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Forum Name: Valvular Heart Diseases

Question: Progression of aortic valve leak


 roundsgirl - Mon Oct 22, 2007 11:14 am

I am 39 year old female who was diagnosed with mild aortic regurgitation in 2005, this was discovered after a synope event, there was also an arachnoid cyst found in brain and now also a thornwaldt cyst. I have dealt with cyst all my life, but as far as my heart, I will give a summary of the echo in 2005 and then 2006 and please advise me of the progression of the disease. 2005
Mild-aortic regurgitation
Aortic valve is thickened
Pseudonormalizied pattern of Lve diastolic filling.(grade 2 diastolic dysfunction)
Lv ejection fraction 55 to 60 %

2006
Now Moderate aortic regurgitation
Restrictive pattern of LV diastolic filling (now grade 3 or 4 diastolic dysfunction)
Mild tricuspid regurgitation
Mild mitral regurgitation
Dilated right ventricle
Mild pulmonary regurgitation
Mildly elevated pulmonary artery systolic pressure
LV ejection fraction 60 to 65%
No LV thrombus

The measurments of the heart also increased. All were still within normal ranges but the size of the heart did increase. The fatigue is almost unbearable. After this echo I was give Clonidine HCL 2 mg and Hydralazine 10mg, to take. My concern is besides the way I feel, the fact that the regurgitation went from mild to moderate in one year, and now that all all my valves regurgitate. Also the diastolic dysfunction going from grade 2 to grade 3 or 4, what is the signifigance of that? I don't have insurance so it is very difficult to keep my appointments as most of my doctors are specialist of some kind. And my health problems are to many to list here. Thanks in advance to any comments that you can give me. I guess I wonder just how serious is all of this, as far as family history, my dad's heart stayed in atrifubilation (spelling), he had a massive stroke and passed away last year. My brother's has 3 stents in his heart because of major blockages, this happened when he was 37 years old. My sister has mitral valve prolapse.

Sincerely,
Rounds girl
 Dr. Chan Lowe - Thu Jan 24, 2008 4:15 pm

User avatar Hi Rounds Girl,

The progression of your aortic valve leak and your symptoms suggest that this is now becoming an issue for you. The leaking of the other valves may be due to the increased pressure from the aortic valve leak. If the aortic valve improves I suspect that your other valves will as well.

I would recommend you talk to your cardiologist about this. You may need to begin taking some medicine to help reduce your blood pressure some (even if it is normal) to help reduce the back pressure on the aortic valve.

In some cases this is not enough or the aortic valve begins to leak more. In these cases, valve replacement may be necessary. If you get to this point you will need to discuss the options with a cardiothoracic surgeon since there are a few different types of valves and each have their own benefits/risks.

There are some cases that remain the same over time. However, with your symptoms I suspect that you will require some form of treatment at some point.

Follow up with your doctor is important.

Best wishes.
 roundsgirl - Thu Jan 24, 2008 10:49 pm

Thanks for your reply. Although it comes after I've had open heart surgery. I had the surgery on Jan 3 2008, the valve was replaced with a bovine valve, although we would have chosen a mechanical valve, but due to some bleeding issues it wasn't an option for me. I hate it because the surgery has been no walk in the park, doctors tell me it will probably last approx. 10 years, they said they don't last as long in youger patients as they do in older patients. Anyway, thanks again for the reply.
 Dr. Chan Lowe - Fri Jan 25, 2008 9:40 pm

User avatar Hi again,

Bovine valves last about 10 years as you were told. Keep in mind that in 10 years, treatments are likely to be very different than they are now so there may be more options once this valve begins to have trouble.

Recovery from open heart surgery can be slow but in the end I think you'll feel a lot better than before the surgery.

Thanks for the update.

Best wishes.
 roundsgirl - Sat Jan 26, 2008 12:08 am

Once again thanks for the reply. It is my hope that in 10 years the procedure will not be so invasive. The first thing I told my family is I will never do this again, it was so painful for me. I don't think you can really prepare yourself for what you will go through. All went well, I start Cardio rehab next week, so hopefully this will aid in my recovery. The depression has been an issue for me, but as I understand it that is pretty common after OHS. Thanks again. I'm hoping to someday chase around some grandbabies. That's what keeps me going, hopes of a better tomorrow.

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