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crransom

New member
Joined
Apr 27, 2022
Messages
4
Location
Michigan
I am 79 years old and in reasonable health for my age. I have had a heart murmur for years with no concern.

It is apparently getting worse so my doctor had me get an ultrasound. Several thing were called mild but I have Moderate to severe Aortic Stenosis (whatever that means). I have an appointment Monday with a cardiologist to discuss it.

Freaked me out but after reading experiences here I'm feeling more positive and will calm down at least until the appointment.
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
9,891
Location
Queensland, OzTrayLeeYa
Welcome aboard the good ship valve.

Glad that you're feeling more positive. Basically (at its nub) you have a simple plumbing problem and this is so well researched, so well developed as a surgery that despite its complexity a well oiled medical machine exists in almost every country on the planet to make this about the most successful medical treatment of a life threatening illness.

I have Moderate to severe Aortic Stenosis (whatever that means). I have an appointment Monday with a cardiologist to discuss it.
It means the valve is clagged up and you probably had a bi-cuspid aortic valve from birth (link to read). It's got you this far, which is testament to how well made to fit the body biochemistry really is. From that link:

...calcified later in life, which may lead to varying degrees of severity of aortic stenosis that will manifest as murmurs.[6] If the leaflets do not close correctly, aortic regurgitation can occur.[6] If these become severe enough, they may require heart surgery. The heart is put under more stress in order to either pump more blood through a stenotic valve or attempt to circulate regurgitation blood through a leaking valve.

OHS has a history of great outcomes for at least the last 30 years (and I had my first one back in 1974).

Rest Easy "they've got this one"
 

Croooser

VR.org Supporter
Joined
Apr 21, 2021
Messages
63
crannsom,

It would help if you have numbers from the tests. Many of us have gone for years with moderate to severe stenosis without needing surgery right away. Most do eventually require surgery. Some sooner, some later. The success rate for surgery ih otherwise healthy individuals is quite high.

Do you have symptoms?

After you meet with your cardio, come back here if you wish to discuss.
 

Chuck C

Well-known member
Joined
Dec 5, 2020
Messages
1,501
Welcome to the forum!

I'm glad that you found it and that it has helped you to calm down. The good news is that you have a doctor who sent you for an ultrasound to investigate your murmur and they found the cause.

You might not ever need surgery, it could be years away if you do need it, or it might be just months away. The important thing is that your valve condition is now known and your medical team can monitor it so that you can get surgery to take care of it in a timely manner, if and when that day every comes.

Aortic stenosis is a narrowing of your aortic valve, usually caused by calcification that has built up over the years on the leaflets of the valve. If you are interested about how the severity is determined you many find the link below helpful. If you look at Table 1 you will see the three most common metrics used to determine aortic stenosis severity, valve area (AVA), peak velocity and mean pressure gradient.

When I was first diagnosed with aortic stenosis, the severity was classified as moderate, and all three of these metrics agreed, falling into the moderate range from Table 1, as determined by my echo. Echos were completed regularly after that to monitor the progress of the stenosis and 12 months out from my original diagnosis, one of the 3 metrics, pressure gradient, had crossed the line into the severe category. The other two metrics were still on the moderate side of the line, but just barely. At this point, I was classified as moderate/severe, which appears to be where you are at now. For me, at my next echo 6 months later, all three metrics had advanced and were in the severe category, and my diagnosis was then classified as severe aortic stenosis. For me it was a matter of months before I crossed the line from moderate/severe to severe. For you it could be years or that day might not ever come.

Aortic valve stenosis: evaluation and management of patients with discordant grading

Hopefully, you’ll find out a lot more about your condition in your appointment with your cardiologist. I would suggest writing down a list of questions that you have for him. Educate yourself, but no need to stress or rush. You have time, possibly a lot of time, before any decisions need to be made.
 

bizinsider

Well-known member
Joined
Jun 27, 2016
Messages
167
Location
San Diego, CA
Regardless of whether you ever need surgery, your attitude, which is great, will serve you well. So will keeping physically fit. Plus - if it's just a valve you'd probably have it done via TAVR. I have a friend who's father well into his 90s just had a TAVR... sailed thru it. Cheers!
 

crransom

New member
Joined
Apr 27, 2022
Messages
4
Location
Michigan
Thanks for all the information. It’s all new to me and knowing what it’s all about is helpful.
I have my first appointment this morning and have list of questions for the cardiologist.
 

crransom

New member
Joined
Apr 27, 2022
Messages
4
Location
Michigan
The cardiologist assured me that I am well on the moderate side of ‘moderate to severe’.
He actually wondered why my doctor referred an ultrasound. We made an appointment for 6 months and if it’s ok we’ll do an annual test.
He prescribed Metoprolol Succinate, apparently some kind of beta blocker? I’ll probably look that up.
All my questions answered for now.

Thanks for all the information.

It’s scary when a doctor uses the words ‘severe’ and ‘heart’ in the same sentence.
 

Chuck C

Well-known member
Joined
Dec 5, 2020
Messages
1,501
The cardiologist assured me that I am well on the moderate side of ‘moderate to severe’.
That’s good news!
He actually wondered why my doctor referred an ultrasound.
it’s a little concerning that the cardiologist wondered that. Your doctor did the right thing in ordering the echo to investigate your progressively loudening murmur.
We made an appointment for 6 months and if it’s ok we’ll do an annual test.
It’s good that your getting a follow up echo in 6 months. I’d suggest pushing for follow ups every 6 months vs annual after that. It’s totally noninvasive and you want to follow it closely. Things can progress slowly for a long time, but sometimes once you get to a certain point things progress rapidly. Once you are moderate/severe you should be watching it closely.
 

crransom

New member
Joined
Apr 27, 2022
Messages
4
Location
Michigan
Here are the numbers I see in the cardiologist visit notes. They don't mean a thing to me.

Moderate aortic stenosis. Mean gradient of 21 mmHg, AV velocity 366 cm/s, aortic valve area of 1.01 cm^2 by echocardiogram

My personal doctor is pretty new to me, he is replacing an excellent doctor we had for over 30 years who is retiring. I think he ordered the ultrasound in an abundance of caution. I will discuss 6 month visits at my next appointment.
 

Croooser

VR.org Supporter
Joined
Apr 21, 2021
Messages
63
Mean gradient and velocity look mild to me but I am not a Dr. However, 1.0 is generally the benchmark for AVA. I would say (as a layman) that the echo was definitely called for. Plenty of better sources of info on the echo results and how they are interpreted are online if you are interested.
 

Brinntache

Well-known member
Joined
Mar 25, 2021
Messages
68
Location
Hamilton, Ontario, Canada
I had ultrasounds for years before I got to surgery. One of the benefits of multiple ultrasounds is that they can see progression. Is it getting worse or is it stable? Big difference in how you treat it.
 

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