Adam’s Heart Valve Surgery Blog

It’s a troublesome, patient dilemma..

Your primary cardiologist says, “You need valve surgery right away!” However, you’re second-opinion says, “Hmmmm… I’m not so sure about surgery just yet. I’d hold off for now.”

What are you supposed to when your first- and second-opinions ARE NOT on the same page? This is exactly what Susan is experiencing with her mother’s diagnosis. Here is Susan’s story and my thoughts:

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At 64, Jack has recently been diagnosed with severe aortic stenosis. Jack writes, “Adam - I’m like a deer in headlights right now. I need aortic replacement soon. I’m curious, the doc mentioned an aortic valve gradient following my echocardiogram. What the heck does that mean? Thanks for all you do, Jack.”

Jack asks a good question about aortic valve gradients (also known as AVG). In fact, I have never received about aortic valve gradients, so I just spent some time researching this diagnostic measure for valvular stenosis.

According Cardiovascular Physiology, stenosis of the aortic valve leads to a pressure gradient across the valve during the time in which blood flows through the valve opening. This aortic valve gradient is expressed as an increase and decrease on each side of the defective valve. The magnitude of the pressure gradient depends on the severity of the stenosis and the flow rate across the valve.

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As we have previously discussed, there are a number of symptoms related to mitral valve prolapse. However, Cindy just wrote me an interesting email about whether-or-not anxiety is a symptom of MVP.

During my own research, I did not find any clinical evidence of the relationship between mitral valve prolapse and anxiety. That said, I thought I would post a blog and see if YOU have any ideas for Cindy. Here is her story:

Hi Adam,

I have a question that I am hoping to get some feedback on. Are there other people out there who have mitral valve prolpase and an anxiety disorder. I am not talking about anxiety that may be present AFTER you find out you need a mitral valve repair or mitral valve replacement. I am talking about a “free floating” anxiety - when you get anxiety for no particular reason, not related to any psychological problem per se. I can go for months and then suddenly one morning I wake up with anxiety in my chest.

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Terry is concerned that her mitral valve prolapse is causing symptoms. Terry writes, “Hi Adam - I was diagnosed with mild regurgitation from a prolapsed mitral valve five years ago. I’m not feeling so great lately. Can you tell me what are mitral valve leakage symptoms? Thanks, Terry”.

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According to reports, aortic stenosis is relatively common problem effecting roughly 2% of people over the age of 65, 3% of people over the age of 75, and 4% of people over the age of 85.

One of the major causes of stenosis is the calcification of the aortic heart valve. This is especially likely to occur in people with a bicuspid aortic valve, but also occurs as a result of age-induced ‘wear and tear’.

Typically, aortic stenosis due to calcification of a bicuspid valve occurs in the 4th of 5th decade of life, whereas that due to calcified aortic valve stenosis of a normal valve tends to occur later - around the 7th or 8th decade.

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