“Did Your Enlarged Heart Return To Normal Size After Surgery?” Asks Sandra
I just received a great question from Sandra about heart valve disease, enlarged hearts and valve surgery.
Sandra writes, “Hi Adam, I read that you had an enlarged heart before your surgery. I was wondering if it has returned to normal size since the surgery? I had mitral valve repair due to severe mitral regurgitation and an aneurysm repair in July 2008. I was told that my heart was enlarged and that it may not return to its original size. I exercised quite vigorously before my diagnosis thinking that my shortness of breath was due to being ‘out of shape’. The more short of breath I became, the harder I exercised. Now, I am wondering if this caused the heart to enlarge even more. My echo at 4 months post-op showed the heart still enlarged. I go again in September for another echo and I’m curious to see if it has returned to normal. Thanks, Sandra”
Sandra is definitely correct. I did have an enlarged heart when I was diagnosed with severe aortic stenosis.
In fact, I’ll never forget when my cardiologist, Dr. Bad Bedside Manner, looked at my echo and said, “Adam… The echo shows your valve has really deteriorated… Your heart has already dilated a bit… You need a new valve. And, you need it soon!”
After that memorable moment, I did a lot of research on heart valve disease (which I knew very little about) and its impact on cardiac function. I learned that when the aortic valve becomes narrowed, the muscles of the left ventricle thicken to maintain pump function and cardiac output.
According to MedicineNet, “This muscle thickening causes a stiffer heart muscle which requires higher pressures in the left atrium and the blood vessels of the lungs to fill the left ventricle… Even though these patients may be able to maintain adequate and normal cardiac output at rest, the ability of the heart to increase output with exercises is limited by these high pressures… As the disease progresses, the increasing pressure eventually causes the left ventricle to dilate, leading to a decrease in cardiac output and heart failure.”
Given that background on stenosis and enlarged ventricles, I think I can better answer Sandra’s question.
According to my last echocardiogram (shown below), which was performed three years after my heart valve replacement surgery, the size of my left ventricle is normal. In addition, it’s also important to note that my left ventricular ejection fraction was normal, at 65%.
Excerpt From Adam’s Last Echo (December, 2008)
I hope this helps you better understand valvular disorders and their impact on the cardiac muscle, specifically the left ventricle.
Keep on tickin!
P.S. To leave a comment, please click here.
About The Author: Adam Pick is a double, heart valve surgery patient and author of The Patient’s Guide To Heart Valve Surgery. This unique book integrates the clinical facts of heart valve surgery with the personal experiences of 78 former valve surgery patients to help patients and caregivers better understand the problems, the opportunities and the realities of heart valve surgery. To learn more about Adam and his heart valve surgery book, click here.
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August 20th, 2009 at 3:07 pm
I also have an enlarged heart and was curious about your answer to Sandra’s question. I just had a stress/echo. and cardiac MRI this week and will probably have to have my pulmonary valve and tricuspid valve replaced this fall. This is right-side of the heart, though, not what you are talking about.
I have a few questions of my own. I was born with a congenital heart defect and had heart surgery to open the pulmonary valve when I was 4 (1951) and then more surgery to remove scar tissue above the pulmonary valve (infundibular resectioning) in 1989. I also had subsequent arrthymia problems following an Amplatzer device put in (2003) to patch a hole in my heart.
I’m concerned because this will be my 3rd open heart surgery. Also, there is very little info. out there on tricuspid valve replacement. I have an abnormal (maybe from birth) tricuspid valve w/severe regurgitation. Also the pulmonary valve is defective and barely functioning. My cardiologist at Northwestern Memorial hospital in Chicago is very good and I have confidence in him, but have not consulted with the surgeon yet. I’m being treated in the Adult Congenital Heart unit there. This is the 2nd opinion I’ve gotten about my heart condition.
I’m wondering if anyone out there has had tricuspid valve replacement. Most of the stories are about other valves being replaced and it’s often the first surgery… so, my case is a bit different.
It was good to see that the heart CAN go back to normal sized, after being enlarged, though! Wow. Who knew.
Thanks for the informative website. I have your book, too.
MJ Samer
August 20th, 2009 at 6:18 pm
hi, i too had an anuerysm repair and an aortic valve replaced this passed september. my heart was enlarged as well and my doctor said he wasnt worried because they do return to normal size. sandra, i wonder if it slowly returns and maybe it will be slightly enlarged for sometime afterwards. i havent heard any reports on mine, so now im curious as well ! good question ! jeff jeffstoveken@yahoo.com for any questions or comments of their own.
August 21st, 2009 at 12:35 am
Dear Sandra,
It is five months today since I had my mitral valve repaired. My heart is still enlarged, but shrinking. My cardiologist assures me my heart will return to a normal size, but I need to continue to learn how to live on body time and not head time. His best advise to me was to sit back, relax and give into my fatigue. So my refrain these days is, “All is well, all is well, all is well in all manner of things.”
Peace,
Patrick
August 21st, 2009 at 1:56 am
Hi Sandra
I had my aortic valve replaced in October 2008. At the time of the operation, my resting left ventricular diameter was 42mm. At my last check-up with the cardiologist (July 2009) it was down to 35mm. I believe that 25mm is considered “normal” so I’m expecting it to return to this kind of level in the next couple of years.
Regards
Allan
August 21st, 2009 at 3:28 am
Adam, what was your ejection fraction after surgery? Your new number is wonderful, and I am so happy for you and your family.
My husband had an aortic valve replaced one week ago, and his EF is 20%. It was about 35% 2 months ago. The doctors say it will probably improve somewhat, but I am terrified by this number. Does anyone else have anything to share about this?
August 22nd, 2009 at 3:45 pm
******I need to continue to learn how to live on body time and not head time. His best advise to me was to sit back, relax and give into my fatigue.******
Patrick, I must thank you for sharing the above message from your cardiologist!! I am coming up on my 7mo post op of mitral repair in Sept. I find I am tired sometimes & get frustrated with it. I say to myself “It has been SIX months, I should be ‘done’ with this by now!” body time vs. head time … I find that a powerful message. And maybe I’ll now go take a nap!!!
Cindy