not match his numbers and there was no point in fixing something that was not completely worn out yet, so he put him on Lopressor to "calm his heart down". He also said, which we completely agreed, that he did not have complete faith in the echo that we had at our home hospital here, some numbers were missing off the report, so he wanted to do a free of charge echo done by his own people, which is where my questions come in. We did get another echo and that tech said that ?in her opinion? he was not bicuspid, that he did have a leak and a lot of calcinosis but he had three working cusps. So I guess my question is what does that mean, have you heard of this? I cannot find any information on a calcified aortic valve at his age, except with lupus, which he does not have, and with the exception of a bicuspid valve. I know that she is only a tech and may possibly be wrong and we will find out our doctors opinion on the matter but by the way he talked today, we will not talk to him again for a few months, after my husband undergoes a CT scan of the aorta to inspect the reported "enlarged ascending aorta", but that will not be for two months or so and I just wanted to know if any of you have any incite for us to put our mind at ease, after all, knowledge is power and I live by that.
 
Welcome to the site, Diana; glad you found it. The first thing that struck me was that--and please keep in mind that I certainly only know a little bit about hearts and valves and such and I'm not in the medical field, but--I don't think I've ever heard of a 12 year old having a calcified valve. Maybe that's something that happens that I've never heard of before. I wondered if something more was going on.

I have read here that a 64-slice CT scan is an excellent thing to more accurately access the situation/condition of a heart and recently a couple of members have posted amazing images from such a scan. I am just wondering if all of his echos, particularly these recent ones, are accurate. Perhaps he needs a test done by more skilled hands.

Another thing to unhappily consider is that a person may have more issues with their heart than just a valve malformation/malfunction. And sometimes a bicuspid valve can cause the mitral valve to also not work properly.

I would think, just from my personal experience, that perhaps you and your husband may need to consider finding a new and experienced cardio, perhaps one who has experience with congenital heart defects/disease (CHD) and/or one who has experience with bicuspids. Many of us here found that some cardios just didn't seem to know what to do with us so we had to look for more experienced doctors.

It's late so you may not get many posts this evening but you can post again at any time to this thread and it will get bumped back up to the top of the threads so other members may offer their comments.

You and your husband have my best wishes. Take care and please post again.
 
welcome, Diana. I don't know where Ft Payne is, but UAB is a teaching hospital. We have a few members her who had their surgery there. If you want to explore further, you might go there.

I don't hve the information you need, but did want to welcome you to VR. There is so much to be learned here.

I am just over the line in Fl (DeFuniak)
 
The only thing I wanted to add is that I find it completely irresponsible for an echo tech to be interpreting the echo. The role of the echo tech is to take pictures and measurements and pass them along to someone who went to eight years of medical school to learn what they mean - your Cardiologist.
 
I am in N. AL also. I originally went to a large group of cardios in Huntsville. My escalating symptoms were completely dismissed and I made an appt in Birmingham as I knew something was not right, much as your hubby did. Sure enough, it was confirmed at UAB. I had valve replacement and the surgeon said the valve was "much worse" after he got in ther and took it out than it showed on echo. So don't take the echo as the end all, and definitely get a second opinion.
 
Diana and Sarah,

I'm curious as to which cardiologists each of you saw (in HSV).

Diana - has your husband ever had any Radiation Treatments to the chest? Radiation can cause stenosis and calcification of the valves.

'AL Capshaw' (also in North Alabama)
 
I have two concerns based on what I read, Diana (and Welcome). First, that BP is pretty high and needs to be treated. It may be related to the second item, which is the "slightly enlarged" aorta. Not an issue now, but this should not be the case in someone so young. That blood pressure may cause the aorta to become a serious problem sooner than 30 years from now. It doesn't get smaller. They have good meds to help but you have to control BP. I strongly agree with the others that with the congenital complication, your husband needs to be seen by a highly qualified specialist with access to good facilities.
 
Diana,

Just wanted to join in welcoming you here. Certainly all those stats need to be checked out and the further tests done. Just thought I would mention (since your husband is 25) that an internist first detected my heart murmur when I was in my 20s and it was not until I was in my 60s that it became necessary to replace the aortic valve and root.

By no means am I saying that the pattern here will be the same, but sometimes these conditions can be carefully monitored and there can be a long period in the "waiting room," as we put it. One particular concern is any increase in the dimensions of the ascending aneurysm, so they do need to keep regular watch on that. If I understood correctly, you all got a free follow-up echo in the doc's office? That was extraordinarily nice.

Again, welcome!
 
I don't have the information you are looking for, but I'd like to welcome you to our VR community. Sorry for the circumstances but glad you found us. Best wishes and good luck.
 
Welcome,,,

Welcome,,,

One other thing to consider. While it it totally unrelated to the valve issue... Blockage can produce the same symptoms. A heart "Cath" can detect this.

Is the shortness of breath at rest sometimes?


Paco512
Mini AVR
Cleveland Clinic
Dr J. Sabik
 
Diana,
Welcome to the group, though I'm sorry that you have to be here. My son's symptoms were completely dismissed and he almost died as a result. Your husband may have a long time before he needs anything done, but I wouldn't rest until you get answers as to why he is symptomatic. If you see a doctor that dismisses your concerns, then please look for another doctor. I realize that you saw a doctor referred by a family member, but that doesn't mean that you should stop there. In this day and age almost everything heart-related is fixable, but only if it gets caught in time.
 
Welcome Diana! I don't have much to offer in way of advice, but I'll be watching for your follow-up posts to see what comes of this! Best wishes!
 
A 64-slice CT will establish a benchmark for his aorta and allow him to assess growth over time. The margin of error is much less using the CT scan to establish the size of his ascending aorta. Unlike a CT scan, an echo has a much larger margin of error. So, this CT measurement will prove useful over time. Hope he doesn't need surgery until his 50s, but as you know, there's no guarantee. The "suspect worsening heart failure" is of concern. And a bicuspid valve is not always easily recognized.
 
I Had A Murmur At 13 Ish Too

I Had A Murmur At 13 Ish Too

Welcome To Vr.com. I Do Agree That Someone Out Here Will Have The Info You Need. I Have Found All Sorts Of Great Stuff While Just Looking Around.
I Had A Murmur Diagnosis At About 13 And As I Remember, The Stress Ekg And Whatever Else I Had Done (1970 Something) Showed A Slightly Enlarged Heart. I Thought I Was A-symptomatic Too Until Recently. What I Thought Was Being Winded From Being Out Of Shape Is Probably A Symptom. I Get Mine Fixed In July.
Best Of Luck To Your Husband And I Hope You Get The Answers You Need.
Sheepdog.
 
My husband and I just wanted to say thank you again for all of your replies. You have made him feel like he is not crazy afterall and we will sit back and wait and listen as his test results come back and see where they lead us. Thank you for the support you all offer here, it is needed and appreciated.

Diana
 
My husband and I just wanted to say thank you again for all of your replies. You have made him feel like he is not crazy afterall and we will sit back and wait and listen as his test results come back and see where they lead us. Thank you for the support you all offer here, it is needed and appreciated.

Diana

Diana,

You have entered a caring community here. I welcome you and wish you and husband the best of luck in your journey and ultimate resoluation of his medical issue.

BTW, I am one of those who posted the 64 slice CT image- the detail is amazing. Not only is there crisp imaging (they can accurately measure the aortic size), but they can see inside the arteries too.
 
I don;t know your what your insurance allows, but I can tell you that you are not that far from a great place, Emory in Atlanta has an adult congenital heart program.

Symtoms are just that, its the body telling you something is wrong, you just need to find the right person who will listen. My cardiologist at Emory, first time I saw her, I knew I had come to the right place. Of course I already knew what was in store when I went in, that surgery was coming and soon, my fear was they would not let me out of there till after it was done. But they were not quite that firm lol, 7 weeks later I went in and had it taken care of.

Emory has a great reputation and where the aorta and dialation (aneurysm) is concerned they have a specialist in that area who is very good.
 
Right/Wrong

Right/Wrong

Diana, Welcome! I like you already! "Knowledge is power!" My father insisted I get a second opinion from a friend's clinic. The cardiologist said I should postpone surgery, and take Lopressor. I didn't feel comfortable waiting for things to get worse, and went ahead with the surgery. My surgeon said he could see my blood through my aneurysm when he opened me up. Plus my heart had doubled in size trying to compensate for my bad valve. A year after OHS it was back to normal. Listen to your husband, have him pay attention to what his body is telling him, and get some other opinions. All the best, Brian Mc
 

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