Valve Pressure up from 3.1 to 4.1

[Christina]

I am not familiar with valve pressure numbers and the correct terms to use. I hope you guys can figure out what I am talking about.
I had my annual cardiologist appointment (I have had a new cardio since last year) yesterday and he's very concerned about how the pressure in the valve has been going up. It went up from 3.1 to 4.1. in one year.
I've had two back to back AVR's in 8/2000 and my valve is a St. Jude's 19mm. He said that the valve is a little small for my size, but it has seated well and has not given me any problems. He suggested I lose a lot of weight so the valve won't have to be replaced. I guess that ought to be enough of an insentive for me to lose the weight that I've been wanting to lose.
From now on he wants to monitor me every 6 months and an Echocardiogram will be done at the same time.

I would really appreciate comments from anyone who is familiar with valve pressure numbers and can talk to me about it.
Thanks!

 

[Ross]

I'll let others with more experience in this area speak on that issue, but if that was found by echo, I don't think I'd worry too much. Now if they did a Cath to confirm it, then maybe I would. I don't give a whole lot of credit to Echo's.

 

[lb151]

Ross,its good to hear someone else that thinks that way about echos. I finally got my doctor to admit how much variance there is. It can vary so much day to day,,even hour to hour. I am so tired of getting my reports and comparing them. I have given my nurse orders to never let me see another one. I go by how I feel . If there is a serious issue I will let my doctor determine it then tell me. I dont think that is a "head in the sand "approach,,just common sense.

 

[ALCapshaw2]

I don't agree with the idea of "keeping one's head in the sand" by not looking at the Echo Reports.

I have created a Spread Sheet which lists all of the Numbers and Comments for ALL of my many EchoCardiograms. When performed by Competent Technicians, the numbers tend to be consistent and *can/do* show progression. I ask my Cardio for an explanation whenever I see an 'inconsistent' reading.

That said Christina, if you do not have copies of your echocardiograms, I suggest that you fill out the "Request for Information Form" at whatever facility you visited for your Echocardiograms and at least keep them in a file. Tell them to send the results to yourself for "Personal Use".

The 'numbers' you quoted do not 'register' with me, especially in terms of Pressure Gradient which is one of the significant parameters in valve performance. Anything below 10 mmHg (millimeters of Mercury) is pretty small and not of concern. You would need the report (which hopefully gives the UNITS as well as the number). Maybe the numbers your Cardio gave you are some sort of a Rating System (like 1 to 4 or 1 to 5 or whatever...)

Regarding your 19mm Valve, YES, that is about as small as they get and it would not surprise me if you would be classified in the category of "Patient-Prosthesis Mismatch" which basically means that the valve is too small to meet the demands of your body. Losing Weight is a means of compensating for that 'mismatch' by reducing body size which reduces it's demands on the heart for more blood.
(Don't ask me how I know

'AL Capshaw'

 

[Christina]

I don't agree with the idea of "keeping one's head in the sand" by not looking at the Echo Reports.

I have created a Spread Sheet which lists all of the Numbers and Comments for ALL of my many EchoCardiograms. When performed by Competent Technicians, the numbers tend to be consistent and *can/do* show progression. I ask my Cardio for an explanation whenever I see an 'inconsistent' reading.

That said Christina, if you do not have copies of your echocardiograms, I suggest that you fill out the "Request for Information Form" at whatever facility you visited for your Echocardiograms and at least keep them in a file. Tell them to send the results to yourself for "Personal Use".

The 'numbers' you quoted do not 'register' with me, especially in terms of Pressure Gradient which is one of the significant parameters in valve performance. Anything below 10 mmHg (millimeters of Mercury) is pretty small and not of concern. You would need the report (which hopefully gives the UNITS as well as the number). Maybe the numbers your Cardio gave you are some sort of a Rating System (like 1 to 4 or 1 to 5 or whatever...)

Regarding your 19mm Valve, YES, that is about as small as they get and it would not surprise me if you would be classified in the category of "Patient-Prosthesis Mismatch" which basically means that the valve is too small to meet the demands of your body. Losing Weight is a means of compensating for that 'mismatch' by reducing body size which reduces it's demands on the heart for more blood.
(Don't ask me how I know

'AL Capshaw'

Al,

I have kept a file and have copies of previous Echo's as late as 2007. Last year I had to change Cardiologists twice but keep forgetting to ask them to send me copies of my Echo reports for my personal file. I will have to make it a point and call them Monday. I see the need to have copies of all tests. That doesn't mean I understand the numbers and to be able to read the doctor's scribbles. Know what I mean?
I also understand now that it depends a lot on WHO performs the Echo and that a lot of variations can occur, and that if you'd have an Echo a few days later that you can have different results?
It is very difficult to read reports when you don't understand what you are reading and have no clue what it all means.

Thanks for your input.

 

[ALCapshaw2]

The EchoCardiogram Reports issued by the local Heart Center are all computerized and printed out (usually on a single sheet of paper). They also list the Normal Range for many of the measurements as well as the Units (mm, cm, cm squared, mmHg, etc.

The Reference Forum has several links to papers / guidelines for reading and interpreting EchoCardiogram Reports. I've taught myself what I need to know to read my reports and always fill out the request for information whenever I have a test.

'AL Capshaw'