“How Quickly Does Heart Valve Stenosis Progress?” Asks Emma

Emma just emailed me an interesting question about aortic valve stenosis and the rate at which this form of heart valve disease progresses.


Aortic Valve Stenosis – Narrow Heart Valve

She writes, “Hi Adam – I’ve recently been diagnosed with moderate aortic stenosis even though I have no symptoms. My latest echocardiogram shows a valve area of 1.2 square centimeters. For now, my cardiologist says we’re in ‘Monitor Mode’ with the chance of surgery in the future. Do you know of any clinical studies that document the rate at which aortic stenosis progresses? I’d like to know how many years before I may need heart valve surgery. Thanks, Emma”

Emma raises an interesting question. As you can see in the diagnostic chart below, Emma’s aortic valve is not narrow enough to position her in the severe or critical category. That said, I imagine her cardiologist will require routine echocardiograms every 6 to 12 months to further evaluate valve function and the potential onset of symptoms.

Guidelines For Diagnosing Aortic Stenosis
(Source: The Cleveland Clinic)

As for Emma’s question about the rate at which aortic stenosis progress, I have done some research on the topic. Thus far, I have not found much data which establishes a definitive benchmark for aortic valve narrowing over time. To some extent, this makes sense as each patient is unique with his or her own physical factors which impact valvular deterioration.

However, I did come across an interesting piece of research that details the rate of aortic stenosis with patients experiencing calcified aortic valve leaflets. According to The Cleveland Clinic, aortic stenosis tends to progress more rapidly in patients with degenerative calcific aortic valve disease than in those with congenital or rheumatic disease.


Calcified Aortic Valve

According to The Cleveland Clinic, catheterization and echocardiographic studies suggest that, on average, the valve area declines 0.1-0.3 square centimeters per year. The Cleveland Clinic also states that the systolic pressure gradient across the aortic valve can increase by as much as 10-15 mm Hg per year. Finally, a more rapid rate of aortic stenosis progression is observed in elderly patients with coronary artery disease (CAD) and chronic renal insufficiency.

Although there is no definitive rate of aortic stenosis progression across the entire patient community, I hope this information offers some insight into this topic. So you know, I suffered from aortic stenosis due to a bicuspid valve with calcified leaflets. Over an eight-year period, my valve deteriorated from a mild diagnosis to a severe diagnosis at which time my aortic valve was replaced via the Ross Procedure.

If you are a former patient, perhaps you can share your experience with Emma — specific to aortic stenosis or other forms of heart valve disease — by clicking here to leave a comment. Or, scroll below to read 20+ patient responses to this blog.

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

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  • Shelby Hudgens

    My experience with stenosis isn’t linear. I was diagnosed in 2002. Pressure gradient and area remained roughly constant (moderate) for the next five years, then began to dramatically change until my surgery in 2008.

  • Lucy Grubbs

    Emma, I was diagnosed with bicuspid valve at 21. turned out i was born with it and never knew. I was told then, your fine just notify dentist/dr if you have procedures done. I am 45 1/2 now and have had 2 children, C sections-no problems. Then, last year ended up in emergency because i thought i had a stroke, thingling and numbness down right arm and face. turned out it was a migrain BUT they said you might want to see a cardiologist. so i did, and i was told you have severe aortic stenosis. While i didn’t think i had symptoms, looking back, i did. I was told about 3 years ago that I had developed excercise induced asthma. well, turned out they were wrong, it was a symptom. I would work out at gym and sweat but could never go passed a certain level -turns out this was a symptom. i got light headed once or twice-turned out this was a symptom. well, i had my aortic valve replaced nov 16th! now, no asthma, i can work out more at the gym. i am amazed how much better i now feel! I had a ministernotomy-my scar is 3 inches, so its small. i chose the bovine valve. fyi, the symptoms were gradual, but you are seeing a doc so they will monitor you, which is good, i was never told to go to cardio until sept last year! good luck!

  • Diana

    Hi Emma,
    Just read your question and Adams answer and thought I would add my two cents worth.
    I was diagnosed with a Bicuspid Aorta Valve about 3 years ago. I was sent to a cardiologist who had an Echo done and was monitored every 6 months, in the hopes that surgery would be done later rather then sooner. Well, my last Echo done in January of this year showed that my valve was narrowed to .8 and my symptoms had gotten a lot worse. At that time, my cardiologist left it up to me whether I wanted surgery then or wait another 6 months. He told me what to watch out for, shortness of breath, heaviness in my chest, chest pain and passing out upon exertion. I elected to do another wait and see additude , but did not make it to the six month. When the doctor tells you that you will know when its time, I’m here to tell you, you will know when its time for surgery. And 3 months after my last visit in January I am now scheduled for surgery May 14th to have my aorta valve replaced. I had my heart cath done 2 weeks ago, and when it is time for you to have one, let me tell you that it is a piece of cake. A lot of people told me that is was nothing, but the fear of the unknown kicked in. But, I guarantee you, that it was positively nothing. The worse part was waiting to have it done. I had no discomfort, no pain at all, just a little pinch where they numb you for the procedure. Thats is it! They did my cath procedure through my wrist. I learned that we do not have nerves in the veins themselves, so you really don’t feel a thing.
    Hope this helps and if you have any other questions, I would be happy to do what I can to answer them for you. Feel free to email me.
    All the best,
    Diana

  • Sandy Gilbert

    Emma, it’s always good to have as many facts about what has happened and why and that sometimes it’s a comfort. I am two weeks post op today and asked questioned each year when they did my echo. I figured my life style was such that it had to be a bi valve and not something that I contributed to. Each year the valve area got smaller and smaller. I did not have pain or any other discomfort that I could detect. I researched the measurements like the chart Adam provided from the Cleveland Clinic. April was my echo month. Last April the measurements were getting near .07. I started to be more alert to my body. Exercising was still ok but left me breathless. My body was telling me time was near. I am 66 years old and never had a broken bone let alone a surgery of this magnitude. I decided that we would take an extensive trip to see my sons and family last Dec. and Jan. and would do an echo as soon as we got home. I was right, the echo was right and so was my Dr. Now was the time.

    My best advise, don’t put off the surgery, get it done while you are healthy and fit. Also, you may have a choice as to where and the Dr. to do the surgery. Read the information here and in Adam’s book, it will help you to make good choices.

    Good luck.

  • Debbie

    Hi,
    Thought I would tell you about my experiences, I was born with aortic stenosis and monitored every year since. At 19 I had my first heart surgery, a removasl of a subvalvular membrane and repair of the aortic valve. I was very symptomatic at the time. Short of breath, etc. This past November I had my second surgery, another aortic valve repair (they replaced one of the leaflets this time) and removal the membrane that had come back. I was as symptomatic this time. So, for me it lookslike every 20 years or so I end up in surgery. I’m 39 now and they think everythng may be lifetime now but we’ll see. Don’t worry…I know it’s nerve racking but the doctors are amazing and the progress is astounding. If you have any questions please fell free to emial me. :)Debbie

  • Dr. Ciuffo

    Let me give you the perspective of most experienced cardiac surgeons on severe aortic valve stenosis. General statistics on its progression and symptoms seldom apply to each and every individual case. I have seen patients progress to critical aortic stenosis in less than six months and others who took years to develop a transition from moderate to severe stenosis. There are patients who develop severe symptoms with an aortic valve area of 1.0 cm2 and others who claim to have no symptoms even with aortic valve areas down to 0.5 cm2 (critical stenosis!). Here is my advice. Resist the temptation to fall in denial: severe aortic stenosis is very dangerous! If you have this diagnosis SEE a cardiac surgeon about it and DON’T WAIT for worsening symptoms. The risk of surgery (1-2%) is far less than the risk of a year of “wait and see” attitude (25%). See my blog post entitled “Aortic Stenosis – The neglected child” to get more information about this disease. If you want to live longer and better….Don’t be afraid of surgery: it is the solution, NOT the problem!!

    Giovanni Ciuffo, MD
    New York Minimally Invasive Heart Surgery Center
    http://www.bigappleheartsurgery.com

  • Dawn

    I was diagnosed with congenital bucuspid valve and moderate aortic strenosis in 1995 at the age of 37, but I probably had the stenosis for awhile. I just thought the symptoms were due to age, being out of shape, etc. At the time I was pregnant and was given the impression I would likely need surgery fairly soon. However, I was monitored closely for many years and I had Ross procedure in the fall of 2008.

    I knew without a doubt when it was time for surgery. There were times when I thought maybe it was time and after echos and discussions with cardiologist decided to continue monitoring. I truly believe weight loss and starting a regualr work-out toutine helped me to hang in longer because I did not have the combined symptoms of being over-weight and having aortic stenosis.

    Eventually that was not enough, but I believe it helped me for several more years. I had lost weight, was working out routinely, and slowly becoming less and less able to climb stairs without resting on the way up, was having much difficulty catching my breath once out of breath, chest pains, etc.

    The surgery and recovery was not nearly as bad as you might think before you go through it. I had a lot of support once I went home, especially in the first few weeks. I could have been on my own more, but it meant a lot to have my sisters take turns coming to stay with me. The one who was there in the ealry stages of recovery was a real dictator about me doing the physical work outs the hospital had recomended. I did not do cardiac rehab, but I walked many many miles while recovering. That is very important. I feel great and recently ditched my old work out routine for one that is more of a challenge.

  • Dorothy Delman

    Hello, Emma and welcome to “the club.”

    I, too, had asymptomatic aortic stenosis and I’m sure each situation follows an individual time line. However, in my case, there were approximately (as best I recall at this point) three and one half years from initial monitoring to valve replacement surgery. By the way, I continued with normal activities during the entire period. I received superb care with absolutely no complications to date.

    Best of luck..and stay peaceful…
    Dorothy

  • John Ristow

    I had surgery to replace my aortic valve on January 21st. Turns out that it was a bicuspid, and also calcified. Do you have any Idea why they could not tell it was bicuspid before the actual surgery? It has been 3 months now since the surgery and I feel prettyl good, about 90%. Cutting the grass, rototilling, walking , doing most all of the physical activities. Just how important do you think a cardio rehab program is? My surgeon said I did not need one, other people told me it was essential. One in a while I have periods of hard heart beats and a little weakness. I figure that is just part of the process or may the Metoprolol I’ve been prescribed. Any info would be appreciated.
    John

  • David

    Hi Emma, I too was diagnosed with a bicuspid aortic valve last year. At that time my stenosis measured 1.1 cm sq. I asked my cardiologist how long I would have before it needed to be repaired and he said 1-4 years. He rationale for that time frame was that a valve will stenose approximately 1 mm per year and that the accepted criteria for surgery is .7 cm sq. I have not seen a written study to verify this but, I did another echo 9 months later and am at 1.0 now. Hope this is helpful and good luck.

  • Helen Galván

    Dear Emma,
    Just to give you an idea, my aortic stenosis was mild/moderate in August 2008 and by January 2010, it was in the severe category, which I think was a fast deterioration. But don’t worry, just keep an eye on it. All the best.

  • ralph

    to Lucy Grubbs

    Can you tell me who your surgeon was ?

  • Jim Hilbe

    My wife was diagnosed with severe A/S at UCLA in December, 2006. Her valve measured 1.0 at that time. We visited Cleveland Clinic immediately for a second opinion, and they agreed with UCLA. I asked my wife’s cardiologist the exact same question you are asking…what is the progression? She answered, it varies, but on average, patients get surgery two years after first seeing me. My wife had her aortic valve replaced at Cleveland Clinic in July, 2009.

    It is worth noting that the UCLA cardiologist stated that it was too early for surgery as of 12/2006. Once you have the surgery, the new valve immediately begins to deteriorate (if it is biologic) or else you start in on coumadin right away which gives you the risk of bleeding to death. It is also noteworthy that while you are watchfully waiting, you might experience sudden death without any advance symptoms. And also while you are waiting, your left ventricle is enlarging, and your ascending aorta is thinning out and enlarging. And after you have the surgery, you have an ongoing risk of stroke, infective endocarditis and structural valve detriioration.

    We felt very thankful that we had excellent advice from both UCLA and The Cleveland Clinic, and when the cardiologist at Cleveland finally surpirsed us by saying in May of 2009, it is time for surgery, we scheduled it without hesitiation.

    In summary, the progression varies and you need the best cardiologist, surgeon and valve you can get. We feel that we received exactly that.

  • Jon

    Hello Adam and Emma,
    Today marks six weeks since I had my aortic valve replacement with a bovine valve. The good news was that all my arteries were clear and did not require bypass surgery I am 58 years old and I was told two years ago that it would be about 20 years before i would need the surgery. But I had very heavy calcification due to massive radiation treatments 37 years earlier due to Hodgkins disease.
    The surgery went well, but problems occurred shortly afterwards. The day after my surgery I developed a sciatica problem which was EXTREMELY painful. The orthopedic surgeon said it may have been caused during the angiogram which may have clipped or severed a nerve. As of now, my right upper leg is numb and feels very uncomfortable. A week later I was diagnosed with C-Diff (the hospital disease) which is a bacterial infection of the colon. I will be on medication for some time for this. Then I was diagnosed with two blood clots…one in my right lung and one in my left calf. I’m also on medication for that. Sans the problems which occurred, the valve replacement wouldn’t have been so bad. I hope no one else has to go through what I did/do.

  • Lloyd Rittiner

    Emma
    I am 60 years old and was diagnosed with mild aortic stenosis with regurgitation a little over five years ago. In August of 2009, I was told that my stenosis had progressed to severe. In September 2009, I had the valve replaced with a cow valve. I was later told that it was discovered during the operation that in addition to haveing aortic stenosis reguritation, I also had a bicuspid aortic valve. Today I am fine and have fully recovered from the surgery. I feel 100% better.

  • Tony Korwin

    I was diagnosed with aortic stenosis in fall of 2008 and originally told 3-5 years. However, when I went back in spring of 2009, they advised surgery within 2 months. Another friend of mine was diagnosed 10 years ago and is still in monitoring mode, so the short answer is there is no normal progression, but I would imagine that depending on your age, living style and elevation (I live at 7000 feet elevation), results could vary greatly.

  • Charlie

    Hi Emma. My name is Charlie. Three years ago I had my first echo which put my aortic valve at 1.7 sq cm. Three years later my latest echo is showing 0.9 sq cm. I am now in the process of planning for my surgery.

  • Kathy J

    Hello Emma! I was born with a biscuspid aortic valve but didn’t have the beginnings of stenosis until I was 27, when it was diagnosed as very mild. In July of 2008 I went to my primary care doc with very high blood pressure. He noticed that my murmur had gotten significantly louder and I had an echo done. I was now in the “moderate” category and was placed on an every 6 months evaluation by my cardiologist. I started having intense shortness of breath upon exertion and dizzyness in December of 2009. At that time the cardiologist said I had crossed into the severe category and advised me not to wait to have my valve replaced. THis past Feb. 22, 2010, I had a St. Jude mechanical valve put in & i cannot believe the difference in how I feel. I thought my fatigue was due to stress at work, but it was from my valve! Each person is unique when it comes to aortic stenosis. You just have to be attuned to your body & do NOT ignore any symptoms. Feel free to contact me if you want to talk about your diagnosis, and good luck!!!

  • Chuck Harris

    I was diagnosed w/ A/S 3 years before it became necessary to operate. I had always known I had a Heart murmur but did not know why. When my doc told me I would need OHS, I was rather shocked. I was even more shocked when a stress test revealed the worsening stenosis and immanent surgery. And when I collapsed at work, that was my ticket to the OR. They did one by pass while they were in and replaced my a/v w/ a bovine tissue valve. That was in Feb of 2009. I’ve been feeling great ever since!

  • Jan Michelsen

    Emma, I was diagnosed with aortic stenosis about 10 years ago. I saw my cardiologist every 6 months and he kept a careful eye on things. I never had any real symptoms, except fatigue, which I attributed to over-work. When I had my last cardiac cath, in December 2009, my cardiologist said it was time and called in a surgeon for a consult. I had open heart surgery which included valve replacement – a bovine valve – and right coronary artery bypass. that was on January 4th, 2010. I was back at work by February 1st! I am 67 years old. With the right attitude and excellent care you will do well. I had an excellent surgeon, Dr. Gordon Knight, of Des Peres Heart Hospital in St. Louis. I think each one of us is different. Some progress very quickly to the need for surgery and some progress very slowly. Don’t worry about how long it will take. Just take each day as it comes and see your cardiologist regularly. You’ll know when it’s time! Good luck. P.S. The surgery was pretty easy: I slept through the whole thing! :)

  • George Trevor

    Dear Emma,
    A very good question and one I have looked at closely since my aortic valve replacement surgery on February 16 of this year. I was diagnosed with moderate aortic stenosis six years prior to my surgery. I was 51 at the time. For the first five years my cardiologist had me do an echo every year. In March 2009 it showed that I had progressed to severe. Adam makes a good point in that you need to know what is the cause of the stenosis. It was only when my adult daughter asked about the fact that my latest echo report said my valve was bicuspid that I asked my cardiologist what that meant. It was then the I learned that my stenosis was likely congenital. By the Fall of 2009 I was having symptoms although looking back I had symptoms before that time. Particularly as to shortness of breath you don’t necessarily noticed it in real time since the onset is gradual. It is only in hindsight that I realized how much worse my lung capacity was by 2009. In September of 2009 I almost passed out while on a family trip to Rocky Mountain National Park. Post surgery I now realize I was in some denial about my symptoms and I cut it a bit too close. (I just read Dr. Ciuffo’s comment and I now know how right he is. Don’t think you are just tired or out of breath.) My surgeon, Dr. Vincent Gaudiani in San Francisco, confirmed that my bicuspid value was congenital. The point I want to make is listen to your body and question your doctors. I feel fortunate that we have this surgery available to us since without it I would likely have been dead within the next year. Surgery went very well with no complications and porcine biologic valve is working great. Good luck to you and I hope any surgery is years away.

  • Duane Hunt

    A side note from the mitral valve side of the heart valve world. Over the past several years I had two trusted family doctors monitor my health routinely every 6 months, including listening to my heart. March 2009–no murmur, fine EKG for an insurance qualification exam by a company nurse. April 2009–checkup, no murmur. October 2009–checkup, heart murmur, beginning of testing, severe mitral regurgitation. January 2010–mitral valve repair surgery. I too have wondered about the speed of this progression.

  • Linda

    I also have congenital biscuspid aorta valve stenosis. It took 4 years for my valve to narrow form 1.3 to 1.2. Any other stories of a slower progression of calcification taking place? Any suggestions of anything to slow the progression? Linda

  • Adam Pick

    Great to see the 20+ comments above! Amazing to read all of your unique stories relative to the progression of aortic stenosis and mitral regurgitation.

    Thanks so much for sharing your experiences, thoughts and advice with Emma and the rest of us! Very, very, very helpful!

    Keep on tickin!
    Adam

  • Mark DuLaney

    Emma,

    I was in your exact situation. At 48 years of age I was diagnosed with mild aortic stenosis from a calcified bicuspid valve. My initial measure was around 1.2 cm. We monitored it annually through a Doppler Echo. After about 9 years we noticed a closing to around .9-1.0cm. I started to have some discomfort when exercising, slight tightening in chest. Doctors did an angiogram and found that it was actually a .5cm opening. At the critical stage and needed replacement! That was accomplished with a pig valve at 2.7cm (just to give you an idea how your blood flow is being affected) and I now feel great! My advice is to monitor closely, if you feel anything unusual it is time NOW to get replaced. At 1.0cm you are there, schedule and just get it done.
    Good luck and happy health

  • Mike

    I also have aortic stenosis due to a bicuspid aortic valve. My valve opening is about 0.8 cm but I have no symptoms. I have been reading a lot about the new non-invasive procedure to replace the aortic valve through a catheter. The procedure was developed at NYU and is still experimental, currently being performed only on patients that cannot withstand the trauma of open-heart surgery. I’m hoping to hold-off surgery until the non-invasive procedure is approved for situations like mine.

  • Mike A.

    My Dad just had a valvuloplasty today – basically inflating a balloon in his severely calcified aortic valve – inserted through a catheter – to open it up. He’s 90 years old and we didn’t want to have full valve replacement surgery for obvious reasons. His energy was going steadily downhill and fluid in lungs was increasing. Jury is still out on how well this will work, i.e. how much functionality he can get back from the valve, but certainly worth a try.

  • Diane

    I had to have my Aortic valve replaced this past summer. I passed out at a company picnic and that is when I found out I had severe arotic stenosis. I’m doing well except for my heart beats too many beats and it feels like it’s pounding away in my chest.

    My cardiologist knew I had Severe Aortic Stenosis November of 09 and sent a letter to my GP recommending another test and valve replacement. What she neglected to do was to tell me. All I was told was that I had a leaky valve. Everything I’m reading here is that it’s serious and should at a minimum be monitored. I wasn’t told to do any follow-up. Is the doctor at fault for not telling me my situation was dire? Is there recourse for a patient who was clearly put at risk?

    I had severe spinal stenosis and had back surgery in January of 2010 and my GP signed off on my pre-op with the information that I had severe aortic stenosis. Just curious how both doctors could be so reckless with my health.

    I had rhumatic fever as a child and that apparently is what caused my murmur and calcification of the aortic valve. I was told I had a leaky valve and that if it got worse I’d have to have the valve replaced someday, not that it was severe arotic stenosis.

    Be your own health advacate. I thought I was doing the right thing by getting it checked out but if your doctors let you fall through the cracks nothing you do will make a difference.

    Diane

  • Sheryl

    My Mom is on Hospice and has been for over 2 years. Next month she will turn 86. Her aortic valve was measured at .3 cm2 this past June, 2 years prior it was measured at .4 cm2. The only other health issue she has is dementia which I suspect may be vascular dementia brought on by the narrowing of the aortic valve causing a lack of oxygen to the brain. She is quite small now, at about 104 lbs. and 5’4″. It is a miracle she is still with us. Most of the day she sleeps. Her father had atherosclerosis. I will be requesting a cardiologist appointment for myself as this appears to be so gradual and I’d rather catch it early.

  • steve

    With the benefit of hind sight my first symptoms of aortic stenosis was when I went to a doctor complaining of prolonged periods of fatigue,frequent tiredness and shortness of breath, made worse by a bout of glandular fever and told him I felt very down and easily stressed, it must be something physiological, after full physical examination was told it was anxiety disorder and sent to psychiatric dept. I spent 23 years in and out of psychiatric hospitals and given countless medicines for fatigue, anxiety, depression, hypertension and irregular heartbeat in that time. 6 years following last admission in 2000, several angina attacks in 2006 finally signalled to doctors on further investigation congenital bicuspid aortic valve disease and a year later valve replaced, I really would like to know if anyone else has been misdiagnosed with early symptoms and how long from these symptoms until angina? In my case 23 years, I really would have thought it should have been evident with heart murmur way before being diagnosed following angina. Can’t be sure if they may have known but didn’t divulge because of effect on mental illness. Any advise on how to prove I was right would be very welcome.

  • Caron

    Hi,

    During my ante-natal booking in appointment 23 years ago, I was referred to a Physician as a heart murmur was detected. Sadly I lost my baby. Following tests and review by Physician some weeks after the stillbirth I was informed that I should ensure that I receive prophylactic antibiotics prior to any dental procedures.

    In more recent years I have developed symptoms of palpitations, dizziness and choking sensation when sleeping, tiredness. Undertaking any type of exercise left me breathless and feeling dizzy and sick. I visited my GP on numerous occasions regarding my symptoms but as I am also going through the menopause, my symptoms were attributed to this, as well as diagnosis for extra heart beat- which I was told was normal for me.

    This week I received at my request copies of my obstetric records and included was a letter from the Physician to my Obstetrician and GP informing them that I had mild aortic stenosis. I am shocked to find this out as no one ever told me I had this problem. The letter also suggested that I should be reviewed during any future pregnancy- I went on to have 2 further children and received no monitoring during this time. In fact I have never been monitored during the last 23 years.

    I have been back to my GP to request an early referral for further tests as I am concerned that my symptoms may indicate that I have severe aortic stenosis.

  • maria

    Dear All

    My mother has been taken into hospital and diagnosed with Severe Arotic Stenosis, this was a shock as it turns out this was known in 2008 with a Moderate Stenosis with no symptons. However the focus is now; she is 94 and lives on her own taking care of herself. Has been active and still cooks and cleans for herself. She has lost a lot of energy in the last 6 months and we can see why now. I guess I am hoping for someone to say they know of someone who has a relative with a similar story and how long they surivived or they got surgery. Feel very much in the dark with no hope and just need to know what to do for the best. Enjoy the time we have left or push for surgery.

    Maria

  • Karen Long

    Hi all,
    I was born with congenital aortic stenosis, I have had 2 open heart surgeries, one was a valvotomy, the surgeons scarred the beating nerve of the heart in that surgery and I was told I could not lie with the problem, I learnt t meditate rather than take high levels of beta blocks. the other I received a human valve replacement as I have a bleeding disorder. I have given birth to 2 children, enjoyed a full life and never let the condition impede me in any way. I know when the valve is giving problems and after the last surgery I contracted endocarditis, which attacked the mitral valve. The surgeon wanted me to undergo another bout of surgery to replace both valves, but I declined that was in 1998. I am once again having a few problems. The main thing that I notice is if you are born with a health issue, you aren’t really fazed by it, but if you develop it later in life, you worry about it somewhat, which is perfectly normal. A health condition is not a good thing, but as we all know we have a large community for support, and medical knowledge is a lot better than it was years ago.

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