understanding echocardiography

[bit of a chicken]

After 36 years of having congenital heart condition I finally realise that I would like to completely understand what everything means, so am hoping that some of you very knowledgeable people can explain a recent echo to me !
I have a copy of the letter the cardio sent to my g.p. I had coarctation repair in early childhood and have mild recoarctation with bav with mild narrowing, but mri report says that there is not significant aortic stenosis, so I am puzzled, I understand the narrowing comes from the stenosis ? Or is it down to the coarctation ? they are in two different places , right ?
on to the echo, if any one can help me understand any of this doctor speak, I will be very grateful.
sinus of valsalva 28 mm ( what is that ?!) sinotubular junction 20 mm, ascending aorta 20 mm,. left ventricular systolic and diastolic dimension of 23 and 40 mm .overall left ventricular dimensions seem to be at the upper range of normal with mild hypertrophy ( what is that, is it good ? ) The descending aorta was clearly seen asnd was mild turbulence in the descending with peak doppler velocity of 2 m/s. the ascending aorta exhibited mild stenosis with peak velocity of around 2.8 m/s . I appreciate that all you people are not doctors, but any explaination would be great. I did ask my g.p to explain it but he was not able to ?! after spending a whole lifetime going along to see these doctors you actually switch off, well, i now want to switch myself on , and ensure i can totally understand some of what I have never bothered to previously question, I do hope this ramble makes sense

 

[Karen]

coarctation issue

coarctation issue

Hi, I can relate to the confusion about the "aortic stenosis" and the coarctation. Seems like it should be the same thing. I also had a coarctation repair many years ago, so I was willing to dismiss the "borderline aortic stenosis" that was in the report after my first echocardiogram 6 1/2 years ago. Even the cardiac PA agreed with me that some narrowing at the repair site would be expected. But the aortic stenosis mentioned in your report probably is in reference to the aortic valve itself. I DO have a 25% smaller measurement at the site of the coarctation repair, but it's the aortic valve that they are referring to with regards to whether or not there is significant "aortic stenosis."

I'll leave clarification of all your other values to others...

It's GOOD to have answers and understanding of the tests that are done.

Good luck...Karen

 

[bit of a chicken]

thanks , Karen, great to get a reply ! I do not know if you can relate to the bit in the post, where i am saying you spend time seeing these docs but I have not really questioned it much. For years it is all channeled through your parents then you are the adult going along but some how feel like u missed a chapter somewhere ! So, have you had a bav replacement ? I had my coarctation repair in 1976, end to end anastasmosis, how about you ?

 

[bit of a chicken]

ps what is a cardiac p a ?!

 

[bit of a chicken]

so, do you have recoarctation at all, Karen ?

 

[Lynlw]

I'm not sure if this is what you are asking, but I believe coarc just refers to after the aortic arch in the desending aorta and aortic stenosis is around the valve (above, below, or the actual valve)

 

[Karen]

Hi again...

No, I do not have recoarctation. But there IS some narrowing where the coarctation used to be. Probably the same, relatively, as when the surgery was done over 40 years ago. I was 15 years old at the time.

A PA is a Physician's Assistant. I thought a cardiac PA would be pretty knowledgable about things like coarctations and BAV, so I was a little surprised that she actually gave me incorrect information before I learned more about my particular congenital heart issues.

My situation is quite different from yours as far as the intervening years are concerned. In 1967, much less was known about the "package" of coarctation, BAV, and aortic aneurysms. The doctors then felt that the surgery I had for the coarctation fixed the problem. My surgeon even told me I could forget I ever had surgery. I still had a heart murmur - he said it was the sound of an imperfect hose.

Probably just within a few years, more was understood and patients with coarctation repairs have had lifelong follow up since then. But I didn't know about my BAV or anything else until 2004 when my doctor sent me for echo and stress test just because it had been a long while since anyone had checked me out cardiovascular-wise. So I was "saved" all those years of worry!

No, I have not had aortic valve replacement. And it may be a long way down the road for me, if ever. Although my aortic valve measures 1.6, it has been the same since my first echo in 2004, and now we understand that that's just the size of my valve - NOT because of any calcification. I have yearly echocardiograms and MRI's at regular intervals (every 5 years) to monitor the aorta for aneurysms. (I have a mildly dilated ascending aorta).

I hope you get the answers and reassurance you hope for! It's a great day when you find a cardiologist who you have confidence in and can turn over the watching and worrying for you... It's hard to give it up entirely, but I have been much less anxious about everything since finding an adult congenital cardiologist that knows what my risks and special concerns are...

 

[Karen]

Hmmmm....

I just read your first post a little more carefully. You said the report stated "the ascending aorta exhibited mild stenosis" so maybe the it IS referring to the aorta rather than the aortic valve.

Will you have the chance to sit down with the cardiologist to have it all explained to you?

 

[DavesMom]

Hi bit of a chicken,

I do hope you can find a cardiologist who can explain the results in simple terms and reassure you. Confidence in your cardio and the ability to communicate with him or her is so important. It's all so confusing.

Karen, our situations sound a bit similar. I had my first surgery in the mid-70s (a commissurotomy) and was given the impression that I was pretty much fixed. So I went around worry-free until 1999, when I was shocked to find out that my aortic valve had become severely narrow and that I needed AVR pronto.

Take care everyone.

Cheers,
Michelle

 

[bit of a chicken]

echo understanding

echo understanding

thanks all for the replies. I do have two cardios that I see and they are good, but I am not due to see them until september. By the time the app comes around I tend to have lost the thread of my concern. I have written to the ACHD cardio and I hope he will reply so that I can fully understand it all.
Thank you for the replies, I think part of my confusion is also so denial that any of it is even there; I would prefer it not to be.
I usually attend cardio outpatients alone too, this time I go along I have every intention to take some one along, and not the children, which is usual practice for me !
This forum is great for making things clearer and just knowing that other people are out there facing similar difficulties. I find the doctor speak really hard to break down. My previous g 'p had scant knowledge of coarctation and how indeed it needs lifelong monitoring.. He actually told me if I did not want to go along for mri, it would not matter too much, as specialists like to be over cautious and that I would be more likely to be hit by a bus than develop an anerysm... well, just look at the evidence on this here forum, whilst I appreciate the value of it being a free choice, I put more faith in the cardiologist right now...
Anyway, very grateful for the responses. Allthe best all. Bit of a chicken.d