Cardiologist Update: April 5, 2011

I had my most recent cardiology appointment back on April 5, 2011. I last saw the doctor about six months ago. I will help you catch up, in case you have forgotten (or not been reading).

I have a mitral valve prolapse. I have been followed by a cardiologist since I moved to the Dallas area back in 2001. The doctor has been following me every six months for a while. When she retired, I got a new doctor. He looked at my echocardiogram and had me come in after three months. But, based on those two scans, he had me come back in six months. There had been a fear that my heart was getting worse, but it turns out, it was not a problem.

So, we are now caught up to April 5. I had my twice a year echocardiogram. The doctor took a look, and he was very pleased. My last three scans all looked exactly the same (the two three months apart and the one in April). So, he was very pleased. He decided that I do not have to be back for another year.

So, it seems that all is well, in terms of my mitral valve prolapse. I have not gotten any worse in the past year, and the cardiologist does not want to see me for another year. It has been my experience, so far, that the doctor NOT wanting to see me is a good thing.

So, you should not hear another heart update from me for at least a year. That will be great! As long as there are not any future problems, then I won't have to go back to see him. I did go and see my nephrologist on April 7. My next post will be about that.

See you next time!

September 15, 2010: Cardiologist Appointment

Hi there, faithful readers (or those of you that just happened to stumble onto this posting). Today is the updated that my normal readers were hoping to see last Sunday. Unfortunately, my free time in the morning was cut an hour short, so I was not able to get online and write up my explanation from my latest cardiology appointment.

I saw my "new" cardiologist about a month ago. I say new because the cardiologist that I used to go see has retired from practice. I think she wanted to spend more time with her family (of which I am in favor). So, the previous visit to my cardiologist, back in June was to check my heart and my mitral valve to make sure everything was still working correctly. You can read that post here: Cardiologist Appointment - June 15, 2010. The doctor thought he saw some disturbing signs, so he asked me to come back in three months, instead of my typical six, to have my heart reviewed again.

The post received a few questions, which I will endeavor to answer below. I did not know the answers myself, so I just asked the doctor to help me out :)

1) Please Explain Ejection Fraction

The ejection fraction is the volume difference between heartbeats. Normally, you would expect to see an ejection fraction of 60% to 65%. My current rating is between 55% and 60%. I asked, and the doctor said that an ejection fraction of less than 50% was very bad, and that they would want to get me into surgery if that were to happen.

2) What is the Thickness of Your Mitral Valve Leaflets?

Normal mitral valve leaflets (shown in the diagram at the bottom as MV) are usually around 5 millimeters thick. My leaflets are slightly thicker than normal, but nothing to worry about at this time.

3) Do you have any enlarged ventricles or atrium?

No, at this time my ventricles and atria are both normal sized. This question is important because the mitral regurgitation can cause the heart to expand in size, over time. If you heart starts to get larger, it cannot be made smaller again. So, part of what they watch for is to make sure that your heart is not getting too big and that your ejection fraction stays within safe tolerances.

4) Please explain regurgitation and prolapse (in regards to the heart).

Regurgitation is blood flowing the wrong way in the heart. In the diagram at the bottom of this post, you can see a rough drawing of the heart. Blood is supposed to flow from the Left Atrium (LA) to the Left Ventricle (LV) and then out of the Aorta (AO). Regurgitation is the arrow that shows blood flowing back across the Mitral Valve (MV) from the LV to the LA.

Prolapse is simply the valve action going back up into the Left Atrium (LA). Normally, your mitral valve (MV) should allow blood flow downward (in the drawing) from LA to LV. The valve leaflets should stop the blood from flowing back up. Mine do not do that quite as well as they should. This reverse action causes the leaflets to be a little spongy, and to eventually wear out.

The doctor is watching the size of my heart as well as the ejection fraction that the valve is allowing. When they start to head toward a more dangerous range, then we will start talking about surgery.

5) What's your current status, then?

OK - big question! I'm still doing fine. The doctor said that he did not see a recurrence of the problems that he thought he noted in June, so I will not see him again for six months (this was my normal schedule). I'm not in perfect heart health, as my Ejection Fraction is down to 55-60% instead of 60-65%. But, until there are any changes, then I will keep my ribcage intact!

Thanks for reading today! The drawing below is my sketch based on the sketch that the doctor gave me at my appointment. Please try an pretend that it looks like a heart.

My next post should be about the post-transplant follow-up that I had on October 7. If I'm lucky, I will write it up next Sunday. See you later!

Cardiologist Appointment - June 15, 2010

Today is Thursday, July 08, 2010, and I am sitting at the Nephrologist's office with my company laptop and MS Word as my only friend. I realized that I have not blogged in WAY to long, and that it is time for me to update everyone on what has been going on. Today's post will concern my cardiology appointment from almost a month ago. I'll try to get another post later this week (or early next week) so that I don't have too much information in one post.

I saw my cardiologist back in June for my biannual (two times per year, not every two years) appointment with echocardiogram. They have been watching my mitral valve to make sure that everything is still working properly and that I am not getting worse.

Note: I said "they" because I recently changed cardiologists. The doctor that I had been seeing has "retired" to spend more time with her children. I'm all for this, as a principle, but was not overly excited to lose one of my favorite doctors. So, if she reads today’s blog, then she'll know I liked her. My new cardiologist is at the same practice, and was recommended by the previous one, so I'm not too worried about him. He's just new, and I will have to get used to him.

Now, I will get back to the appointment details. I had my echocardiogram, and it seemed about the same to me as all the others that I have received. However, when the doctor came to tell me the results, he had some bad news. It appears that my ejection fraction (I think) has gone from 60 to 70% down to about 55% (based on visual observation). This is not the best direction for that to go.

The doctor told me that he was slightly more concerned, based on the previous echocardiograms that had been taken. He said that he would like to see me every three months instead of every six months. He said that I still have a "moderately severe" mitral valve prolapse, but with the reduced flow through the valve, he'd like to see more often.

At some point in the future, I will need to have my valve replaced. It's not that time, yet, but the doctor wants to be careful and make sure that I do not suddenly have a major problem because of my mitral valve. So, he is going to watch me a bit more closely. I guess I will just have to wait and see.

Overall, it was a good appointment. The whole reason I was going in to have the echocardiogram every six months was to watch my mitral valve and make sure it was not getting worse. Since it has gotten a little worse, they now want to check me more often. Luckily, the echocardiogram showed what it needed to show, and they are now going to check me more often.

One day, I will need heart surgery to have my mitral valve replaced. I'm not sure what that will involve, but I'm sure it won't be pleasant. On the plus side, I've never had open heart surgery, so that will be new. It's always fun to have something to add to my "List of Surgeries."

That's it for today's post. I will have two more blog posts coming up soon, so stay tuned. Thanks for coming by to read.