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[alpage]

Hello all,

Last week I was walking outside in cold weather, at a fairly quick pace, and felt a squeezing pressure and discomfort in my chest. I stopped walking and the sensation went away. Turns out that now I am having angina related to the valve condition. I did have a couple of very mild episodes before that. This one was quite definite! I saw my cardiologist and he advised me to take it much easier when out in cold weather and he will send a report to the surgeon. I will be making an appointment with the surgeon to discuss timing of surgery. The cardiologist agreed that I likely need surgery sooner rather than later.

In some ways I am glad that I encountered this under conditions of 'stress' rather than staying totally housebound and find out only when it reaches the point where I would get chest pain even at rest. I did walk around a large indoor shopping center on the weekend and that was not a problem.

I know that the doctors try not to recommend surgery too soon, but it looks like in my case surgery a bit sooner would have been better. I'm not accusing my cardiologist of being negligent, I just think my valve got worse faster than he anticipated.

Today I took another walk, much slower, and I still had a bit of discomfort. On the way back I was walking very, very slowly. I felt lousy the rest of the day, but feeling better now. I won't be doing that again! A month ago I could have walked the same distance and only felt a little out of breath.

Anyone else been through this?

Alan

 

[hensylee]

Mornin al - Sorry to hear of your discomfort. I had bypass and before surgery, cold started pain and SOB. Don't know if this helps you with valve, but just my comment re the heart letting us know what's happenin. God bless

 

[Nancy]

Hi Al-

Joe has problems with cold weather, always has. He says he has trouble breathing on exertion. He sometimes wears a mask to keep the air going into the lungs warmer, but they're hard to breath in. And if he isn't dressed warmly enough he's subject to unbelievable shivering, which is severe and lasts a long time.

It's hard to tell whether it has to do with his heart problems, or the Coumadin, or other meds. he's on. Probably a combination of all of them.

He also has problems with very hot humid weather.

 

[Mb]

My husband also developed "angina" about 8 weeks prior to surgery. Surgery was 10/3/02. In some ways, looking back, I think that the steps backwards he took, prior to surgery, was beneficial, in that he absolutely knew he had to get this done in order to live. He got to the point where you are at. The shortest of walks, etc. would just exhaust him....good for nothing for the rest of the day. In fact, I had to speak with our daughters about walking with their Dad, as he tried to keep up with them, and then would get so tired and out of breath. Of course, they ddin't realize whwat was happening.
So the bottom line is, your body is really telling you that it really is time....past time, to get this done. Best wishes to you.
Marybeth

 

[Jean]

Definite Signs

Definite Signs

Hi, Al! Two years ago before my surgery, I had the same symptoms you are having...just had to slowly plug along, couldn't let the sheep and goats starve. But I can say that that is ALL gone now. Even last winter which was normally cold, I had no troubles. It is one of those things that let us know we need help and then is such a reward to be rid of after the surgery. Good luck and get those doctors going.

 

[gary]

Have you been catheterized?

Have you been catheterized?

In the runup to my AVR during 1999, my cardiologist was perplexed about the conflicting results he was getting from the testing he did after I had a low grade CHF episode that scared the bejesus out of me, thought I was going to die when I couldn't catch my breath.

His exam which included first the EKG and then a resting Echo and then an exercise treadmill echo for 9 minutes, proved inconclusive for timing of the surgery (which I knew would have to be done one day).

So his next step was to do a catheterization to examine the AV and to check the coronary arteries. While the arteries proved normal, the 'wedge pressure' was alarming to him. He recommended immediate surgery at that point.

While Catheter is hardly risk free, it was the definitive confirmation for his diagnosis.

I have heard the The Trans Esophageal Echo (TEE) is also a highly accurate in assessing the valve but don't know how good it is in 'seeing' the CAs.

 

[Jessica_B.]

Regarding winter...

Regarding winter...

Hi Al,

I had problems with cold and angina-like symtoms for years leading up to my transplant as the scartissue and blood vessels would really make my life hell. Whenever the temperature crept below freezing I said a silent prayer and hoped it would pass quickly. After my transplant I no longer have this problem but then suggesting transplant as the cure would be too radical of an approach, wouldn't it ?!?

Anyway, I dressed appropriately for the weather but at times resolved to taking a nitro-pill. And on the days when the temperature went really low, I simply stayed at home but that only works so long... It's no mystery that cold has this effect on heart patients so please discuss it with your doctor -- maybe he has some coping strategies if drugs (like nitro) aren't applicable for you or if the problem needs further assessment.

All my best,

/Jessica

 

[alpage]

Nancy, I know what you mean about really cold weather as I grew up in Montreal and we had some very cold winter days. But so far it's been fairly mild - just hovering around freezing. I think if it gets really cold I will need to be even more careful.

Gary and hensylee I've been run through all the tests including TEE and catheterization. Fortunately my coronary arteries are in tip-top shape, so it's all related to the valve and thickening of the heart wall.

Marybeth and Jean, I'm already sold on the need for surgery. In some ways it's a bit scary to have this sort of reminder, but the cardiologist was fairly calm about it. I will be hearing from the surgeon regarding any change in surgery date when he has received the report from the cardiologist. I'd be happy to go for surgery tomorrow, but the surgeon is heavily booked so I am likely to still have to wait a while. The original plan was for surgery in May or June, but that seems rather a long time to wait.

Jessica, the cardiologist really only advised being careful walking, so I will see my family doctor who I hope will have some additional advice and information.

Thanks to all that shared their experiences. It's comforting to know that other people have been through this before me.

 

[KristyW]

Al,

I had AVR this past June and then went through Cardiac Rehab. The one thing that all the rehab technicians stressed was that they didn't want us outside exercising (brisk walk) when the temperatures were below 32 or above 90. The extreme temps are very hard on our circulatory system. Below 32 degrees the blood vessels all constrict due to the cold, and above 90 the body has a difficult time regulating its own temperature.

Check with your cardiologist though, just to make sure.

 

[Nancy]

Hi Al-

The very best thing would be if they moved your surgery up. All of these unexpected symptoms are only a reminder that your body is getting more stressed.

It's so hard to wait under these circumstances. Joe's been in the place you're in now several times, and it stinks.

So I'm keeping my fingers crossed for you that it can happen sooner rather than later.

Don't push yourself too hard right now, save that for later.

Take care

 

[fdegranville]

Angina

Angina

Hi Al,
I relate to so much of what you've said. First, having been brought up in Quebec and Montreal, I understand the cold. Cold wind really makes me cough, until I lose all my breath.

But as for the chest pain, I can also relate. When it first started to happen I didn't even know what it was. Then one day going to Macy's, walking kinda fast to cross the street, it really hit hard and there was no doubt in my mind what it was. I've not had it that bad since, but bad enough to make me have to stop.

I have to go back and read your profile, I have mod MS and 3+ AI

good luck,
fdeg

 

[JBriau]

alpage:

Have you ever had a stress test done. It is a very good test to determine your abilities.
I know how you feel. I am on the waiting list for surgery here in
Edmonton. my other test show a very serve leaky valve. I
surprised my Cardiologist and surgeon when I passed the stress
test. Most people with as a servere valve as mine show alot
more sysmptoms.
If you haven't had one maybe you should ask your cardiologist
about a stress test.



Judy

 

[alpage]

I would be happy to have any test that would help the surgeon and cardiologist make the best decision regarding timing of surgery. An extensive seach on the Internet on stress tests and aortic stenosis suggests that the stress test can be more dangerous in the presence of severe aortic stenosis. Unfortunately that is the situation I am in. Perhaps six or nine months ago it might have been less risky.

Two years ago I had a "gated nuclear angiogram" which involved exercising on a bicycle. I passed that test with flying colors.

In any case, I had an echo in September and a cardiac catheterization (angiogram) in November which gave them sufficient information to determine the state of my valves and coronary arteries. I'd be happy to have another echo to see what changes have happened since September.

Alan

 

[Jessica_B.]

Hi Al,

A stress test might just be, as you say, too dangerous. Cold weather has this effect on people with heart conditions. Are there any further reasons for them to suspect you have developed diseased coronary arteries since November?
I am not trying to play down the risk and it is good that you would be ready to have tests done to rule out further problems but the tests might just not be what you need at this point. Continue with the careful walking, dress warmly (cover your mouth with a scarf or something to that you don't inhale too much cold air) and just hang on. For me surgery resolved the problem almost entirely, I hope I was not an exception and that it will do the same for you!

/Jessica

PS: If you are nervous and want a safety rope you might want to speak to the cardio about how to best handle the situation. DS.